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Permit h CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00297 16, DEVELOPMENT SERVICES DATE ISSUED: 5/25/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134AD-01200 SITE ADDRESS: 11383 SW LAKEWOOD CT ZONING: R -4.5 SUBDIVISION: ENGLEWOOD LOT: 052 JURISDICTION: TIG Project Description: (2) branch circuits for HVAC. 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: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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: SCOTT & CA YOUNG STAR ELECTRICALSERVICE 11383 SW LAKEWOOD CT PO BOX 1784 TIGARD, OR 97223 BEAVERTON, OR 97075 Phone: 503 - 799 -8643 Contact #: PRI 503 - 579 -9201 FEES Description Date Amount Reg #: ELE 26 -963C [ELPRMT] ELC Permit 5/25/2006 $53.50 LIC 153627 [TAX] 8% State Surcharge 5/25/2006 $4.28 SUP 43I3S Total $57.78 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 o OUNC at 5' , . -6699 or 1- 800 - 332 -2344. Issued By: Permittee Signature: 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 Applica l). ��4vE® FO OFFICE USE ONLY lig City of Tigard MAY 2 5 2006 Date /By: d ■ • IL PermitNo.:�C ` --- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 .t C < Phone: 503.639.4171 Fax: 503.E 6®F TIGARD pate/By Other Permit • - T I GA RD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: ®See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information .n TYPE OF- WORK , PLAN ; REVIEW" • El 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 CONSTRUC , exceeds 10,000 amps at 150 volts or ❑ Floating buildings. • less to ground, or exceeds 14,000 ❑ Commercial -use agricultural Il l - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ,• - - — , - - • ❑ Emergency system. larger separately derived system. •''' - JOB' SITE INFORMATION AND.'LOATION "' ' ❑ Addition of new motor load of ❑ "A ", "E ", `9 -2 ", "I -3 ", Job no.: Job site address: / 9 t3.3 �� 1a Six or or more. R occupancy. Recreational ❑ R /4 �i1too ❑ Six or more residential units. ecreational vehicle parks. City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than . / 1� / � �. ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more. .FEE SCHEDULE Cross street/directions to job site: Description I Qty. 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 75.00 2 ' DESCRIPTION OF WORK , : (with above sq. ft.) Limited energy, multi - family . Wl/1 residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 • PROPERTY" OWNER : . (_ . . ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 • Name: ���s �/G+ /�� ' C /` 601 amps to 1,000 amps 240.60 2 Address: {% s 31 /. a w 4 o, d 0,,.,L Over 1,000 amps or volts 454.65 2 City /State /ZIP: `J( Temporary services or feeders installation, alteration, and /or relocation • Phone: ( ) I 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 to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner si ature: Date: Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with • y APPLICANT I • ❑ CONTACT PERSON above service or feeder fee, 6 2 t J/ J i each branch circuit Business name: C��� �/'1��/ / J � / /� ��_� B. Fee for branch circuits l ( c without service or feeder fee, 46.85 2 Contact name: �'/ �z1� �P� first branch circuit Address: e „ 0 , d a , =)I 1 g.7 Each add'l branch circuit / 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Cl. en. v �� f �/� 0) Each manufactured or modular 90.90 2 / dwelling, service and/or feeder Phone: (5 3) �-2 q ,_ 9 got / Fax: : ( ) Reconnect only 66.85 2 E -mail: ' Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: e ... _ L- __ A e ► energy panel, alteration, or Address: l t D 13 (3, / •2 5j extension. Describe: Page 2 2 City /State /ZIP: I , 0 v - p / /\/' ©ke / Each additional inspection over allowable in any of the above / / Per inspection .62.50 - Phone: (y )/ "7 9 q Q 0 / Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: /.i5 // d- Cp 7 Electrical Lic.: ,6..._ 9 ,Suprv. Lic.: 113/3 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: / _,(L/ Subtotal: 17, . ��� of _A - name: J ` Q D ai !� - , Plan review (25 %.of permit fee): - - �/T//J� / �/� `' /� State surcharge (8% of permit fee): V Authorized signature: TOTAL PERMIT FEE: , '7. 1 / 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. I: \Buitding\Permits \ELC- PermitApp doe 05/23/06 440- 4615T(I 1/05 /COM/WEB • i Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY Fee for Al residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System *' ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: 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 ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ 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 \Pemiits\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC200600297 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2512006 Phone: (503) 639-4171 vitit Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE:. 6/5/2006 TIME: 7:02AM PAGE: 38 SITE ADDRESS: 11383 SW LAKEWOOD CT CLASS OF WORK: SUBDIVISION: ENGLEWOOD LOT #: 052 TYPE OF USE: PROJECT NAME: YOUNG DESCRIPTION: (2) branch circuits for HVAC. OWNER: YOUNG, SCOTT & CAROL PHONE #: 503-799-8643 CONTRACTOR: STAR ELECTRICALSERVICE PHONE #: 503 Inspection Request Scheduled For: Date: 815(2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 145 NC or heating unit circuit 031098.01 503-579-9201 Corrections/Comments/Instructions: 3o 4--(0 - RASS _I_ 1 PARTIAL_APPROVAL n_CANCEL fl NO ACCESS I I FAIL I I CALL FOR INSPECTION L ADDITIONAL FEES ASSESSED Inspector: Date: - 0 Phone #: (503) 718- Z-zg; L7g