Permit CITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2007 -00680
COMMUNITY DEVELOPMENT DATE ISSUED: 10/3/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 DC -13800
SITE ADDRESS: 15825 SW OAK MEADOW LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.11 LOT : 634 JURISDICTION: TIG
PROJECT: HARRIS
Project Description: 1 service, 3 branch circuits.
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: 1 W /SERVICE OR FEEDER: 3 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:
HARRIS, RUTH C ACCESS ELECTRIC & CONSTRUCTION LLC
15825 SW OAK MEADOW LANE 2870 SE 75TH AVE. STE. 108
TIGARD, OR 97224 fieelts OR 97123
f44?.d 4-d1O
Phone: 503 - 648 - 4333 Contact #: PRI 503 - 642 -4333
FAX 503 - 642 -9699
FEES
Description Date Amount Reg #: ELE C -16
[ELPRMT] ELC Permit 10/3/2007 $100.25 LIC 162666
[TAX] 8% State Surcharge 10/3/2007 $8.02 SUP 4931S
Total $108.27 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 thro gh OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: Mei G ip(7- a
OWNER INSTALLATION ONLY " � J
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
10/02/2027 10:25 1 ACCESS ELECTRIC PAGE 01/02
.4 .
' Elect r ical Permit Application 1.0K OFFICE I'. l'SI OBI.\
City Of r1g8A'd � .{ 1 „ .. may, 1 � 0' hg PermitNo.. 7� pia br
IN 4 13125 i25 SW Hall Blvd.. Tigard:. § 223 ` , ' Review
Ili . Phone: 503.639.4171 Fax: • 03a. . • -. • ?a. g ?' - •ate/By. Other Permit
Inspection Line; 503.639.4175 pate Kcady/by: rats; gt See Paige 2 for
T 1 i: A R R supplemental information
Interact: www.tlgard or.gov t J l on? _ N :^ of l ed/Meoltod
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❑ New construction ®Additi�ldflltbn> ot�lsaegrA
_ Pl ease check ell that apply (submit a sets Of plans w /items checked below):
❑ Demolition ❑ Oti',1�, ��• ��n ���rG�� ®j�Y 13 Service or feeder 400 amps or more rJ Building over three stories,
,
. . CA ' O ; CONSFit$ VCUON; ; • ; 1 ` t.: , : • •..• where the available fault current Marinas and boatyards.
• - :;�� : :: =: -:.. _: . exc eeds 10.000 stra at 150 volts or Floating buildings.
--' - " - • ' • • ... ` OO :: :.`,• less to ground, or exceeds l4, Commercial -use agricultural
El I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building a mps for all other installations. I buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 rim pump. b installation of 73 SCVA or
(] Emergency system, larger separately derived system,
JOB 5r1 E . I FORMAc?ION AND 7 0f<A !L OI N ' 0 Addition of new motor load of "A ", "E ", "1 -2 ", "1 -3 ", • • Job no.: Job site address: 15825 SW Oak Meadow La 1 DOHP or more. occupancy.
❑ Six or more residential units. Recreational vehicle parks.
City/State/ZIP: Tt rd, Or 97224 14etlth care facilities. Supply voltage for more than
ty DHezerdoos locations. ' 600 volts nominal.
Suite/bldg./apt. no.: I Project name: Harris 0 Service or thedcreuu amps or more.
Cross street/directions to job site: Deer dry.
- -' _ New reablesalal single- or multi- falrrily dwelling unit.
Includes attached garage. j ,
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft_ or portion j 3140 1
Tax map /parcel no.. Limited energy, residential
75.00 2
• .. • . ' :. ., :.> DESC ONi.'OF WORK ^: -' (with above sq, ft.)
.1 • - • - Limited energy, multi- family • 75.00 2
Panel with three circuits residential (with above sq. ft.)
-f Services or feeders installation, on. and/or relocation _,
A
� 1P 1 �J 200 amps or less / 80.30 : R0.`30 r2
...
•RO E�2TX'�
.ER�: � ...' �. '- r '� �.::• ..., •:::.. :"�•' �. i�_ ?�l�n�> �::.:.':: 201 amps to 400 amps '- ' 106.85 2
Name: Jay Harris 401_amps to 600 amps 160.60 2
601 amps to 1,000 amps _ 240.60 2
Address: same Over 1,000 amps or volts 454.65 '2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or las 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 599 amps i 133.75 2 ,
Branch circuits- new, alteration, pr extension, per panel
Owner signature: „Date: A, Fee for branch circuits with
_. —.._ ..
0 APPLICA.141' . . ..: ' + ;. C81 CONTAGF: PERSON .:, above service or fe e 6,65 2
each b s
Business name: Access Electric & Construction, LLC B. Fec for branch circuits
Kent Zimmerman tt+rrhaur service or feee7oe fcc, 46.85 1 _ r 2
first branch circuit 1 -
Address: ` Each add'I branch circuit 6.65 .1 ""
J Miscellaneous (service or feeder not included) -
City/State/ZIP: Each manufactured ormodular 90.90 2
dwelling, service and/or feeder
Phone: (503) 642.4333 i Fax: : ( 1 Reconnect only 66.85 2
E- mail: Pump or irrigation circle • 53.40 2
• ... . 'CONTRACTOR:' , Sign or outline lighting - 53A0 , 2
Business name: Access Electric & Construction, LLC Signal energy p p a nel .(a l e r limited
, alteration, or
Address: 2870 SE 75 Ave Suite 108 extension. Describe: Page 2 2
City /State/ZIP: Hillsboro Each additional inspection over allowable in any of the above
Per inspection v J 62.50
Phone: (503) 642 -4333 Fax: (503) 642 -9699 JO" i -- l O Investigation per hour (1 hr min) 1 62.50
CCB Lic.: 162666 Electrical Lie.: C16 Suprv. Lie.: 4931S Industrial plant per hour I 73.75 T
. .;' . , ' °:ELECIAC :L :VERMIT FEY:Si ::•.: :::::::.:.:.. .
Suprv. Electrician signature, rrquiretJ Subtotal: /p0. a 7 _
Print name: Kent Zimmerman D : l lose Plan review (25%of omit fee): _
State surcharge (8% ofjpermit fee): ', C
Authorized signature: TOTAL PEkMII FEE: /0 D . a
This permit application expires if a permit Is not obtained witni ta
u
Print name: J Date: days after it bas been accepted as cam.t
' Number of inspections allowed per permit.
1: 113uildina \Permlle\EI,C- PermitApp.doc 05/23/06 440- d417T(11IDS/COM/WEB ,OD A .
°-- 5 e ., o a_
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00680
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10f3120Q7 ,. �
Phone: (503) 639 -4171 i i
Inspection Requests (24 Hrs.): (503) 639 -4175 "' I I
INSPECTION WORKSHEET FOR DATE: 11/7/2007 TIME: 7 :00AM PAGE: 48
SITE ADDRESS: 15825 SW OAK MEADOW LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.11 LOT #: 634 TYPE OF USE:
PROJECT NAME: HARRIS
DESCRIPTION: 1 service, 3 branch circuits.
OWNER: HARRIS, RUTH C, PHONE #: 503-648-4333
CONTRACTOR: ACCESS ELECTRIC & CONSTRUCTION LLC 60Z PHONE #: 503-642-4333
Inspection Request Scheduled For: Date: 1117/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1°9 Electrical final 0591460/ 503 - 680 -9430 Y
Corrections /Comments /Instructions:
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r
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NO6 L--6 Date: 411101 Phone #: (503) 718- Ytit