Permit ELECTRICAL PERMIT
4 i CITY OF TIGARD
PERMIT #: ELC2007 -00170
° COMMUNITY DEVELOPMENT
DATE ISSUED: 3/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S126DC-08500
SITE ADDRESS: 09277 SW LOCUST ST ZONING: R -12
SUBDIVISION: MLP1999 -00006 PP2000 -018 LOT : 002 JURISDICTION: TIG
PROJECT: DECKER
Project Description: Branch circuit for heat pump.
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:
RALPH DECKER OWNER
9277 SW LOCUST ST.
TIGARD, OR 97223
Phone: 503 - 293 -3810 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 3/19/2007 $46.85
[TAX] 8% State Surcharge 3/19/2007 $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: ALe, c '{ j ' 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.
. i •
glesix Permit Applica FOR OFFICE USE ONLY
Received / �
City of Tigard Date/By:3I . I 0 l B Permit No� (�(J�7 0
° 13125 SW Hall Blvd., Tigard, OR g 1 9 2007 Plan Review
' Phone: 503.639.4171- Fax: 503,� g,�,�Q6Q _ Date/By: Other Permit:
T I G n K D Inspection Line: 503.639.4175 pp����i0�0 �7F 1 ARD Date Ready/By: Suns: BI see Page 2 for
Internet: www.tigard- or.gov o/i6LIING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction Addition/alteration/replacement
❑ 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.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1- 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "l -3 ",
Job site address: a C I IOOHP or more. occupancy.
Job no.:
l i CJ tD L :x_L S-4-, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: (o a a 3 0 Health -care facilities. ❑ Supply voltage for more than
(�/� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no:: Project name: ❑ Service or feeder 600 amps or more..
FEE SCHEDULE
Cross street/directions to job site: Locus A 6 re PjaN CIDurc3 Description I Qty. I Fee. I Total I
New residential single- or multi- familydwelling unit.
Includes attached garage.
Subdivision: Lotno.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax inap /parcel.no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
r n ee. `dI tr'6 Limited ei energy, (with above sq.11 ' 75.00 ' 2
�5� 12\ S 1 UW �J� residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
. 200 amps or less ' 80.30 2
PROPERTY OWNER 1 ❑ TENANT 201' amps to 400 amps 106.85 . 2
Name: �� _ 'jn 401 amps to 600 amps 160.60 2
'��"'� `"
...eel—P.4- 601 amps to 1,000 amps 240.60 2
Address: CA 7x11 ' � S 4. ..L Over 1,000 amps or volts. 454.65 2
City/Slate/ZIP 1 Temporary services or feeders installation, alteration, and/or
t '��—„ .,--1 2Z3 , relocation
Phone: 15'b t 3 — 31s► 0 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation ' being made on property that I own which is not 201 amps to 400'amps 100.30 2
intended for s•. r ., v , t, : exch. �' cording to ORS 447, 449, 670, d 7 1. 401 amps to 599 amps 133.75 2
` r Branch circuits _ new, alteration, or extension, per panel
Owner signature:. k . Da g I i �. 6
I A. Fee for branch circuits with
❑ APPLIC ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2 •
Business name: B. Fee for branch circuits
without service or feeder fee, I 46.85 �S
Contact name: first branch circuit
Address: Each add'I 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: 0 Signal circuit(s) or limited -
�(1 I,t' qcn-.� 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 (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: • ' Subtotal:
Print name: Date: Plan review (25 %'of permit fee):
State surcharge (8% of permit fee): 3 i lbh
Authorized signature: TOTAL PERMIT FEE: 7 • / •
Print name: Date:
This permit application expires if a.permit is not obtained within 150
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I ::Building\ Permits \ELC- PermitApp.doc.05/23 /06 4404615T(I1/05/COM/WEB
Electrical Permit Application - City of Tigard �r '
Page 2 - Supplemental Information;
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all 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
❑. B
• •
oiler Controls -
•
❑ Clock Systems
❑ Data Telecommunication Installation •
D . 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 \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD • _
BUILDING DIVISION PERMIT #: ELC2007 -00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/19/2007
Phone: (503) 639 -4171 '9ll�l
Inspection Requests (24 Hrs.): (503) 639 -4175 R: _..
INSPECTION WORKSHEET FOR DATE: 4/13/2007 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 09277 SW LOCUST ST CLASS OF WORK:
SUBDIVISION: MLP1999 - 00006 PP2000 - 016 LOT #: 002 TYPE OF USE:
PROJECT NAME: DECKER
DESCRIPTION: Branch circuit for heat pump.
OWNER: DECKER, RALPH PHONE #: 503. 293 -3810
CONTRACTOR: OWNER — — PHONE #:
Inspection Request Scheduled For: Date: 4/13/2007 Pour Time:
Code # Inspection Description Confirm #' Contact # Message
199 Electrical final 046467 -01 ", 503 -703 -3913 N. Y
c P .. -
Corrections /Comments /Instructions:
M?
,7(
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: T NUILf Date: 1 4f 1 3(01 Phone #: (503) 718 - V1' 1'V
.