Permit CITY OF TIGARD _ ELECTRICAL PERMIT
PERMIT #: ELC2008 -00156
COMMUNITY DEVELOPMENT DATE ISSUED: 3/19/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104CA - 03400
SITE ADDRESS: 13648 SW LAUREN LN ZONING: R -
SUBDIVISION: HILLSHIRE LOT : 034 JURISDICTION: TIG
PROJECT: AVIS
Project Description: Installing (3) branch circuits in garage.
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: 2 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:
RICHARD & JULIAN AVIS PACIFIC NORTHWEST ELECTRIC INC
13648 SW LAUREN LANE PO BOX 310
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 579 - 2641 Contact #: PRI 503 - 657 - 1188
FAX 503 - 722 -9058
FEES
Description Date Amount Reg #: ELE C6
[ELPRMT1 ELC Permit 3/19/2008 $60.15 LIC 162893
!TAX] 12% State Surchar 3/19/2008 $7.22 SUP 5089S
Total $67.37 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: Ae Permittee Signature: 7/77 ).-v
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.
03/18/2008 21:39 5037229058 A PACIFIC NW ELECTRIC PAGE 01/02
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w ' r I'012.0E ICE I ISE ONIA'
lectrical Permit Applicat _ S7�
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City of Tigard • ` ° '' .'' Dn1elR ; J
IN 1 3125 SW 1131 F31vd,. Tigard, OR • tr .'ti , �o �t�n itavicw Inds: PCrmit: •
P� �0 � I tga . _�� )or1c la sre rnRe 2 r
R Phone: 503.639.4171 Fax: 503.59' , l9G k —
� �o ®\ .t�� Date Rcadyl3y: g n ry plementnl lnfnrmnlinn
n l..lnc: 503,- 3 9,4175 V M II1 /Mcrt
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1 , ;;,lul r } i l ,l t ! 2 . 1 ... ' ' 1 I' ' " ' . it IIJ �,I II,. di , pl cs,se chec FlII flint apply (snbm 2 Pols of ,ltlns W /Items ncceked be:1m
fi h..r;li,:, '' °;' n . u. o' I;L �I 1 Rnil over three stories
❑ New construction
ddition /AlteratiOnJTCplaCemCnl: Q $arv l1 or f 400 amps or ntnro )tsarinas and bontynttls.
wl+erc the availaltlo fnup; current � GlnalinlS b +�ildings.
Demolition Other: Ir ,. „p; exceeds 10,000 amps Flt 1;0 volts or _ .11ii : 1'' �I�l llli i'li l( Yli ,,,. G i ,sc t c, urn
riil�;i '>}i[��f s ' 6 1� 4� a i ll `, ILL �» ' ; I 1' , I ; I Icst In emend, i x
d � D0 0 r. n ^, n tr, +
, .. ' 11 v 'I; . . h„ puilctings.
n d :� 'a mi ` dP '' �� nm : far e Miter xc ellFltih , 0
y f ly c s "" Accessory building p 75 KVA cr
- a 2- fa dwelling 0 Com /i � Y [IFlrc p,nnp, 0Inelollnlion of
O slon,, InrRur sepacnr 7 derived sy�lcn
Multi-family 0 Master builder I'P,me sy L 1_ry „”, •1 - :I
:, , glilil;, _;s:,: : i'Iiiy�,,,1 y,y� .i'y�. y i it f r " 1 1
� l ipl �l'.l iii' ,: i o- Addition en v/ motor toad of ❑ occnpnnoy,
I ,,,, '� ''.'i.;i1;117.d1iO1''r,�,511� 1 W����n, At�OV f,, 'I;:ui : .:.,I, d..,i -..1 Iom- lr�r,note,
0 Rccrcnl{nnal ve hicle parks,
. ,r...:,,' to ad e ss: �e ,,. R iy i ol a vehicle more arks ,nn
'r ''• ,,.tit. 1 I _u� SA) �� � 0 SI •SOf 1114MrCAi(�OntIF11 nI11tP, Simply Job no.: address: l lA 7" In f acilities. u
��, — Sim ly vo sominnl.
„ , r11-Iarsirdous (tensions. Ano
Caty /SLntc/ZIP: i � (a - —��� 0 Service or feeder 600 a or more. N y � i q I ,;, '
i,' ,; r i e.11't"'''' ,'��li 1._.1,,,,1_,,,. i r I ,I� t�F r' I 1 1 I' l :G w jfl• , � ' .1, �. i ,y:, . Nwriprion __Project natnG: „!I.I:r:' 1 jo ,,'' :I jll'I �.r ii t,;:' i. � .,,,,
Suite/bldg./apt. no.; 1 ,, I,, J, 1 '>�,i,.1;)z;,nl:i:� '�"'�' � ��cnt�t�,•_ —
Cross Street/directions to job silo: _ -- ' Nrw residential single- or multi- family dwelling unit.
—._� ^ �° includes atl'nched garage. -. .�- ---� 4
�-- 145,1.1
—_� '.. r ^~ 1,00 s(1, t1. or less 1 �.,_., `—
._. 101:110.: 33,40 _
Subdivision: _ _ 8a. nd ddb sq,_or p
�� — Limited energy, residential — 75 2
Tax map /pttrce' n0.: {;.',1^Ill ;l'I ini ii{ 'P! i't TI ri 1 ijU'.; (WitUEl_gceq ti,) -----
I'; ,���"�l,�i.� {' i, :, {!, {" ,�',It , �It'` d," ����, ��j, j ' S1 :Il�i.tifl!'�EI!IIIG] "!1ll�,l' ! .I:i�,,,�,� - g y multi - family � 75,00 2 '
,,,,,,�, r a JJi,it 'l ..L i it'll " :� 41 i�11;,,i,:1stu.w:ie4 o :. Llm suer r
�' - ` t � a � rCal(1C { wills nbma s 11,) _��� ��
� q �, * lr, CLt( r wt �� wit , Services or feeders installation, altcratinna and /or rclocnlion 2 ._
200 amps or less an.3a
pw rum kta "'Ft( a+nti irrr d4- tttil ti . .. i 0 -.85 7..
.. a to 40 a �_�
r I I i t 3 P ll'1 �i , ll � A If i V4 ( i ., . i I + iEi��' E�4 l lf'.' l� �'�' �P Z r1 p• — 2-
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1p , [ ,i o, i,l'i,' „ i� l l ., a ;.',' - l 4:1 „ !•, r l } i ,, � • �1:1 401 amps to f,00 amps 16 t1,G0
�' 601 amps in 1,000 amps 240.60
Name; - Ali t� _ _...--�- 45 — 2
Over 1,000 amps or volts J 4.65 . --
Address: ����- --., Temporary srrvle�a or feeders instnllntion, altcraiicln, and/or
re location :• --- .-
Phone: (
City /State /Zit': - — —.� 6-.85 —
100.30
( ) 200 amps or less
� V. _. —� — 2
1j ��� �P � I Fax: 201 amps to 400 amps �_
Owner itt94sl11srtion' This i11S1:allfll',lnn is being made on property dint I own which is not 133,75f 2
Y b[l l amps to 599 amQs � �� c nncl
intended t'or arti ,loose, rent, or cxchani e, according to ORS 447, 449, 670, and 701. Branch circuits- crew, alterntpon. extcni inn_, p p,
Owner signature: 11 1; i'r, { � t %CC tot branch circuits F is w ith w ith Date: A. n � - - - "• I ,W,,�I p�a ��1l�� ���� ���I shove service or Feeder Fec. G,GS 2 '
r . ,,,I j f,�1 .il;'' t1 f,��' il�'li li ti ll! +',l j ijil,��} I �f V,��i7{ `�” ,.., f�haiaiii i • "1ti t ,- branch circuit .
1 A91"1I:114A' 1 fi : I 144, nd; ii+,� i r I i It �;l, , 1,15. i .I vuUti: 1 F1 each (tTan
.`,�t� � h, ,I, ��d.+.l�.,:�.;,ry,;i'b !
{1,;,rit ,I�L�� _.�
�ac � �,�,,�.i 4- 13, Fee for branch circuits S
Co rtic SS name: ` a( �_ without service or fender fee, i 46,85 fi g— 2
Contact name; ,..----_-/ yt.4,� — — first branch circuit
Each ndd'I branch circuit - .C15 .-
Address: 0 Q _ _�� Niigeclianco (ser vice or feeder in -�_ ____...1
�._ —
X Each manufactured or modular 90.90 2
( il.y /Slal,c /7..iP: 5,t � Oa— �� dwelli11g scrvicc and /or feeder �= _ _,—_� _
"� { �ccrntncotonly — 66.115 Z'
Phone: ( e>) X11 7 tax:: (93 ' WI?' ~- 705 $` .. s3,4o V 2
�6� 1 / -`
E-mail- � '��, f il{ i t r Pump or irrigation circle " ';',; Si gn or outlinelightingy — 53.40 _ _ 2
11` i ' I:
�Y .. u r I �I J� � u, �1�f t i�,� .�'t,l v'll���l l .,, �f r!'lill {•�Llril�rllJw! J I �N d lit or limited -
4 ,. ,,,: °'°„- 4 Signal circt (s)
Susi name: Ilr v W (1.-o •g .1..e 1 energy panel, alteration, or P €c 2 2
a_c.� . ^� extension. C)escrihe:
Address: __ _ Aeib ----- ____ — ---
- -- --~
Each additional inapectio0 over nllnwable in any of the above
City /Sl'acc /Zit . _ Per Inspection 62.50
TI i ax: ( ) Investigation per hour (1 it iota) 62 . 50 _— •�•—
Phone: (' ) I 73,75
Industrial plant per hour ;
Su rv. Lie.: to <.:;.,' l ' C ` ;;;fli p
--
CC.:ii Lie. ! (prL$' � ElCCtI'IC11 I..iC.:� r ,,, Iil!' . �,JIJ .1: : BillictiiE�'lIN,i�_'�iXJ l : I ._ ;'G:
Suprv. Electrician signature, required; Art _ plan review (25% nfpermb fee __ T
Print name: — �,� t6,..k ' [C:3 —(61.1 a State urcharge (12 °/6 of permit f �.,,, _
A
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['nTAI..PLRMII'I'T;I: �p'� 51
Authorized Signature: ,
This per npplitntinn expires IT n rycrm lt Ia not benlreecl within iR0
Print name: ' " �Q Date: "1 dnYc offer it hnn been nrceprrn ns comQlrte.
— — {. --- * Nnmher of inVectin ollowcrl per permit.
..,....u�..._, n,...,,.,..,m r_n,,. «.;•ns,,. dam. os/z'!!n� 440.46157(, 1 /05 /COMRV1741
• . . - , ,..
CITY OF TIGARD ,
• BUILDING DIVISION PERMIT #: ELC2008-00 I tie
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1912008
Phone: (503) 639-4171 A
.
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Inspection Requests (24 Hrs.): (503) 639-4175 . '---....
INSPECTION WORKSHEET FOR DATE: 3/2712008 TIME: 7:03AM PAGE: 48
SITE ADDRESS: 13648 SW LAUREN IN CLASS OF WORK:
SUBDIVISION: HIIISHIRE LOT #: 034 TYPE OF USE:
PROJECT NAME: AVIS
DESCRIPTION: Insialling (3) branch circuits in garage.
OWNER: AVIS, RICHARD & JULIAN PHONE #: 503-579-2641
CONTRACTOR: PACIFIC NORTHWEST ELECTRIC INC PHONE it: 503-657-1i8e
Inspection Request Scheduled For: Date: 3/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 067276-01 603-657-1188 Y
7)
i c i ti v 57 iv&91/1"k A 46Z*4
Corrections/Comments/Instructions: iit
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• PASS III PARTIAL APPROVAL 0 CANCEL fl NO ACCESS .
. .
n FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date:
.
...
-/ ao_Wh61 Phone #: (503) 718-
'". • , ' \.