Permit CITY OF TIGARD ELECTRICAL PERMIT
.,Iii :: " PERMIT #: ELC2007 -00444
COMMUNITY DEVELOPMENT
DATE ISSUED: 6/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DC-17500
SITE ADDRESS: 13270 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT : 030 JURISDICTION: TIG
PROJECT: GREENWOOD
Project Description: 200amp service, 1 br. circuit.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
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:
GREENWOOD, CAROLYN K BOONES FERRY ELECTRIC INC
GREENWOOD, BARRY J PO BOX 628
13270 SW LAURMONT DR WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone: Contact #: PRI 503- 682 -4936
FAX 503 - 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
[ELPRMT] ELC Permit 6/29/2007 $86.95 LIC 88482
[TAX] 8% State Surcharge 6/29/2007 $6.96 SUP 4918S
Total $93.91 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: c�Qs1 , Permittee Signature: t, z r # , 6-----
,
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.
1 .n Vu °o. 29. 2007 7.40AM ^ licaB00NES FERRY ELECTRIC No, 8709 P. 1
FOR OFFICE USE ONLY -
• City of Tigard RECEIVED Rece/B eived :✓ d 7 !�
PermitNo..� 1
" 13125 Sw Hall Blvd., Tigard, OR 7223 Dat � DD
sets of plans wgitcrns checked Phone: 503.639.4171 Fax: 503,5 6 Plan Revi w
Inspection Line: 503 - 639.4175 �� �! L ) Date/II : Oilier Permit:
c,A}tD
r
Date Ready/By:
• l L Internet www ugard or gov T Y , : / P! see P�
C OF TIGARD No tified/Method: _ : ®2 [or
W t ji { r sy 1 n w ) , ,1 n 5, L Supplemental informalloa
J hll,fr l L 1 :�ar�" aV T y " r g i A CFF 'J'r1 T
l° ,.xd.�;;ts� h_,? a..�ia ir n: � J 3` s � i k i '� �t , ✓ t r � b >
>,: r ..r3l. ,. -,' au 7 `, 410. a 2 2i i' lli S {fat l5 xv, 1Fr"lY 1 r
. i..,• , — h., �_.i•>}411. -... u.FT,i._Jr'Jt,..7� ,.,u ?f.: 5 �1:",� 1 �� ��n S� �y,t, ltl �u 1T'.�.r`^'Sy'��l�� �kFr��r�t �')� t ' T �1� :
❑ New construction Addition/alteration/replacement Please olteck all that apply (submit Z below) �
a 1=1 Demolition ❑Other: ❑ Service or feeder 400 amps, or more ID puilding over three stories.
ei fu i1; 1 } i t G ` '�1, a l 'll �� > a f a, +is t i U t x _ where the available fault current El Marinas and boatyards,
vw.r� feEc g „1 ;�r _;1 tirtTI l ,i � 54: sr n { �rlt,'� r+�it+ ' � , " k . TI„� , d r,„r ' y 4,1 s 10,000 amps at 150 volt s or ❑ Floating exceed
SS �`r , < �San.,..t Floating buildings -
' i9 I- and 2- family dwelling' E Commercial /industrial te ns to ground, or exceeds 14 000 ❑ m arc;al -use agricultural
❑ Accessory building alt?ps For all other lnslallaljons. bComuildin
❑ Multi ., ❑ Master builder
, o� P , _ ..�., ���'— ,� y 0 Other � ❑Fire pump. [� installation of 75 KVA or
�l�(i Li`,,� { ° y ��� x 1 ���`a��� f Y� l gS r1 J`��'A�' 9 f ,�� iC3 �E I X1 AY � � 1 A � � Y � R" c^ r ak 4( w ! �' #,7
S e r a + Y ill t r t it d lF t 4 i4r ❑ [B c3 $ new o larger separately derived system.
�► , }tf a I ' §1. °`.: CI Addition of new motor load of ❑ "A "E ", N -Z "(-3 ",
Job no.:
`, Job site address: Z• L 100HP or more. occupan
• ' �, ❑ Si x or m or e residontiat
City/State/ZIP; un;la
❑
Recreational vehicle parks.
,\ g0.>ris O - ❑ Hcahh care facilities. ❑ Supply voltage for more than .
Sui[e/bld /a t, no -: ❑ Hazardous locations. 600 volts nominal. .
g p Project name 11 , CI Service or larder 600 am ps or m ore
�i , _ rr— r
Cross strceVdirections to job site: b' t e ;mi 4t 1) E4 bjl��i J k � To jFt� }F
Descriat�0u Qt/. Flo, Total
•
•
New residential single- or multi- family dwelling unit.
•
Includes attached garage.
Subdivision: Lot no.; 1,000 sq. ft. or less ,
Tax map /parcel no.; 1 145.15 4 •
r E add' 500 sq. ft. or portion • 33.40 1
�`'t,.,„�' °Jyk }Y7'� r s €t`S 7B 1 y f iB Y l t -r 1t .re.�7T �ei'A FP4 �.4 1! "'a t�S! (with aboves
Limited e - ,
� : th ® �f energy, residential
%a.: R?aFi,.,,, ra �..e �41iz1)i srY rvt= t y� q. ft.) 75.00 2
by �`wdx.. �Strc����;:lrtri�
‘(e.--0,, Cp ���' • Limited energy, multi family
�` residential (with above sq. ft.) 75.00 2
•
r �,�-o Services or feeders installation, alteration, and /or relocation
in ATOM rr 1t lYi i,L� t) �\" 51 �` b ISx e yrs 200 am s or less 80.30
11 �_�l {i�'`i1,." � ��!".5 �.�r ",,..'F"" 1. ix lii�"ti ��l #r?,.t�- �..,3j $�r c B* S l`� hu a,, .£� � ;^d� 3 1t o +Lo f3 N � P
S,t�' u� �' 1 p C Q�\,'�J 2
�. ,r: .a�,.,1.r, w� 1:,1 `r,Z,,a i 2 ° ,.',niatii. ' 201 amps to 400 amps • 106.85 3if 1 / 2 .
Name: 401 amps to 600 amps 160,60 • 2
•
ldreSS: 601 amps to 1,000 'amps 240.60 2
Over 1,000 amps or volts 454.65 2 • •
--i1y /State /ZIP Temporary services or fenders installation, alteration, and /or •
Phone: ( ) relocation
Fax: ( ), • 200 amps or less • 66.85 • Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amp 1
•
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps •133 -75 ,. 133.70 2
Owner signature •
Date
• Branch circuits, new, alteration, or extension, per panel 2 •
Ml w li� {;# + r �r ;tt�u t;�,`�tk i i ce, a ^arc nr�, n, 5`� A. Fee for branch circuits with
�fi gi .. 6�,.,.1aLt zx ,�� F,� ��. 1 u 't art yy,,^, r a 1?? above service or feeder fee, '
Business name: each branch circuit s : 6.65 f D 2
• B. Fee for branch circuits
Contact name: without service or feeder fee, • '
• first branch circuit 46.85 2
Address: W Lath add'I branch circuit
• 1 6.65 2
•
City /State /ZIP: Miscellaneous (service or feeder not included)
•
•
Each manufactured or modular
Phone; (. ) I Fax:: (. ) dwellin service and /or feeder 90.90 2 •
E-mail;
r Reconnect only 66.85 2
•
d . t? ' � gttl S� ^tt ,e, v r, r it �;?� ,,``„r 7 > ,.. • Pump or irrigation circle
'(i.. L �21f.1;,�.Y..r.,C, ! rrof.�a4 d,S ° `S"" C, � -n it { r � Y "! t "k�, r ,.ta rw'a, alf
_ t 53 40 2
w , _. ? o „]z tti �-l:c?,*e ,.,,....ia_ , 1'rsWr.. a�:y�o-fg Sign or outline lighting 53.40 2
Business name: Booties Ferry Electric INC Signal circuit(s) or limited -
Address: P.Q. Box 628 energy panel, alteration, or
extension- Describe: Page 2 2
City /State/ZIP: Wilsonville OR 97070 , Earls additional inspection over allowable in any of the above -
Phb[ie'- (503) 682 -4936 Fax: (503) 682 -7946 Per inspection 6z -50
_ Investigation per hour (1 hr min) • 62.50
CCB Lic.: 88482 Electrical Lic.: 3 23C Suprv- Lie.; Industrial plant per hour 73.75 • •
,Suprv. Electrician signature, required: /��..+�kn E °ra ;ter i 'b r. f t ro,
/ . t tir,arr- ,2 r .- ._ ��.gk N. t e ? ra 1 ?�f5 f 7 r F.;1`-
• •
�;.^ Subtotal:
int name v +l1 -
A 4 A Dale: ` Plan review (25% of permit fee):
y State surcharge (8% of permit fee):
•
ltofiaed "signature: L
Aut
TOTAL PERMIT PEE: ' . q i
•
('tin[ name: This permit application ex Ors if
Date: p' a permit is not obtained within 180 '
days after It has beet, accepted as complete
Ia luildingWarmlts \ELC- Pern,hApp.doc 05/23/06
• Number of inspections allowed per permit
440 -4615T(1 km/comma
•
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2007-004M
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2007
Phone: (503) 639 -4171 dN4pu�il�l
Inspection Requests (24 Hrs.): (503) 639 -4175 �&W
INSPECTION WORKSHEET FOR DATE: 7/3/2007 TIME: 7:03AM • PAGE: 23
SITE ADDRESS: 13270 SW LAURMONT DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 030 TYPE OF USE:
PROJECT NAME: GREENWOOD
DESCRIPTION: 200arnp service, 1 br. circuit. •
OWNER: GREENWOOD, CAROLYN K, PHONE #:
CONTRACTOR: I3OONES FERRY ELECTRIC INC PHONE #: 503-682-4936
Inspection Request Scheduled For: Date: 7/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 051386 -01 503-682-4936 N
Corrections /Comments /Instructions:
414 (qc PA.0
PASS. n PARTIAL APPROVAL._ _ _ CANCEL I I NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector-
I v `� Date: 1 '3' 0 Phone #: (503) 718- 1.44