Permit 1
A r' CITY OF TIGARP ELECTRICAL PERMIT
' PERMIT #: ELC2006 -00439
DEVELOPMENT SERVICES DATE ISSUED: 8/7/2006
13125 SW Hall Blvd., Tigard, OR 97223 '503 - 639 -4171
PARCEL: 2S104BA -05600
SITE ADDRESS: 13760 SW NORTHVIEW DR ZONING: R -12
SUBDIVISION: CASTLE HILL #2 LOT : 089 JURISDICTION: TIG
Project Description: (1) branch circuit for NC unit.
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:
GORDON FERLITSCH GRF ELECTRIC
13760 SW NORTHVIEW DR 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503- 579 -7937 Contact #: PRI 503- 829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 8/7/2006 $46.85 LIC 76751
[TAX] 8% State Surcharge 8/7/2006 $3.75 SUP 16555
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: �u� Permittee Signature: S s7.,c,
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.
Aug 07 06 11:23a Grf Electric 503 -829 -5747 p.1
y •
Electrical Permit Application Receive / �� j R OFFICE USE ONLY /C` l�
Date/By -l) N�l� Pcrmit No.t&d,r al/A i�670
Planning Approval Sign
City of Tigard Date/By: PermitNo.:
N. 13125 SW Hall Blvd. j Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 ,, Post-Review Land Use
lcsr � r , � Date/By: Case No.:
Internet: www.ci.tigard.or.us �,1 ,. � Contact Juri .• ® Sec Page 2 for
24 - hour Inspection Request: 503 -639 -4175 � Name /Method: .// Supplemental Information. •
. • 'TYPE' OF W O R K _ . • . . PLAN REVIEW. (Please aleck ill apply) '' 2 ' . .
0 New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health-care facility
commercial ❑ Hazardous location
A.ddition 1:1 Other: • ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
' CATEGORY: OF:CONSTRUCTION " ' • 1 & 2 family dwellings four or more residential units in
Et I & 2- Family dwelling 0 Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three statics ❑ Feeders, 400 amps or more
0 Accessory Building L • Multi - Family 9 Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan 0 Other
Submit sets of plans with any of the above.
JOB SITE INFORMATION and LOCATION The above are not applicable to temporary construction service.
Job site address: I 'glop ..s1„) n13 tir-iti, ✓ 1 e•✓ FEE!► 5CEEDULF.
Suite #: I Bldj. /Apt. #: 0. -, Number of inspections per permit allowed
:rescriptioe i Qty Fee (a.) Total
Project Name: r 7' S c.v New residential- single or multi- family per
Cross street/Directions to job site: dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 l
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.06 2
Tax map /parcel #: Each manufactured home or modular dwelling
',DESCRIPTION :OF WORK "
service andfor feeder 90.90 2
' � Services or feeders - installation,
I C-4 ;,e K .4 C-- alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 snips 106.85 2
401 amps to 600 amps 160.60 2
ps to 00 a
PROPERTY.OWNER : :1 •T]ENANT : ".' o 1 am t0o0 am10ps nr mps • 2
volts _ 454.65 2
Name: (90r tthe l� Pit 1 / r t S f�/1 Reconnect only 66.85 2
Address: / 37 r , St,t., /Oh i► v ,P..l 0 tom'• Tem p oraryservices or feeders - installation,
-7 alteratlon,or relocation:
'f 66 85 1
City /State/Zip: • ,e1C -- � ? Zz-3 200 amps or less _ 166.85 2
Phone: Q 201 amps 400 amps
`I -, -11_ -7 Fax. 401 to 600 amps 133.75 2
0.APPL CA : NT ` . ` . 0 CONTACT•'PERSON` ,. Branch circuits - new, alteration, or
Name: extension per panel: l
A. Fee for branch circuits with purchase of . 6.65 f 2
Address: service or feeder fee, each branch circuit
B Fee for branch circuits without purchase of l, � � t�
City /State /Zip: _ service or feeder fee, first branch circuit f ' 46.85 ! - 3 2
I Phone: I Fax: Each additional branch circuit t 6.65 2.
E-mail: Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 2
r" . - :ii.' ! - ". _ . :'i CONTRA Each sign or outline lighting 53.40 . 2
Job No: Signal circuit(s) or a limited energy panel,
alteration, Of extension Page 2 2
Business Name: e g L- I t� e- C'_-h.-rr. .� Description:
Address: [ , n p� Y(1 1 4; 4 _,, [4► Each additional inspection over the allowable in any of the above:
City /State /Zip: M /, Of— 17 19 H %- - . Per inspection per hour (min. 1 hour) 62.50
Phone: 51)3 - gy...e} - '-f .--j Fax: 5 •- 8 zi - S 77�yrr-'-] Investigation fee:
`� �o . S I Lic. #: .3 - `f e 4 C. other. 1
CCB Lic. #: � .. - • . - , ` * ; - -. '. .... • . ,
Supervising electrician Subtotal Subtotal S + t , �S ,
signature required: w' � � b i'l fate Plan Review (25% of Permit Fee) S ..-'
Print Name: J0 1 i ti < — .... Lic. #: f 4 5 5 _ State Surcharge (8% of Permit Fec) S
t,
TOTAL PERMIT FEE S' e'" iO
L
Authorized Notice: This permit application expires if a permit is not obtafned within
Signature: Date: 180 days after it.has been accepted as complete.
•Fee methodology sct.by Tri- County Building Industry Service Board.
(Please print name) •
i:lllsts\Permit Forms\ElcPermitApp.doc 01/03
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC200&- 00439
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/7/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/11/2006 TIME: 7 :06 PAGE: 70
atriAl
SITE ADDRESS: 13760 SW NORTHVIEW DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL #2 LOT #: 08g TYPE OF USE:
PROJECT NAME: FERLITSCH
DESCRIPTION:. (1) branch circuit for NC unit.
OWNER: FERLITSCH, GORDON PHONE #: 503- 579 -7937
CONTRACTOR: GRF ELECTRIC PHONE #: 503,329 4146
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # % essag -
199 Electrical final 034t300 -01 503-557 -2220 Y
Corrections /Comments /Instructions:
lip 4*A/ X1`0 *- r
CI Ill'
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GM P. Date: 6 ' 1/'� Phone #: (503) 718- 261-#7/