Permit ,.f CITY OF TIGARD . ELECTRICAL PERMIT
PERMIT #: ELC2006 -00291
�I � 'i DEVELOPMENT SERVICES DATE ISSUED: 5/23/2006
,,, ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104CA -02600
SITE ADDRESS: 13571 SW LAUREN LN ZONING: R -7
SUBDIVISION: HI LLSHIRE LOT: 026 JURISDICTION: TIG
Project Description: (1) branch circuit for NC unit.
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: 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:
.WILLIAM BOHRINGER OWNER
13571 SW LAUREN LANE
TIGARD, OR 97223
Phone: 503 - 590 -6395 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 5/23/2006 $46.85
[TAX] 8% State Surcharge 5/23/2006 $3.75
Total $50.60 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: ( ; Permittee Signature: UV je
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.
r ,..... r..
EleCtrical Permit A -lie .1,C pti"FacimEIV r V ,. c. FOR OFFICE USE ONLY
Cit I y of Tid Received _
Date / '-- ' .e.'
..........* 1,
13125 SW Hall gar Blvd., Tigard, OR 97223 MAY 2 3 2006 , , , Plan R / eview Permit No: -
Phone: 503.639.4171 Fax: 503.598.1960 --- - . hiNC:il'i'.ti ,, Date/B : Other Permit:
Inspection Line: 503.639.4175 /i: —
A,--1, .1.4,J i _.. , _a ...liji . - '1 I ' Date Ready/By- Rell RI See Page 2 for
Internet: www.ci.tigard.or.us CITY 'Jr ';'''''.;;... ........ Notified/Method : Supplemental Information
e , .,,,, -v., „.. -,.:17'„,, ,.:, , , ... ,, 4 ,, .,...'.',01 -., ,:-.„, z v.;; ,_ v.'', '...it-,00:, :': ..,:.--_.::,,.. :4 .:: , ..4_4.' ■ -.",i',„ " ...1 ;7,, „.,:, ., .,.- ::.4-:
0 New construction 0 Addition/alteration/replacement Please check all that apply:
El Service over 225 amps, comm'I ['Hazardous location
0 Demolition 0 Other:
Am't OService over 320 amps - rating [IBuildng over 10,000 sq. ft.,
trfiv of 1- and 2-family dwellings 4 or more new residential
v ."...,* •nr• ,A., 9, 'e" 94. 'Itlt-i fArr. '...
Eg 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building ID System over 600 volts nominal units.in one structure
['Building over three stories ['Feeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other:
['Occupant load over 99 persons OManufactured structures or
l • -1 ,4 9 1 1.•,; • ,WN,":W-R.—T , I9NOPAVOS;I.191-W,‘,YA"'.•V•;;I:,.' , 1:1E8reasill8lning Plan RV park
Job no.: Job site address: 13571 SW Lauren Lane pHealth-care facility 00ther:
. Submit I sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
' fV, - ; 4 7"'*.Zili - .'f• It7- '7
Suite/bldg./apt. no.: Project name: Air Conditioner Electrical
Description I Qty. Fee. Total **
Cross street/directions to job site: Walnut & 135 Ave New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less • 145.15 4
Subdivision: Hillshire Lot no.: 026 Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: 2S104CA-02600
Limited energy, non-residential 75.00 2
iner"fgA kiejgIr*v;Vokreei A,#.;-5*,,,s7 E ac h ,44.. '',N, - , '' e , , •g„; ,, ,,ilf:40 -, ..n..% ; -, un manufactured or modular
dwelling, service and/or feeder 90.90 2
Addition of branch circuit to outside electrical box for air conditioner.
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: William J. Bohringer 601 amps to 1,000 amps 240.60 2
Address: 13571 SW Lauren Lane Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)590-6395 Fax: ( ) 200 amps or less 66.85 I
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 or exchnge,ccrding to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: IZ).,(...atilm - Date: Z 80i ( Branch circuits - new, alteration, or extension, per panel
A. ee F for branch circuits with
L A '' ', r ,,, .,,::, , ..p.,..:.;4: a`Y:, ., ;4 _-■ 0 '1 - " ..,; , ...,, _ .,_,-..,,,,,. ,, '.4:,.."4, : .4 service or feeder fee, each
6.65 2
Business name: branch circuit
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
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
OisrfkAr• t17044 liNi energy panel, alteration, or
' extension. Describe: Page 2 2
Business name:
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax ( ) Industrial plant per hour 73.75
1 ..K40 ''-44 Wateaf.;;,
CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal 4 / '",
Suprv. Electrician signature, required: Plan review (25% of permit fee)
---
State surcharge-(8% of permit-fee) - 5 ( ,..., ,)
Print name: Date:
TOTAL PERMIT FEE
Authorized signature: This permit application expires ifs permit is not obtained within 180
days after it has been accepted as complete
Print name: I Date: • Fee methodology set by Tri-County Building Industry Service Board
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: FLC2006•00291
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/230006
Phone: (503) 639 -4171 '�� k� i Q ° t
Inspection Requests (24 Hrs.): (503) 639 -4175 '. ° °'� �
INSPECTION WORKSHEET FOR DATE: s3/3/2Q06 TIME: 7:06Am PAGE: 7
SITE ADDRESS: 13671 SW LAUREN LN CLASS OF WORK:
SUBDIVISION: I1ILLSHIRE LOT #: 026 TYPE OF USE:
PROJECT NAME: BOHRINGER
DESCRIPTION: (1) branch circuit for A/C unit.
OWNER: BOHRINGER, WILLIAM PHONE #: 603-690-6396
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 0/312006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 A/C or heating unit circuit 034323 -02 503 - 690.6395 N
C� rrections /C �t�ns �—
A-k_ a ‘o! Ga,,,„,,,,c -c i ` .4i"-L ( f' s c=- yo 4,4-7-1
ez__ u/vri--- pilm, ..,.......----
411
t- PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO_ACCESS _
FAIL • ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - #iP Date: g ; > ' C Phone #: (503) 718 - Z-Ker