Permit ,. `�
4 CITY OF TIGARD ELECTRICAL PERMIT
511 PERMIT #: ELC2008 - 00482
: COMMUNITY DEVELOPMENT DATE ISSUED: 8/20/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DB-03400
SITE ADDRESS: 11569 SW SHEFFIELD CIR ZONING: R -
SUBDIVISION: BRITTANY SQUARE NO. 2 LOT : 058 JURISDICTION: TIG
PROJECT: ERICKSEN
Project Description: Electrical grounding for water service.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
STEVEN ERICKSEN METROS BEST ELECTRIC
11569 SW SHEFFIELD CIR P.O. BOX 30075
TIGARD, OR 97223 PORTLAND, OR 97294
Phone: 503 - 579 -6371 Contact #: PRI 971 - 563 -9418
FAX 503 - 262 -8251
FEES
Description Date Amount Reg #: ELE C430
[ELPRMT] ELC Permit 8/20/2008 $66.85 LIC 147298
[TAX] 12% State Surchar 8/20/2008 $8.02 SUP 46195
Total $74.87 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 B i Permittee Signature :,S
,eri 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.
• Rug,20 08 02:23p Casey's Plumbing 5032628251 p.2
'Si ec rica Perirtit It mention ctec- ky'i' .. cr .I
erne pp 'cation . .i:
City of Tigard RECEIV - "I"a�1• !��
I .
r ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review • Phone: 503.639.4171 Fax: 501598.1960 ate/BY: Other Permit:
Inspection Line: 503.639.4175 AUG 2 a 2 0 I D finis
TIGARD ate Ready/By: H See Page 2 for
Internet: www,tigard- or.gov Notified/Method: 77 Supplemental Information
TYPE OF WO CITY OF TIQA PLAN REVIEW
e ew construction ❑ Addition /allerati ld CAl ®'VIS'O Please check all that apply (submit 2 sets of plans w/items checked below):
Demolition I:1 Service or feeder 400 amps or more ❑ Building over three stories.
❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
an 2-family dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
/ y g ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION El Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A "E', "1- 2 ", "1 -3 ",
Job no.: Job site address: l 1 Lo ci J c ' to (� 100HP or more. occupancy.
� / S ix or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: C. c i R ❑ Health -care facilities. ❑ Supply voltage for more than
` (yul 4) c 4 1 2 7 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: Project name: an en./ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total f •
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft. or less 145.15 4
Tax map /parcel no.:
Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. Ft.)
Limited energy, multi - family
75.00 2
C C 0 ("f�vrnIA. N. C •..�C
� �2Y �1�C.XA" a v' residential (with above sq. It.)
�) Services or feeders installation, alteration, and /or relocation
Irk1 \.` e P 200 amps or less 80.30 _ 2
'PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
;V
} C= t.J✓ecks.Q..■ 601 amps to 1,000 amps 240.60 2
Address: 1 \ ° [ - GI ' i c' G .:du- .3z Over 1,000 amps or volts 454.65 2
City /State/ZIP: 1 a t g. ( (�` c 7 - Temporary services or feeders installation, alteration, and /or
�+ t relocation
Phone: (3) J- 1 , Fax: ( ) 200 amps or less 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to400 amps 100.30 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 I 2
Owner signature: Date: Branch circuits new, alteration, or extension, per panel
A. Fee for branch circuits with
)RCAPPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
((��
each branch circuit
Business name: e iv G
'S (.' S C Le 'I ' 1 ' ( B. Fee for branch circuits
Contact name: CSec without service or feeder fee, 46.85 2
_ first branch circuit
Address: 1' eY' � Each add'I branch circuit 6.65 2
+ c,3 ` ' t Miscellaneous (service or feeder not included)
City/State/ZIP: 1 v.- -1-laaff U ', e gq�Z�Lf Each manufactured or modular
�^ / ' / 7 l // a Q dwelling, service and /or feeder 90.90 2
Phone: (qi i) J .1 .� y i s Fax.. (5j Q L t� 2S% 66.85 '85
Reconnect only . � � 2
E -mail: (y +-/J r n ei s Q,(A4"1/\b ‘fl �) • (' C('f 1 Pump or irrigation circle 53.40 2
CON RAC1'OR J Signor outline lighting 53.40 2
Business name: t Signal circuit(s) or limited -
/� Pos=t- E e_c.4vc G energy panel, alteration, or
Address: '- V j�, X ` b+�•.. 1) extension. Describe: Page 2 2
City/State/ZIP: and ,. / � r1 . G t l ) J ' "1 2 LIr
I { Each additional inspection over allowable in any of the above
Phone: .q-1 / h� �7 ) �TTlll��� -. C Lt 1 1 C l Fax: � , n - 'I a~) D ` 1 Per inspection 62.50
Investigation per hour (I hr min) 62.50
CCB Lie.: l y,ZC C Electrical Lie.: C f Suprv. Lic.: £ f 11 ` Industrial plant per hour 73.75
Suprv. Electrician signature, required: � � t 1 1 ) \ - ` `J ELECTRICAL PERMIT FEES
•+ G J ! Subtotal: Li(), 6
Print name: �C 2. Date: Plan review (25% of permit fee): $ - •
�� hT+v State surcharge (12% of permit fee): S. 6 9.
Authorized signature: to i OA r, * ` TOTAL PERMIT FEE: ) L , s',
Print name: 1\1(y( rh kit e((ke Date: /,2,01 b g This permit application aspires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1: 18uilding \PermitslELC- PermitApp.doc 05 /23/06 440- l615T(11 /05/COM1tAVEB
CITY OF TIGARD
BUILDING DIVISION .50-0-- PERMIT #: ELC2008.00492
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/20/2008
Phone: (503) 639 -41711
Inspection Requests (24 Hrs.): (503) 639 -4175 "' � —
INSPECTION WORKSHEET FOR DATE: 8/22120 IME: 7:01AM PAGE: 23
SITE ADDRESS: 11569 SW SHEFFIELD CIR - 741' CLASS OF WORK:
SUBDIVISION: BRITTANY SQUARE NO. 2 1 LOT #: 058 TYPE OF USE:
PROJECT NAME: ERICKSEN
DESCRIPTION: Electiical grounding for water service. .
OWNER: ERICKSEN, STEVEN PHONE #: 503-579.6371
CONTRACTOR: METRO'S BEST ELECTRIC PHONE #: 971 - 5639418
Inspection Request Scheduled For: P - te: 8/22!20 Pour Time: t t...r
Code # Inspection Description Confirm # Conta . Message 5D
199 Electrical final 074509. 1 6 3-' . 4947 ;4 "
O
Corrections/Comments/Instructions:
1%61'4=1 g14%N W i LU kriV$ or N e p ttnq AL t
/ //e∎0I ---;.. - , / • a da.� 0 .
ASS ❑ P.•'TIAL APPROVAL 111 CANCEL El NO ACCESS
❑ FAIL J - e CTION F S ASSESSED Insecto: 411111 Date 2 Phone #: (503) 718
°_?Z'
,. `�
4 CITY OF TIGARD ELECTRICAL PERMIT
511 PERMIT #: ELC2008 - 00482
: COMMUNITY DEVELOPMENT DATE ISSUED: 8/20/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DB-03400
SITE ADDRESS: 11569 SW SHEFFIELD CIR ZONING: R -
SUBDIVISION: BRITTANY SQUARE NO. 2 LOT : 058 JURISDICTION: TIG
PROJECT: ERICKSEN
Project Description: Electrical grounding for water service.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
STEVEN ERICKSEN METROS BEST ELECTRIC
11569 SW SHEFFIELD CIR P.O. BOX 30075
TIGARD, OR 97223 PORTLAND, OR 97294
Phone: 503 - 579 -6371 Contact #: PRI 971 - 563 -9418
FAX 503 - 262 -8251
FEES
Description Date Amount Reg #: ELE C430
[ELPRMT] ELC Permit 8/20/2008 $66.85 LIC 147298
[TAX] 12% State Surchar 8/20/2008 $8.02 SUP 46195
Total $74.87 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 B i Permittee Signature :,S
,eri 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.