Permit A.. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00622
4 DEVELOPMENT SERVICES DATE ISSUED: 9/28/2004
,,� mI 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136CA-05800
SITE ADDRESS: 07700 SW SPRUCE ST
SUBDIVISION: SLEEPY HOLLOW ZONING: R -25
BLOCK: LOT : 006 JURISDICTION: TIG
Project Description: 07700 SW Spruce A & B, reconnect only.
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: 2 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TYLER, JOYCE L HATTERAS CONSTRUCTION INC
2393 SW PARK PL #212 2131 GOODALL CT
PORTLAND, OR 97205 LAKE OSWEGO, OR 97034
Phone: Phone: 503 - 699 - 8758
Reg #: LIC 116793
FEES
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 9/28/2004 $133.70
[TAX] 8% State Surcharge 9/28/2004 $10.70 Elect'l Final
Total $144.40
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: Permit Signature:
•
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:
CONTRAFOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: , C - - —
- - — — - DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application FOR OFFICE LSE ONLY
Cif of Tigard Received Date/By: Permit No.a -
C16 g
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 it 'J+ . v Date/By: Other Permit:
Inspection Line: 503.639.4175 '! � � Date Ready/By: runs: 0 See Page 2 for
Internet: www ci tigard or as Notified/Method: Supplemental Information
TYPE OF WORK li PLAN REVIEW
❑ New construction 4ddition/alteration/replacement Please check all that apply:
❑Service over 225 amps. comm'I 0 Hazardous location
❑ Demolition ❑ Other:
OService over 320 amps – rating ❑ Buildng over 10,000 sq. ft..
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
CI Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family 0 Master builder 0 Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATIO ❑ Egress/lighting plan RV p
Job no.: Job site address: 79a0 S. e S ❑Health -cart: facility ❑Otter
Submit 2 sets of plans with any of the above.
City /State/ZIP: T SCHEDULE
02 9 al-' 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: / �/��} ' Project name: % 3 / J - al • / 1 1.42)c Description 1 Q7• + Fee. I rota! I ••
Cross street/directions t job site: 5' l � l •- •'}-k A /s � L� New residential single- or multi -family dwelling unit.
Includes attached garage.
1.000 sq. Il. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 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
DESCRIPTION OF WORK Each manufactured or modular
t'
dwelling, service feeder 90.90
1� -0� .mil 2
1'.�ir` Q— O� Y...415 Y...415 r� k.....) Services or feeders installation, alteration, and/or relocation
S `C t \ 200 amps or less 80.30 2
.PROPER \bNER I 0 TENANT
201 amps to 400 amps 106.85
( 401 amps to 600 amps 160.60 2
Name: -E L �\ 0 --,- i I ezr_ 601 amps to 1,000 amps 240.60 2
Address: e a 39 3 5T E p c ,„.... t o 0. #0q. i c a , Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
l
City /State/ZIP: Q\ l 0. e 0 2 9' '"? CZD S Temporary services or feeders t ion, alteration, and/or
Phone: (3) as 3 SIS? S' I. Fax: ( ) relocation
200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
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
a APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
• service or fader fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: �� `1 J v �� without service or feeder fee. 46 8
` a 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
rr / Pump or irrigation circle 53.40 2
Phone: + /�I�. ' J�' Fax: ( )
�' Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel- alteration, or
/ i extension. Describe: Page 2 2
Business name: 7 /� /F Cp,,e\c. �� r�
Address: I / Each additional inspection over allowable in any of the above
Per inspection 62.50
Ci /StattJZlP 5 / Investigation per hour (1hrmin) 62.50
22 RI
Industrial plant per hour 73.75
Phone: 7 �, ` b 74/ _ f� / 3s-
iLECTCAL PERMIT FEES*
0,,, / CCB Lic.: J/ 99,3 IE 3 lectrical Lie.: Suprv. Lic.: Subtotal � - 7 D
IG
Suprv. Electrician signature, required: Plan review (25% of permit fee)
– -- �— Slate surch.ugc (it%u n
l Ice) / /- 1 0
nl
Print Hae: l n ` ,Y , c) Date:
TOTAL PERMIT FEE /q9, ti 0
v Authorized signatur - This permit application expires if a permit is not obtained within ISO
0 / �
_ days after it has been accepted as complete
c) Print name: Date: 9 ' O y • Fee methodology set by Tri•Count} building Industry Service Board
/ •• Number of inspections per permit allowed.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (5(i3) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
c.� BUP
Received Date Requested / ° AM PM BUP
Location 7 7 19 Suite 17 f 13 MEC
- -6ontact Person Ph ( 1 PLM
Contractor Ph ( ) SWR L L
BUILDING Tenant/Owner ELC O) 1 - e 0 6 ZZ
Footing
ELC
Foundation
Ftg Drain Access: ca �ci't _ ' ( ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation c ) N G C1 � (� \A C 3 0 \/\ V 1 5 L�
Drywall Nailing `ct
Firewall Fire Sprinkler % � �0 �'��1` L T 1 6 �` y� 1'I p' IiYIG� �� ' U<<(-
Fire Alarm. `W\ C Nj C.-10V \� (Y\ i\s1t - i 1 N v Veb11 p�
Susp'd Ceiling p //�� j 1
Roof w l� J � ` 2 v ►tv� v £ G v\3 5 1.-bP Dc (.7D
Other:
Anal U♦
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service j [ -
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain - (
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Rough -In
UG/Slab
Low Voltag
Fire Alarm
PA S PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA f
Approach/Sidewalk Date / / � - Inspector t Ext
Other:
Final DO NOT REMOVE this Inspection record tCom the job site.
PASS PART FAIL
•