Permit r;, . CITY OF TIGARD ELECTRICAL PERMIT
°
. --- 1 PERMIT #: ELC2008 -00411
0 COMMUNITY DEVELOPMENT DATE ISSUED: 7/18/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104AB -08500
SITE ADDRESS: 13439 SW SCOTTS BRIDGE DR ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 5 LOT: 114 JURISDICTION: TIG
PROJECT: SMITH
Project Description: Installing (1) branch 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:
BETTY JO SMITH ELECTRICAL SPECIALTY CONTRACTORS
13439 SW SCOTTSBRIDGE DR PO BOX 2853
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 - 590 - 1968 Contact #: PRl 503 - 723 -0371
FAX 503 - 656 -4537
FEES
Description 'Date Amount Reg #: ELE C126
[ELPRMT] ELC Permit 7/18/2008 $46.85 LIC 168161
[TAX] 12% State Surchar 7/18/2008 $5.62 SUP 15585
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- 01012_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: 2 % fialcZQV `"
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.
'! ,., ,
Electrical Permit Application rot: ( ) N I OFFICE ) vl.Y
1 �� City of Tigard C E ICW Permit No.v 13125 W 'OR 9
�-�i� • ft Phone: 503,639,4171 Fax: 503.59 1Q Dal& Bye Other Permit: /'/ .: — '3 6
T I G i1 R D Inapcclicn Line: 503.639.4175 !)ate Re al ylDy: runs Sec Pope 2 for
Internet: www.tigprd- or.gov 0.' r milled/Method: Supplemental Inform nrina
1"Y .
❑ New construction 53, Addition /alterdtio lit Hulse check all That apply (submit 2 sets'trillans w /hums chucked lxhnv);
Demolition ❑ Oilier: $ ❑ Service or feeder 400 amps or more ❑ !landing nets three spores.
wham tlte:wniinbk Null current ❑ Marinas and bontynrds.
• . • CATEGORY OFrCONSTRIJt: TfON • exceeds 10,000 amps at 150 vonL% or ❑ I +hlatiug huikliuga.
less to ground, or nxeeoiL+ 14.000 ❑ t:nutnecrcpal -use agrie
1'./ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building I;em fnr all nailer iiir+ailrimis, buildin'pS,
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump, ❑ Installation of Fa KVA or
❑ Emergency system. larger separately derived system. ' ' ;JOB SITE INFORMATION AD
NOCATIION: •
. :.'.... Addition newmorlandof ❑ •'A' "P."1 , .I - t'
. ❑ Addit r motor
Job no.: 1oh site address :1 A / . I, ,.
lnotlr or more. Y„ patty.
11� SW
IA_ P. II it _ ... L . ❑ Six or more residential units, ❑ Recm:dioto vehicle parks.
City/State/ZIP: ` a ❑ Health -care facilities, 1:1 Supply voltage far mpre than
ajr a .
0 Flaeardoua locations. (100 volts nominal.
Suite/bldg. /apt.no.: I Project name: c 0 Service or feeder 600 amps ormom. .
: ; ,...'..:': : II'EE .:SCHEDULE '
Cross strect/directions to job site 'men ,Iwo ., __.. • 1 Qty. I Fee: — (_rant 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. It, or less 145,15 — 4
Ea. adtf l 500 sq. II. or portion 33.40 I
Tux Imp/parcel no.: ,
Lim (with ;glove sq. )id
enlial 75.00 2
Limited energy, multi- family 75.0(1 2
residential (with above so. 0.)
Services or feeders Installation, alteration, and/or relocation
200 amps or leaa 80.30 2
..-
•• PROPERTY OWN,Eli • .. 0 ',:TENANT.. : : _:•.::: 201 amps to 400 amps _ 106,85.... 2 ..
Name: 401 amps to 600 amps 160.60 2
(.0! amps to 1,000 amps 240,60 2
Address: Over 1,000 amps or volts 4.54.65 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or Icss - __ 66.85 —Q
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1IN1.30 2
intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps ■ 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits tvil/t
f
APP . .
LICANT .. • - . .....Er :CONTACT; "pEltSON :, : ;:: above serv or foxier fee,
each branch circuit
Busines rlatttc: li. Fee for branch circuits
wil/tnn service or feel.k fee, 46.85
Contact name: , •
_. first brunch circuit_ .._.... o r!. • 4
Address: Each add'I brunch circuit 6.65 2
Miscellaneous service or feeder not included
City/State/ZIP: F.neh manufactured or modular 90.90 2.
dwcllin - service and/o feeder
Phone: ( ) Fax:: ( ) .... _. r
_ Reconnect only IIM 66.85 —
E - mail: Pump or irrigation circ l a 53,40
CONTRACTOR .:::.. Sign or outline li ttin; 53,40
1e /lam rid Gpedi n nt /1U I I ,,,, 1 Signal citauil(s) or limited-
Busintxs name: E tiff VLF • e .0 tAJL t..Y/7 XL- energy panel, alloutiun, or
Address: P.O. ib.oX, x$5 extension. Describe: Page 2
City /State/ZIP: , ri 0 • 97046 Each additional iris' etion over allowable in an of the above
Phone: D ) '-7Z . . 6 -7 Fax: (S05) L1 '' 1
Per inspection 62.50 --
l Investigation per hour (I hr mitt) - 62,51 --
CCB Lie.: I log) wl Electrical I .: Cf . s y , Suprv. Lie.: I rd's Industrial plant per hour 73.75 � -
Suprv. Electrician signature, required: . • . . .'.•E L L��
G !ER IIx.:FEES R '
L / . L Subtoro
Print name: A J Li ft/ / ' , a10: -7, e
Plan review (25% of pennit fee):
, ( � Stott surchar a (12% of ptamil fee): .
Authorized signal re: / TOTAL PERM fI'! k'I:: / I
_ AL , J o' `
Print name: r Thin permit application aspires Ira permit Is not ohlnined within ISO
.rd
CI Date: �' 7. II d days after It has been accepted as complete,
° Number of inspections allowed per permit.
I:i anirdirO'cnilsELC.PemilApp.-. v;vn( 440 .45Sit11n VOM/wlin
Z iz # O96L86S605 f ZIr: -L1, -LO
CITY OF TIGARD - -
BUIL - DING DIVISION PERMI C k 4204 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 � l i
Inspection Requests (24 Hrs.): (503) 639 -4175 ./- IL.
INSPECTION WORKSHEET FOR DATE: Z S og TIME: PAGE:
SITE ADDRESS: / 3-€7 7 en4 O / CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: ' TB (_____ rD 4c
OWNER: /W ' E- 7Y � PHONE #:
CONTRACTOR: � PHONE #:
Inspection Request Scheduled For: Date: Pour ime:
Code # Inspection Descrip ' n Confirm # Contact # M- -sage
_
IT 9 EX-et-T /C 4L__ _ 0 3 zs-
Corrections /Comments /Instructions:
, / 7 .3-
PASS ❑ P' ' IAL APPROV , ❑ CANCEL ❑ NO ACCESS
FAIL A LL • INSP CTION II ADDITI• AL FEE - ASSESSED
Inspector: , _ Date: Z"S 1 Phone #: (503) 71.8. .),g)
CITY OF TIGARD '
BUILDING DIVISION PERMIT #: ELC2008 -0t 411
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED 7/18/2005
Phone: (503) 639 -4171 Au III
Inspection Requests (24 Hrs.): (503) 639 -4175 ":- .
INSPECTION WORKSHEET FOR DATE: 7/24/2008 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 13439 SW t3COTTS BRIDGE DR CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 5 LOT #: 114 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIPTION: Inf:talling (1) branch circuit for NC.
OWNER: SMITH, BETTY Jo PHONE #: 503-590-1968
CONTRACTOR: ELECTRICAL SPECIALTY CONTRACTORS PHONE #: 503723 -0371
Inspection Request Scheduled For: Date: 7/74/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 073131 -01 503-557-2220 Y
Corrections /Comments /Instructions: O; 3 2- ,
• P At) ,ik ;4,42 Li d)r• C ; � fee A�rr�e / - t
5
,Pc-0_ h d- A/c sco4 §fr pone /
j e c - a& HO - 2 1
0 Suppori1. PVC- e 3r 4k 35O.3DCV
MG - Le cia y c _
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
'FAIL -'LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: kel44 Date: --2_ 9- - 0 Phone #: (503) 718-