Permit i .
,;.,_ TIGARD
CITY OF ELECTRICAL PERMIT
T V PERMIT #: ELC2006 -00415
DEVELOPMENT SERVICES DATE ISSUED: 7/28/2006
' „ I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133AD-12800
SITE ADDRESS: 12647 SW SPRINGWOOD DR ZONING: R -7
SUBDIVISION: SUMMER LAKE LOT : oog JURISDICTION: TIG
Project Description: Replace furnace, re- locate NC feeder, GFCI.
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: 2 PER INSPECTION:
201 - 400 amp: 1st WIO 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:
JOHN DRAPER L & K ELECTRIC
12647 SW SPRINGWOOD DRIVE 3540 SE KELLY STREET
TIGARD, OR 97223 PORTLAND, OR 97202
Phone: Contact #: PRI 971- 506 -8351
FEES
Description Date Amount Reg #: ELE 26 -1180C
[ELPRMT] ELC Permit 7/28/2006 $93.60 LIC 157326
[TAX] 8% State Surcharge 7/28/2006 $7.49 SUP 49755
Total $101.09 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. 4,
Issued By: /f
: , /`,0 a ,, 2 _, 1 Permittee Signature: 5..t -t- v 1
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.
JUL -27 -2006 09:40 PM L &K ELECTRIC 5032334920 P.01
/' r r ■
°� Electrical Permit A � 1>Gip V I.1 Ilt 1 tI 11, Il X14 1).\.,1 1
City of Tigard act �6 MI _ ' "m ium
13125 SW Hall Blvd., Ti ard, OR 97223 t t
g JUL 2 ' 200 . ."� D to /B : Other Permit:
:: .1 Review
� �
Phone: 503.639.4171 Fax: 503.598.1960 , , { F { ate/B
Inspection Line: 503.639,4175 . ,j• l a f i { � - Date Ready/Sy; 63 See Pate 2 for
Internet: www.ci,tigard.or.us �11 Y or flu 17 Notified/Method: Supplemental information •
• t?4TA .'*':",Z• ^6.on...,,Ji• %F`5T r'i+ N'i ! "}FtRf 'i'dh.• .AA' i �, . i �f�': , Cn ah . ,+:taxi i#i,c
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CI New construction Ei Addition /alteration/replacement Please check all that apply:
El Demolition [] Other: ❑Service over 225 amps, oomm'l ❑Hazardous location
. t , �,;, ,, ,. "I' ,,r • - ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft„ •
id. „ ,: .r .'. !' 4 - r — T' ) t •C0 1@ ;1 ;', .. :;. „. , of 1- and 2- family dwellings 4 or more new residential
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
Multi-family ❑Building over three stories OFeeders, 400 amps or more
CI y ❑ Master builder ❑ Other:
,; „ ❑Occupant load over 99 persons ❑Manufactured structures or
.5:; : :1E •" '' .r. .u;.< >' • • dam' tt'' ", '-x,SL�7 t. ' 1 ;'.=;,. a le d . , .. �5 , : .,;: ❑EBresahighting plan RV perk
Job no.: Job site address: 12647 sw spring wood drive []Health -true facility ❑Other: ,
Submit sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: r ;
tlneriptlan I Qty, Fee. DAM 1 "•
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage. _
- 1,000 sq. ft, or less 145.15 4
•
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
•ti;� . ....z1" : 2 a :,,.- . •. '" ''''', 's , t" , .- • i.,L 'Each manufactured or modular
Connect new /replacement furnace, Re locate A/C feeder, GFCI receptacle dwelling service and/or feeder _ _ 90 - 2
Services or feeders installation, alteration, and/or relocation
200 amps or less ( 80.30 eb 2
. : 1'a ; r 1' i ` mulkiki u : s ' 4 ' .. 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: John Draper ^ 601 amps to 1,000 amps 240.60 2
Address: 12647 SW Spring Wood Drive Over 1,000 amps or volts 454,65 2
Reconnect only 66.85 2
City/ State/ZZIP: Tigard, OR 97223 Temporary services or feeders Installation, alteration. and /or
Phone; (503)579 - 4042 I Fax: ( ) relocation
200 amps or less I 66.85 1 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
: % 1 t :? I s , 1 01Mi • " I lr 7Li 4'` a .`r; • . A. Pee for branch circuits with
service or feeder fee, each
Business name: L & K Electric, Inc. branch circuit Z 6.65 1 3 ,36 2
B. Fee for branch circuits
Contact name: Larry Peterson without service or feeder fee, 46.85 2
first branch circuit
Address: 10122 SE Shady Lane Each add'I branch circuit 6.65 2
City/ State/ZIP: Gresham, OR 97080 -8604 Miscellaneous (service or feeder not Included)
Phone: (971) 506 -8351 I Fax: : (503) 663-0343 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
En s , gM ;T , i . � , _AiA° L l ,,: :. , .. _.. energy panel, alteration, or
extension. Describe: Page 2 2
Business name: L & K Electric, Inc
Address: 10122 SE Shady Lane Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Gresham. OR 97080 -8604 Investigation per hour (I hr min) 62.50
Phone: (971) 506 -8351 Pax: • (503) 663 -0343 Industrial ,rant • hour 73.75�•y�
, .' .'. :, • .tii 4� ice" .1 -? .::! `i" .' . + t 1;:w .it.. h_' . ;;. ":.7',,r .' .
CCB Lic.: 157326 Electrical Lie.: 26-I 180C Suprv. Lie.: 4975 S Subtotal Q3 t 0
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Date: 07/27/06 State surcharge (8% of permit fee)
Print name: 7. � �
I, TOTAL PERMIT FEE /0
Authorized signature This permit application expires if ■ �- p' permit Is not obtained within ISO
days after It has been accepted u complete
Print name: a,J Date: 07/27/06 • Pao methodology eel by Tri- County I:balding Industry Service Board
"
Number of inspections per permit allowed.
0BWldln4 \Pannit,\ELC•PermitApp.doo 12/03 .140.46 I iT( I WM/COM/WEB
CITY OF TIGARD - ,
BUILDING DIVISION PERMIT #: ELG2(1060041r
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/28/2006
Phone: (503) 639 -4171 AwNiceit
Inspection Requests (24 Hrs.): (503) 639-4175 ,-.4.11-___ '1....
INSPECTION WORKSHEET FOR DATE: 8/2/2006 TIME: 7 : 06AM PAGE: 70
SITE ADDRESS: 1 2($47 SW SPRINGWOOD DR CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 009 TYPE OF USE:
PROJECT NAME: DRAPER
DESCRIPTION: Roplace furnace, re- locate NC feeder, GFCI.
OWNER: DRAPER, JOHN PHONE #:
CONTRACTOR: L & K ELECTRIC PHONE #: 971 - 506.8351
Inspection Request Scheduled For: Date: 8/2/20Q6 Pour Time:
Code # Inspection Description Confirm # Contact # M sage '4` .
199 Electrical final 034059-01 971 - 506-8351 Y V\t
Qorrections /Comments /Instructions:
v 90 �r/e a: f � � y
et r
►; PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CM!? Datex'Z - 0 Phone #: (503) 718- Z �pG /�