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Permit ELECTRICAL PERMIT . „ CITY OF TIGARD '� COMMUNITY DEV PERMIT #: ELC2006-00710 • DATE ISSUED: 12/14/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112CB -09200 SITE ADDRESS: 15196 SW KENTON DR ZONING: R -7 SUBDIVISION: ASHFORD OAKS NO. 2 LOT : 106 JURISDICTION: TIG Project Description: Final inspection for work done by previous owner. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 1 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: HARRY WORNATH OWNER PO BOX 1015 MCMINNVILLE, OR 97128 Phone: 503 - 472 -1657 Contact #: FEES Description Date Amount Reg #: [HRELC] Hourly Electrical 12/14/200( $57.87 [HRTAX] Hourly 8% State 12/14/200( $4.63 Total $62.50 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: �l /: O,�� Permittee Signature: ( ru e � -� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application -' 4,, FOR OFFICE USE ONLY Received , l /� City of Tigard Date/By. Jr / 7 ' O It I► - Permit No. . � 7 l) ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' 0 ,: ' Phone: 503.639.4171 Fax: 503.598.1960 DateBy. Other Permit: T I G A R D Inspection Line: 503.639 Date ReadyBy: ® See Page 2 for • Internet: www.tigard - or.gov Notified/Method: Supplemental Information • 'TYPE OF WORK PLAN REVIEW - ❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. . ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY .OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1 - and 2-family g ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family 0 Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or . JOB SIT INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. . ❑ Addition of new motor load of ❑ "A ", `T ", "l -2 ", "1 -3 ", Job no.: Job site address: 151 rk `� k ewk o h� y- ∎ Six or or more. occupancy. • ❑ Six or more residential units. ❑ Recreational vehicle parks. City / State/ZIP: ry lv i 0 ct --/I ❑ Health - care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: 1 Project name: ❑ Service or feeder 600 amps or more. i FEE SCHEDULE ' . t Cross street/directions to job site: S I L1- Description I Oty. I Fee. I Total I ' New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 . Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 ` , e � O J E6 +N q/ �� ( r Limited energy, ( th above \,v\ N R � ( N5 ) � L � ( 0., , residential (with ab sq. fl.) 75.00 2 p e Services or feeders installation, alteration, and/or relocation 'F C' 1.11te -rte r VI ecir v�7Ct,J, 1,y ‘ C7 rev to us 0 "t 200 amps or less 80.30 2 ®.PROPERTY OWNER L ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 1.4 a r ( l N 0 >r J.;.h 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: f_ (� OTC (©is" Over 1,000 amps or volts 454.65 2 l City /State /ZIP: \ (� , e- l 1 �1 C'� I Temporary services or feeders installation, alteration, and /or v 111 rl �l I. b relocation Phone: (5(1) ) 41 . - i65'7 Fax: ( ) 200 amps or less 66.85 1 ' Owner installation: This installation is being made on property that I own which is not 201 amps t o 400 amp 100.30 2 intended for sale, leis-, rent, or -xc an•e, according to ORS 447, 449, 670, and 70 . 401 amps to 599 amps 133.75 2 / Branch circuits - new, alteration, or extension, per panel Owner signature: a, /,'it,' * t $ - - J Date: 1 H) j`i A. Fee for branch circuits with . ❑ APPLIC • . ❑' CONTACT' PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee first branch circuit 46.85 2' Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR - Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited - energy panel, alteration, or • Address: extension. Describe: Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above . Per inspection / 62.50 Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50 CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour _ 73.75 ELECTRICAL PER MIT FEES ` Suprv. Electrician signature, required: Subtotal: j"? .3' . Plan- review - (25% of- permit- fee): - -- - - - Print name: Date: . State surcharge (8% of permit fee): V' (j J? Authorized signature: TOTAL PERMIT FEE: 61.2 . This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. ' Number of inspections allowed per permit. 1:\ Building \Pem,its\ELC- Pem,itApp.doc 05/23/06 440-4615T0 1/05/COM/WEB - 'Electrical Permit Application - City of Tigard i "' • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: r,RESIDENTIAL WORK ONLY: � - ` ( Fee for all residential systems combined ... $75.00 Check Type of Work Involved: El Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* • ❑ Other COMMERCIAL WORK ONLY; - 1 Fee for each commercial $75.00 • system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems • ❑ Boiler Controls ❑ Clock Systems El Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation El Intercom and Paging Systems ❑ Landscape Irrigation Control* • ❑ Medical El Nurse Calls ❑ Outdoor Landscape Lighting* • ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\ Building \Permits\ELC- PermiIApp.doc 03/23/06 CITY OF TIGARD , BUILDING DIVISION PERMIT #: ELC2006 -00710 I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12114/2006 Phone: (503) 639-4171 iiititiiifi Inspection Requests (24 Hrs.): (503) 639 -4175 �' INSPECTION WORKSHEET FOR DATE: 1211512006 TIME: 7 :04AM PAGE: 4 SITE ADDRESS: 15 SW KENTON DR CLASS OF WORK: SUBDIVISION: ASHFORD OAKS NO. 2 LOT #: 108 TYPE OF USE: PROJECT NAME: WORNATH DESCRIPTION: Final inspection for work done by previous owner. OWNER: WORNATH, HARRY PHONE #: 503-472-1667 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/15/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 041132 -01 503- -472- -1557 Y Corrections/Comments/Instructions: P$Y\J© 6. M1N SC 6" Q0,,zo g KLL 0 c t NS�'eLL G-- ,., NO C�N4I c i 6 A s 1 N CIA \Y ba- em tZEg A\ 0 3 NQ CS") .L. Cfcc 1:,a__Ce V .1 - QZ i p fsf So 6) G-,a- ?E/ . sW 4 0.36 P. ;1 oN L is, ,1-4 c 6 EL E - , cAL. czt∎TR, PodorL. ■\A b `- cszic raer1 mss - k pe-44 I ss v �l� cal' of `� ,9140D NA, a - 1 9 i __ _ _ _ ❑_PASS _ ___ _ _PARTIAL APPROVAL ._ ❑ CANCEL NO ACCESS X :),AIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: V ■6 0 C Date: t J i 4 Phone #: (503) 718 -ZT 't