Permit •
4. CITY' OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00376
:. COMMUNITY DEVELOPMENT DATE ISSUED: 6/27/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S109AC -06200
SITE ADDRESS: 13346 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT : 030 JURISDICTION: TIG
PROJECT: KHUU
Project Description: Circuit for A/C
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: SIGNAUPANEL:
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:
SYKIET KHUU GRF ELECTRIC
13346 SW NICOLE LN 15460 S PARADISE LN
TIGARD, OR 97224 MULINO, OR 97042
Phone: 503 - 608 -2868 Contact #: PRI 503 - 829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 6/27/2008 $46.85 LIC 76751
[TAX] 12% State Surchar 6/27/2008 $5.62 SUP 16555
Total $52.47 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: � . - � M 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.
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Jun 27 08 07:57a GRFELECTRIC 5038295747 p.1
e
), �� Pi)R 1.t1.1•I, I' I s4 011,
F ectrical Permit Application
of Tigard G� �.�� i t�era;tNio. :. _ t — d0 3
13125 SW Mall Blvd., Tigard, OR c ) Plan Rtviaw 1 Otto Puma:
Phone;: 503.639.41 Fax: 503 6 0 `\w Ct 1 L• • ,Datc/B : We: a Sea Pate i [oe
In
r i c • , ., t.: i Insprction Line: 503.639.4175 V1 IR Sea Pate I woman= womabrunet w,ww.tigard- or.gov J
WO v' .103%. `
V` J. PLAN REVIEW ebeeladOeMw .
TYPE OF �\ Floor: d,mt an that apply 4ubAit):tnv of W wWixom 7
^ 0 New eotls{tOGti0n Other: 1
' . ❑ s Mae at feeder loo Amps or more D bias rivet duet stories
CI Demolition ❑Other: 1 11 ✓ � "`'"
where the mantle fi tantao( Olden= and aoaq> rd+
•
' CATEGORY OF CONSTRUCTION accede MA.0o0 maps at 1 S0 rolls or Mariam builCiaga •
■ leis to palate, or exceeds 114000 13 Comm are
aeial - Wellborn
aa4 family dwelling ❑ Comm ercialrin4usQ ❑ Ac ccsSOry buil ding amyl rocrvother iamllattion, 0l of r Icon
❑Multifamily ❑ Master builder ❑der ❑9ity wart.
O F;aireenev , nano. Urge: separately derived swcm.
]OB S377i: 171FORMATIQI. AND LOCATION O Addition aceo�a.
_ �,/� ^ 1 icon? es mate.
fob no.: Lob site address: / 3 3 t• S( 4 ) (V 1 6,4 to O Sim or mote ratidntar voile. 0 Recreational wehiela parka.
D �Pb vohnas [or more than
❑N ( micas . 600 vale/ nominal.
City/State/ZIP: - / e , y ,.. C► 72'i- `^t . C In ame d mu c (ao lion
J name: L 08avix [cedar 600 =Os DI amt •
SuiWbldgJapt no.: j f I2c.t FEE SCHEDULE
...w. Dnrrvion 1 on. T _vs. I Tau. 1
Cross saect/directlwLS to job Site: New residential singlet or moil - nattily dwelling unit.
Includes attached gage.
1.,000 sq. R or lest 145.15 , 4
Subdivision: Lot no.: I
Ea. add'l 500 sq. ft. or portion 33.40 • Tax maplparcel no.: Limited energy, residential 75.00 2
DESCRIPTION Of WORK (with show s�lL1
Limited cagy, multifamily 75.00 2
I 6 4'y A-.. ^ } f residential (with above sl it)
e. v Services or feeders twteliatine alleratioa andlor relocation
200 amps or lest 80.30 1 2
iKPAOYF.RTX OWNER ❑ 203 cw400air 10685 2
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401 amps to 600 amps 160.64 2
Name: r �- � L! U 601 sups m 1,000 amps 240.60 2
/ 3 3 < < _S ( 4 6r ) r � � G L In `
Address: Over 1.000 amps or oohs 454.65
Temporary services or feeders inavpation, al teradosa. a od/ar
City /5tatcrint �/1'l�� -1;7'
relocation
amps or tag 66.85 L
Phone: ( ) � b Z ( Fa ( ) 201 amps to 400 amps 100 .30 1 2
being made out property that 1 own which is oat 133.75
2
This installation is be prop amps s g to 599 p
Closer for sale, le The 670, and 701. 401 amps i I
intended for sale, lgtt9e. rent, or elccttange, according to ORS 447, 449, Branch circuits— new• alteration, or extension. Leer Par el
QwttCT signature: Date: A. Fte Re branch circuits with
Q APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6 1
each branch circuit I
Business nom: D. Fee for branch circuits
w s ervice or fe eder fee I
1 46.8 L105 2
COWS= name: first branch circuit 2
Each add'lbranch circuit 6,55
Address: Miscellaneous (service or feeder not included)
City/State/LIP Eaeb manufactured or modular 9290 2
dwelling. service andIor feeder 66.85 2
Phone: ( ) l Fax: : ( ) Reconnect only 53.40 2
E-mail: Pump or irrigation circle "
Si •. or outline lighting 53.40 2
CONZRAClOR panel. al r
A Signal dreunts) o rariWelled -
Business name: 6 E l- 1 P !' �'l�t l energy o oq 0r
Page 2 2
extension. Descrtbc:
Address: I �I'Cv a S . P Yid rit'.l�iR �
Each additional Inspection over allowable io any of the above
City/State/ZIP: 11 , w , 7 Per pi 6250
P b ( (��i b LCi • r. C.1.. co Fax: ( ) L.: - r 1 Li- _ Investigation per hoot (1 hr mill 62.50
1 ? —n Indusvisi plant per hour TT 73.75 ,
CCB Lie.: (y f I Electrical Lie J— ir* (� �7 ELECTRIC-AL PERMIT TEES •
Sultry. Ekettician signature, required: 3�" .
�
_ l Suprv. Lic,: Subtotal.
s Z1 ri f Plan review (25% of permit feet ,
Print Mme W t f 1 lit lot � ir i Y v t Date l �j Maw surcharge (12% of permit fee):
TOTAL PERMIT FEE: 'j ( '
AtafhCKt signature: TYu penile application spine. Ira permit u are t au: within tall
Pint name: [DLitt: days after it had trees templed as compiere.
• %unb r of inape tons sltnwe i pia permit.
11awi1diatYoroluWLGPvaisMPMs 0117+06
. •..ssa.allsTttl/Oa+GOM1►VES
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00376
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2001
Phone: (503) 639 -4171 Alike
i l l
Inspection Requests (24 Hrs.): (503) 639 -4175 /' tr—
INSPECTION WORKSHEET FOR DATE: 7/3/2008 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 13346 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 030 TYPE OF USE:
PROJECT NAME: KHUU
DESCRIPTION: Circuit for NC
OWNER: KI-IUU, SYKIET PHONE #: 503- 608 -2868
CONTRACTOR: GRF ELECTRIC PHONE #: 503 - 4146
Inspection Request Scheduled For: Date: 7/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072168.01 503. 680.5116 Y
Corrections /Comments /Instructions:
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S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7 — 3 Phone #: (503) 718-