Permit CITY OF TIGARD ELECTRICAL PERMIT
111 ' PEIT #: ELC2007 -00025
COMMUNITY DEVELOPMENT DAT ISS UED: 1/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BD -02000
SITE ADDRESS: 11795 SW SCHOLLWOOD CT ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.2 LOT : 108 JURISDICTION: TIG
Project Description: (1) branch circuit for heat pump. Job # T32543.
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:
KEN & JODI BROWN WEST SIDE ELECTRIC CO INC
11795 SW SCHOLLWOOD CT 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 590 -9543 Contact #: FAX 503 - 736 -0677
pRI 503- 231 -1548
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 1/10/2007 $46.85 LIC 13306
[TAX] 8% State Surcharge 1/10/2007 $3.75 SUP 46545
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: �� ��r - � _ � Permittee Signature: S >� Pf\n
`
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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Electrical Perm t Nii. on . FOR OFFICE USE ONLY .
City of Tigard
OR 1 Received i .. .... , /ti A..._ ' ,..
1.,
.„,„,m)., . 01-00
_ -__________041_
I 1125 SW 1 lall Illvd.. Tigard. 97' N 1 200 1
liA )..!..ior../....
ph...J..,
l'illItIV: 503.09A 171 1:os: 503.398.1960 • Other roemii:
Maim:Lion Line: 50).039/117 , • 1 . y O DM - jl 'All,, or) jj. -iirke„dyjiiy: . .___ .____. ... . . . ....
.... 4 ° 11, ...,5- ffel See Page
liiioroet: www.M.tigartl sirms tat' . .
Nutilied/teletlind: hopplanummllelormaime
-......... -
Wp WOR -ralnSL ' . .. ._.. -- .. . ..___-__.._._. . .. .. - ... ....- ..-
311;11_!! ' P K PLAN REVIEW • ...- .- -- _ _.__ .. ,
[:1 Ncw cot1S11114.0011 1 dd i I ion/al teration/replaccoien ( Please check all that apply:
IlSei vier! over 225 amps. cumin niluzu,,,,„,.1,..i„„
fi De....titi. n Other:
...-______-._ .. ..... _ _____
• ., . . ElServicc ()M. 320 amps.-- rating El 'wilting OW 10.000 1 rt..
CATEUORY 01: coNsTRucrioN of I- taut 2 family dwellings 4 or more new lesidclotai
I - ;11 Idly dwelling • [l c „
:„ i.v ACeessuiybuilding • - aiystrio uvcr 600 volts lioniiiiiil unite ill um aimetutc
I 1 tYlulli r Masier builder 1 Other: Oltuilding over three stories riFecilers, 400 amps or inta e
• • -- - pOccupatit load over 99 pelsons 0Manufacturcd strUallIt'S 01
• ._ _. J01.1 Sil INFORMATION AND LOCATION 1:11igiviz/liglit illy. plan IW park
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Job no.:352 1 Jul) iT 1 (
. . Submit _7,,_ sets orphans with any of the above.
City/Slaw/7.1P: 1 Cid_ _ _4_7. 2 Z 3, The above arc nut applicable to temporary C1)11411111;0011:i1AVICe.
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. • SCUED
Ntillcib144,./apt. no.: 1 PrOjecr name: 0 i /17 k ...... 4 C -
FEE*
. . 1/escripitos I ULE Q.y. I Pee. I
Cross streclidireetions to job site; New residt;11,;1singl t--;;niulii-Iamily dwelling
" • •-• • - ---- Ineluditt a melted gontue,
1,000 s.i. 11, ur less 1 •1
_ _ ........ ___- . . .. . ... . ..._ ___ ..._
SubdiVitlion: Lot no.: La. add'I 500 so. It. or 'Melina DA 1
- . • •" •" Limited wow, resideittial 75.00 -1
-
Tax tilap/pdrcel no.: • •••-••• • ••-•- -------
- ----. ..- .. . . limited energy, in 75.00 2.
DESCRIPTION OF' WORK Each riatinifactured or modular _
- .. .. .
dwellitilLservice and/or feeder 90.90 ?
vvl e gervic,v, or fcrtlery installation, alteration, aud/or relocation
200 amps or Its 80.30 2
_____ .. .... . . . .
V PROPERTY OWNER I
CI •I'ENANT _ .
" 201 :Mips to 400 amps
---• -••• • ••• --
• ••
401 amps to 600 amps 106.85
•- - - • - •••----- --
160.60 2
. . ....__ ............ _ ___ ......
Name; Ile?, (An 31110.% lo I (1(X) 90111S 240.60 i
- - - • • •• • • -- • -• - 24= -......' '
Adt.il C:;S: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 -,
•
C:ity/Stutt:R.IF: •
Temporary services or feeorrl installation, alteration, a ndior
-
relocalion
Phtutc: ( So-) -e'i O 4 1 545 i Fax: ( ) 200 amps or less 06.85 I -
. . ... r...." ..... _ _ __ • ..._ _ _.... .. . ... . ._. ..... , _
Owner installation: This installation is beini., made on property that I own which is not 2W amps to 400 amps - I 1 11 ------ -- 2
iillendetl lin sale, lease. ;ern, or exchange, according to ORS 447, 449, 670, and 701.
I:67i; - .---- -. - • "
401 amps CU 600 :owe 2
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OWIlif signature: Dale: Ilranch l'ill*Ctlit- II
S CW, alter n
atio, or extensiou, per panel
• . ... ....... _____ _ ____-
0 APPLICANT I 0 CONTACT PERSON A. Fee for branch circuits with
---- --------------- -- • •- • • - V.:1 or feed trr AT, ll:11
6.65 ,
l...{11fiillCSS fizone; brunch circuit ..._. ...
Compel name: without service or feeder Ice,
I 46.85 Lic..g5 ,
. ....... ..... . ._. . -
each branch circuit
AdtireSS: -
Fitch ■Kitrl branch circuit 0.65 .1
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City/State/ZIP: Miscellaneous (seroico or feeder not it ellidorll
- -
Pump or irrigation circle 5.1.40 '2
Phone: ( ) Vax: : ( ) . . .__ ,_____ ........._ _ ..._____
Sign or outline. lighting 51.40 2
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1.;-1)1;61: Signal circuit(s) or limited-
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CONTRA( rrou energy parte!. altenniost, or
• extension. Describe: Page 2 2
13usincss mune: West Side Electric Cu., Inc. •
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Address: 1834 SL 8 T11 AVE. Each additional inspection over allowoble in Oily of the above
-• -. •--... - --
- pa 1nspection - 62.50
.
City/SI:tie/ZIP: PORTLAND, OR 97214 investigation per hour (1 lir 11611) ...... 62.50 ..
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Phone: (503) 231 Fax: (503) 736 Industrial plant per hour 73.75
F.I.F.C.TRICAL PERMIT PUS'
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((Is Lie.: 13306 [ lilectrica ' .• 26-135C :upry ! : . - 654 . . Subtotal 14 3 ;
Soprv. Electrician signatun; rcyair • . . --.
, ..4 /.ii < 7-N ( __
. L ' ";_ oft-- .__... .... Nn vi
u ft w (25% of permit (CL)
State surcharge (8% of pet • ( cc)
_ 3:7 5
Vrint name: r ... , II , / ,.... _,.., DaItt:
. ... . i C (
( i 40
__....... . . _. . .C.4...` 0. _ . .. ...t* . 'e %. >, TOTAL 11 FEE
, Z
Atiihnii/cd signature: ' TialiTre;;; niealinn expires if a permit it nut ubtairied within ISO
• • - • • - . . • • -- - • •••• - •
r . ---- •• • • •• • - • • • - • a.y tatoe le lots Itc a e
eu ccpted as complete
Prim name:
• • • - . . Dlte• . • Fee Mcdt0(143Ingy NA21 by Tii-Couniy Bowing Industry Service hoard
.. -. .. I... .. . -- " Number of impectious per peimit allowed.
i WeilJeerenims11:LC-ProuilApp due I2/03 440401 ST410102/COM/WW)
2 d 1.1.90 -9E1. 1 EDS) *03 oT....moa/3 apTs 2sam eL2:0I LO 01 uer
CITY OF TIGARD -
BUILDING DIVISION • PERMIT #: ELC2007 -00025
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '' •.
INSPECTION WORKSHEET FOR DATE: 1/16/2007 TIME: 7 :09AM PAGE: 45
SITE ADDRESS: 11795 SW SCHOLLWOOD CT CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.2 LOT #: 108 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: (1) branch circuit for heat pump. Job # T32543.
OWNER: BROWN, KEN & JODI PHONE #: 503. 590 -9543
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503 231 - 1548
Inspection Request Scheduled For: Date: 1/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 042137 -01 503 - 231 -1548 N
Corrections /Comments /Instructions:
1 q i tA/t4 d yiu
((l
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: /i b / Phone #: (503) 7182 /4"