Permit • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00591
__,J14, �'�l�i DEVELOPMENT SERVICES DATE ISSUED: 8/16/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S104BA -12400
SITE ADDRESS: 13630 SW MARCIA DR ZONING: R -12
SUBDIVISION: CASTLE HILL NO. 3 LOT : 154 JURISDICTION: TIG
Project Description: Branch circuits.
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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: SIGNALJPANEL:
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 FOR: 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:
DAN CHILDERS BOB'S ACTION ELECTRIC INC
8963 SW PICASSO PL 2700 NE BURTON ROAD •
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PORTLAND, OR 97223 STE A
VANCOUVER, WA 98662
Phone: 503 - 710 -0580 Phone: 360 - 254 -7200
FEES Reg #: SUP 4322S
Description Date Amount EL 37
E 37
[ELPRMT] ELC Permit 8/16/2005 $53.50
[TAX] 8% State Surcharge 8/16/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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- eb- 332 344.
Issued By: Permittee Signature: 1> 'ca
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
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OWNER'S SIGNATURE: DATE:
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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.
MSC- �o5 -{ aaS6
` Electrical Permit Application,. fir- FOR OFFICE USE ONLY
v , ci - Received
City of Tigard �� � 0���� PermitNo.: _ l
CC \ Date/13y: / /
13125 SW Hall Blvd., Tigard, OR 97123 �, Plan Revie •
Phone: 503.639.4171 Fax: 503.598.1960 t,,,),- /u�+u"m:, ' A Date/By: O Permit:
Inspection Line: 503.639.4175 C.: Date Ready/By: - 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
4;
r :d< � ..e<r ,'''.w 401,? ..t,7,; ,�.;.::.;�m;,'-'it:' '' " •;i 'x'a •c'" ;�r • ;'- ,. A ,ti '1'1, t .a V tr sy „ ; ,y •c . 2., : r,r - 1 R EVIEW .
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❑ New construction ❑ titi6/alferation/replacement Please check all that apply:
['Service over 225 amps, comm'l ['Hazardous location
❑ Demolition ❑ Other: S ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
, " - "•-y.r tj y f J. -i .'.. A".: �, ,
,- 4 ,1c �' , ''';;i';'°..- 4 ''''' ? v < CAT�GIb. ',, ' - CONSTRUCTd IV_.• ;T -, �� n" ..�
� -Z of 1- and 2- family dwellings 4 or more new residential
- a °...Y =:E ` g *"`a - N: ,,u�i� i ..,. .: _..r .. �, :� ..�. °�- _-. -.: s-� ,�h % a.l'l.,tir- #dwr s'.�
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
` i -,-, ,,;; , i„ Si'FE 3 1,q,vIATI i p ib ',TOCATrON ;« ` 4 "-i 4 i ; . .,. ❑Egress/lightingplan RV park
Job no.: 05 Job site address: 13630 SW Marcia Drive ❑Health -care facility ['Other: Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
, .. '.:4'` ;:,i:;'zf ; �`∎�',I�EEE* SG`IFEI.V. t ? •!,,
Suite/bldg. /apt. no.: Project name: -
Description I Qty. I Fee. I Total
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax Tax map /parcel no.: • Limited energy, non- residential 75.00 2
.r., o ;o' >+., +� r. , h,':_,'
t;=,_. . ;:,; -, >1 ,�, a ;., , O',., DESCRIP'1(• 0' i OF• OR, , , -r, : 2 l - : r r ) , . ' Each manufactured or modular
dwelling, service and /or feeder 90.90 2
A/C & service plug Services or feeders installation, alteration, and/or relocation
• 200 amps or less 80.30 2
i.Y, A , b: • 1
•-. , , c „ 201 amps to 400 amps 106.85 2
r - , . ... . . .. PROF,ERT ': O ..;
.. . ' . 0, 4 - ' , '❑ , / TE N A N TS ' '1,1 - A. ` •,, i. 401 amps to 600 amps 160.60 2
Name: Dan Childers 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
8963 SW Picasso Pl. Reconnect only 66.85 2
City/ State/ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and /or
Phone: ( 503) Fax: ( ) relocation
503 710 - 0580 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
14g " -. "7 ill:: ` * 4* ' :d ` ,tw g A. Fee for branch circuits with
•%,�; [p `-' i ® AP)�L GeS.1�FT..' " i S ��'' • q; ' ' ®i C� )FSUI� �. y: * ,
'.�. tKY - l�%j ,p y N � S. .T,I ": . •, _ . � .
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 1 46.85 46.85 2
Address:
Each add') branch circuit 1 6.65 6.65 2
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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 -
E,• :, ,1'44. °; » , , :;41 .:1~:i, f , , 1,` ,40. 4 *0 t IlOF ;`-.• ; %Ax »i 6i t' °, -+: r j;`y:1'.ew i energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: rr rt Each additional inspection over allowable in any of the above
2700 NE Burton Rd. A Per inspection 62.50
City/State/ZIP: Investigation per hour (I hr min) 62.50
Vancouver, W 98662
Phone: ( 360) 254 -7200 I Fax: (360 ). 254 - 8219 Industrial plant per hour 73.75
;:s,' � . ,.' ,) , '•" 'ELECECRICg;,;;PEItMITOES+ i '''Y; : .... l e :
CCB Lic.: 53136 Electrical Lic.: 37 -4310 Suprv. Lic.: 4322S Subtotal 53.50
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4.28
Printname: Kevin Broselle Date: 8/12/05
• TOTAL PERMIT FEE 57.78
Authorized signature: f< Jr�� This permit application expires if a permit Is not obtained within 180
.c. I/ days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri•County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PermitApp.doc 12/03 440.4615T(10/02/COMIWEB
CITY OF TI ��
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BUILDING DIVISION i L/IZ�. PERMIT #: ELC2005.005.9I
13125 SW Hall Blvd., Tigard, OR 97223 , DATE ISSUED: 0/16/2005
Phone: (503) 639 - 4171 x� i, uiWGI hit ∎
Inspection Requests (24 Hrs.): (503) 639 -4175 .4.4 "III
INSPECTION WORKSHEET FOR DATE: 1/1612007 TIME: 7:09AM PAGE: 44
SITE ADDRESS: 13630 SW MARCIA DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 3 LOT #: 154 TYPE OF USE:
PROJECT NAME: CI11LDERS
DESCRIPTION: Branch circuits.
OWNER: CHIILDERS, DAN PHONE #: 503
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360 -254 -7200
Inspection Request Scheduled For: Date: 1/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message £ AA «^
199 Electrical final 04213E -02 360-254-7200 Y 3 Li ,'M/
Corrections/Comments/Instructions:
e M ql/ / / 1 .41 - (1,(44 /V-- / / / y MI : /// , t‘ 9( ' () di-
...
fr 1 91# ;I
itg.4*
❑ PASS ❑ PARTIAL APPROVAL IrA CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ■ • DDITIONAL FEES ASSESSED
f k‘
Inspector: Date: f(//bhone #: (503) 718-
CITY OF TIGARD l
BUILDING DIVISION PERMIT #: ELC2005 -00581
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639 -4171 itit p l�l �
Inspection Requests (24 Hrs.): (503) 639 -4175 5AJ
INSPECTION WORKSHEET FOR DATE: 1/18/2007 TIME: 7:06AM PAGE: 13
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SITE ADDRESS: 13630 SW MARCIA DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 3 LOT #: 154 TYPE OF USE:
PROJECT NAME: CHILDERS
DESCRIPTION: Branch circuits.
OWNER: CHILDERS, DAN PHONE #: 5Q3- 710 -058()
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360.254 -7200
Inspection Request Scheduled For: Date: 1118/2007 our Time:
Code # Inspection Description Confirm # Contact # s =,:,
to /Irk- )
199 Electrical final 042257 -01 360-2F 200 1 2j R
Corrections /Comments /Inst uctions: ! -0S-8 d
' - old( 1 1 o'i 4 ' 'VG 4 A
C-0 ‘ 7 7_ t i 4-) w ilill
4,
A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CAI Date: 1 18 07 Phone #: (503) 718- 2411/
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELC2005 -00591
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639 -4171 ,,w11y
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_.., F'I �..
INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 109
SITE ADDRESS: 13630 SW MARCIA DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 3 LOT #: 154 TYPE OF USE:
PROJECT NAME: CHILDERS
DESCRIPTION: Branch circuits.
OWNER: CHILDERS, DAN PHONE #: 503 - 710.0580
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360 -254 -7200
Inspection Request Scheduled For: Date: 9J1512005 Pou Time: R
Code # Inspection Description Confirm # Contact # Mes e f 0 !7
199 Electrical final 015617 -01 360 - 254 -720 Y 2
Corrections /Comments /Instructions: The electrical installation defects noted
on this report shall be corrected and
r an ion request made within 20
/ /y calen� p�iQq 11 1 2...._ c _ 9 V gi
5 / 4 -- ce- -- 77 (br7
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p - L_. iilhieke____ I i ill- . .2:Kr aNc---
O // &2 e /p-F.J.Ofrke&pic77-461
=A ∎i Lre/V_ AsAr- De- /0,1-
__ 3yie_____p--:-Ne.z_E___ );4k___ --- ,
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I C; L :1 C ION ❑ ADDITIONAL F ES ASSESSED / C o s--
Inspector: r"A ■f/�I�/ Date: Phone #: (503) 718
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Community Development UI
Building Division • 13500 SW Hall Blvd. •
Tigard, OR 97223
Phone: 503- 639 -4171 T I GARD
FAx TEZANSM TI'AL
SECOND NOTICE
Contractor. Bob's Action Electric
Permit Number: ELC2005 -00591
Owner. Childers, Dan
Site Address: 13630 SW
Date: 12/11/06
This is the second notice faxed to you with regard to the inspection worksheet
attached. The first notice was faxed to you on 8/24/06
The electrical installation defects noted on this report shall be corrected and an
inspection request made with 20 calendar days per OAR 918- 271 -0030.
You are urged to contact this office if you cannot make the required corrections)
within the 20 day limit.
Gary Noble
Senior Electrical Inspector
503-718-2446
Fax: 503- 624 -3681 •
Email: garyna tigard- or.gov
I: \ENGFAX.DOT
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