Permit 1
CITY OF TIGARD ELECTRICAL PERMIT
11 ° PERMIT #: ELC2008 -00348
COMMUNITY DEVELOPMENT DATE ISSUED: 6/18/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125CD-09100
SITE ADDRESS: 07502 SW RED CEDAR WAY ZONING: R-4.5
SUBDIVISION: JACKSON WOODS LOT : 006 JURISDICTION: TIG
PROJECT: RAINBOLT
Project Description: Installing (1) 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:
KEN & CAROL RAINBOLT WEST SIDE ELECTRIC CO INC
7502 SW RED CEDAR WAY 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 245 -5252 Contact #: FAX 503 - 736 -0677
PRI 503 - 231 -1548
•
FEES
Description Date Amount Reg #: ELE 26 - 135c
[ELPRMT] ELC Permit 6/18/2008 $46.85 LIC 13306 •
[TAX] 12% State Surchar 6/18/2008 $5.62 SUP 4654S
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 lawn 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: ` /� KGs Permittee Signature: c "7,/
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.
lib? •a/aV ‘ 1%.141. 1 l.• r
319987 503.598.1960
01 :17:34 06 -17 -2008 2 /2
�� t E�EIV E
i. .
of Tigard ,r ti:, ;.
13125 SW Hall Blvd., Tigard, OR 97 �_ 4. 1 > crmrt No.:
r Phone: 5.4171 Fax: 5
Ins ee :. 03.639
5 Line: 503 Fax: 5 Plan Review
1_
IGAR.D p JUN 17 2008 DateR Su n s . Permit:
r " Internet www.tigard- or.gov
Dare Itcady /By;
NorifiW/Ntcthod; runs: 0 See Page 2
g for
se Supplemental Information
•
TY W ��. OF, e Iki Y; (B ' i
❑ New construction Ii • • dditiort/alte �t IN 7• • r � ' • 11 ' ' : PLAN .REVICIV
Please cheek all drat apply (submit 2 sets of plans w /items checked below);
❑ Demolition Other: Service or feeder 400 am s or mole
P ❑ Building over three stories.
•
_ CATEGORY OR CONSTRpCTION where the available fault current
exceeds 10 amps at 150 volts or ❑ bloating and boatyards.
1 4 1- and 2- family dwelling l ❑ Floating buildings.
$ ❑ Commercial/industrial ❑ Accessory building l ess to ground, or exceeds 14,000 ❑ Commercial - use agricultural
amps for all other installations. buildings.
❑ Multi- family ❑Master builder
❑ Other ❑ fire pump. ❑ installation of 75 KVA or
30B • • SITE INFORMATION AND LOCATION ❑ emergency system.
• larger separately derived system.
— Job no.: [} ''r 7C Job site address: Cq 1 7 ❑ Addition of new motor load of ❑ ••A• "E•" •' 12" •• I
la � � I� eL (2.t �[J C 100HP or more. occupancy.
City /State/ZIP: ca x or more residential units. ❑ Si
/ / C q 7 2 -2 . ❑ Recreational vehicle parks.
i C✓� i 1 O HHealth f reare fncilirics. ❑ Supply voltage for more e than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project name:
1 L vt L,, I / C, ! � (- - ❑ Service m
or feeder 600 amps ur ore.
Cross street/directions to job site: �P r n 6 �.� FEE SCHEDULE
-
Dcscri tins `a
New residential single- or muttl- fii
amm dwe ®nit.
Includes attached garage.
Subdivision:
I Lot no.: 1,000 sq. ft. or less -
145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40
Limited 1
. DESCRIPTION OF :WORK, ;.:`.:...•; energy, residential 75.00
(with above sq. Ii.) 2
l.. /1 �,�p , �. Limited energy, multi - family
z��� residential (with above sq. 0.) 75.00 2
•
Services or feeders installation, alteration, and /or relocation
PROP 200 amps or less
ER'fY :.O1/N> R I 80.30 2
• ! �' 201 amps to 400 amps
Name: hh l .' 106.85 .. 2
._.1�A�1. a ,! N ( It amps to 600 amps 160.60
— 75 - 0 Z / 601 amps to 1,000 amps 240.60 2
Address:
L f IL ' n /' : e. Over 1,000 amps or volts 454.65
City /State/L1P: . _ 2
r �/ - , Temporary services or feeders installation, alteration, and /or
, ) relocation
Phone: (f
ZO S — SL "z I Fax: ( ) 200 amps or less 1 66.85 1 I
Owner installation: This installation is being made on property that I own which is not 401 am 201 amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. amps to 599 amps 133.75 2
Owner si nature: 2
g Date: Branch circuits - new, alteration, or extension, per panel
CANT A. Fee for branch circuits with
...' SI AP PLI
I :[ PERSON above service or feeder fee,
Business name: WEST SIDE ELECTRIC CO. each branch circuit I 6.65 2
B. Fee for branch circuits
Contact name: GLENN GROSSMAN without service or feeder fee, I 46.85 Ci�, 3
first branch circuit % 2
Address: 1834 SE 8" AVE. - Each add'I branch circuit
•
6.65 2
City /State /ZIP: PORTLAND, OR 97214 Miscellaneous (service or feeder not included)
Each manufactured or modular
90 90 2
Phone: (503) 231 - 1548 I Fax: : (503) 736 -0677 dwelling, service and /or feeder
E - mail: GLENNG n EVE Reconnect only 66.85 2
STSIDEELECTRIC.COM j
Pump or irrigation circle 53.40 2
-:-1.,---, :':: : , , : : : . ..i'.;; :! !'::, ;, :,.; ':, •:.' '..CONTRACTOR '.
1 't,^ ?. ' ' ,,,, .' Sign or outline lighting 53.40 2
Business name: WEST SIDE ELECTRIC CO. Signal circuit(s) or limited- -
Address: 1834 SE 8 AVE. i energy panel, alteration, or
extension. Describe: Page 2 2
City /State/ZIP: PORTLAND, OR 97214 Each additional Inspection over allowable in any of the above
Phone: (503) 231 - 1548 I Fax: (503)736 - 0677 Per inspection 62.50 S
_ Investigation per hour (I hr min) 62.50
CCB Lie.: 13306 Irlcctrical Lic.: 26 -135c Suprv. Lie.: 4654S Industrial plant per hour 73.75
Suprv. Electrician signature, required: . • • ELECTRICAL 'PERMIT FEES • i •
0 Subtotal: c../ 6, , 5 : ;
Print name: RANDALL ROBERTS Date: / -�
Plan review (25 °, of permit fee): —'
10 f r • � 5 State surcharge (12% of p ermit fee): -
P ) , ( � Z
Authorized signature:
TOTAL PERMIT FEE: I 5.-.2. ,-./..--7-
Print name: Date: This permit application expires if a permit is not obtained withh 180
— I Z days after it has been accepted as complete.
1 : 11 :tUilding 1 PamitaLC- PerrnitApp.doc 05/23106 I I • Number of inspections allowed per permit.
44 0.4615T(I I /0 /COM/P. ED
CITY OF TIGARD - .
BUILDING DIVISION PERMIT #: ELC200&00348
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/18/2008
Phone: (503) 639 -4171 4y�:i <I
Inspection Requests (24 Hrs.): (503) 639 -4175 r__..
INSPECTION WORKSHEET FOR DATE: 7/1/200' TIME: 7:00AM PAGE: 20
SITE ADDRESS: 07602 SW RED CEDAR WAY CLASS OF WORK:
SUBDIVISION: JACKSON WOODS - LOT #: 005 TYPE OF USE:
PROJECT NAME: RAINBOLT
DESCRIPTION: Installing (1) branch circuit for heat pump.
OWNER: RAINBOLT, KEN & CAROL PHONE #: 503 -245 -5252
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503. 231 -1548
Inspection Request Scheduled For: Date: 7 /1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess
199 Electiical final 072061 -01 503- 231 -1548
Corrections /Comments /Instructions:
4 PASS x rARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
III FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ Date: 7 / / e Phone #: (503) 718- 7-6.17/
III