Permit cyl , CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY PERMIT #: ELC2007 -00668
OMMUNITY DEVELOPMENT
DATE ISSUED: 9/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DA 01700
SrTE ADDRESS: 11067 SW SUMMER LAKE DR ZONING: R -
SUBDIVISION: AMART SUMMERLAKE LOT : 039 JURISDICTION: TIG
PROJECT: SWEARINGEN
Project Description: (4) branch circuits for spa.
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: 3 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:
GARRIT SWEARINGEN MICHAEL RAFFAELL CONSTRUCTION INC
11067 SW SUMMER LAKE DR 15170 SW KIRK RD
TIGARD, OR 97223 OREGON CITY, OR 97045
•
Phone: 706- 217 -5585 Contact #: PRI 503 - 632 -6720
FAX 503 - 632 -6732
FEES
Description Date Amount Reg #: ELE 3 -299C
[ELPRMT] ELC Permit 9/26/2007 $66.80 LIC 58422
[TAX] 8% State Surcharge 9/26/2007 $5.34 SUP 2562S
Total $72.14 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 rule re set forth O • = 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies o hese rules or direct questions to OUNC at
503.246. 99 or 1 .800.33.
Issued By: Permittee Signatu e:
k
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:
• ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �, �..itJ� -� DATE:
LICENSE NO:
Call 513.639.4175 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 A lication FOR OFFICE USE ONLY
1 .
� EIVE D Rece ived f ,
Ci of Ti and 1 �p7 ,Y�X Permit No.: Ikell#0, 0
�' g Date/By:
to 13125 SW Hall Blvd.. Tigard, OR _ Plan Rcvicw
Phone: 503.639.4171 Fax: 503.5985 NED 2 5 20 Date /By. Other Permit.
TIGARD Inspection Line: 503.639.4175 : Dale Rcady /Hy: lurix. ■ El See Page 2 for
Internet: www.tigard- or.gov CITYOF TIGARD i Notified/Method: c..- Supplemental Information
TYPE 41411141ING DIVISION PLAN REVIEW
❑ New construction ® Addition /alterationlrcplacement Please check all that apply (submit 2 sets of plans willows checked helmer
❑ Service or feeder 400 amps or more ❑ Building over Three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,1100 amps at 150 volts or ❑ floating buildings.
Tess to ground, or exceeds 14,000 ❑ Commercial-use agricultural
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFOR 41 :�'TIUN AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "r1' "l " "1 -�" "1 -3"
100HP or more. occupancy.
Job no.: Job site address: 11067 SW Summer Lake Drive ❑ Recreational vehicle parks.
❑ Six or more residential units,
City /Statei7,I P: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ I lazarduns locations. 600 volts nominal.
Suite /bldg./ apt. no.: Project name: Swearingen ❑ Service or feeder 600 amps or more.
FEE SCHEDULE ■
Cross street/directions to job site: Description 1 Qty. I Fee. I Total I • I.
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 I '
Tax map /parcel no.: Limited energy. residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
SPA Limited energy. multi- family 75.00 2
residential (with above sq. ft.)
Change out lights Services or feeders installation, alteration, and/or relocation '
• i
200 amps or less 80.30
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 j 2
Name: Garrit Swearingen 401 amps to 600 amp 160.6(1 j 2
601 amps to 1.000 amps 240.60 2
Address: 11067 SW Summer Lake Drive Over 1.000 amps or volts 454.65 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation ■
Phone: Fax; ) 200 amps or less 66.85 1
I Phone:/- 706 a-! 7 - 5 � � S (50� 6 � 1 - rs 7 � i s
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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A, Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT' PERSON above service or feeder 1'cc. 6.65 2
each branch circuit
Business name: 13. Fee for branch circuits
Contact name: without service or feeder fee, I 46 RS 46.85 2
first branch circuit
Address: Each add'l branch circuit 3 6.65 19.95 2
- Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 I 2
t 1 dwelling. service and/or feeder
i Phone: ( ) Fax:: ( ) Reconnect only , 66.85 2
E -mail: Pump or irrigation circle 53.40 2
1 CONTRACTOR Sign or outline lighting 53.40 : 2
Business name: Michael Raffaell Construction, Inc Signal circuits) or limited- I I
energy panel, alteration, or
Address: 15170 S. Kirk Rd extension. Describe: I Page 2 2
City/State/ZIP: Oregon City, OR 97045 Each additional inspection over allowable in any of the above
Per inspection 62.50 i
Phone: (503) 632 -6720 Fax: (503) 632-6732 Investigation per hour (I Itr min) 62.50
CCB Lie.: 58422 I Electrical Lie.: 2562 -5 Suprv. Lie.: 3 -299 -C Industrial plant per hour 73.75 I
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: p �� Subtotal: 66.80
Print name: Michael Rat7aell f Date 09 -25 -07 Plan review (25 % of permit fee):
State surcharge (8% of permit fee): 5.34
Authorized signature 4 . O Q
TOTAL PERMIT FEE: 72.14
I This permit application expires if n permit is not obtained within 180
Print name: Michael Raffaell 1 Date: 09 -25 -07 days after it has been accepted as complete.
• Number of inspections allowed per permit.
f 1 Building :Pcrntits\tiLC- PcrmitApp.dnc 05/23/tt6 440 4515T111i05!COMAVEB
a 'd ZEL92E9 EOS jaedjeN TaeyoTW e9' =01 LO SZ des
CITY OF TIGARD e
BUILDING DIVISION Q 5 PERMIT #: ELC2007.0 3 9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/21)07
Phone: (503) 639 -4171 1..11 ��� �,
Inspection Requests (24 Hrs.): (503) 639 -4175 .._— !+' 'I I
INSPECTION WORKSHEET FOR DATE: 1013 TIME: 7:00AM PAGE: 105
SITE ADDRESS: 11067 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: AMART SUMMERLAKE LOT #: 039 TYPE OF USE: '
PROJECT NAME: SWEARINGEN
DESCRIPTION: (4) branch circuits for spa.
OWNER: SWEARINGEN, GARRIT PHONE #: 706- 217 -6595
CONTRACTOR: RAFFAELL CONSTRUCTION INC, MICHAEL PHONE #: 503. 632 - 6720
Inspection Request Scheduled For: Date: 10/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 99 Electrical final 058675-01 603.781 -9857 N
Corrections /Comments/ Instructions:
i _
I 1
1 i i
S. , - . . 1 A . , I, . .. .L - L`
- I- —
I
1 ' 6k4ed)
, x ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 ) 0 Phone #: (503) 718-
CITY OF TIGARD A
BUILDING DIVISION . L (` 1 / PERMIT #: ELC2007- 00668
13125 SW Hall Blvd., Tigard, OR 97223 L 51 a - DATE ISSUED: 9/2612007
Phone: (503) 639 -4171 gpggy i
Inspection Requests (24 Hrs.): (503) 639 -4175 _. F- -.
INSPECTION WORKSHEET FOR DATE: 9/27/2007 TIME: 7 :00AM PAGE: 72
SITE ADDRESS: 11067 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: AMART SUMMERLAKE LOT #: Q39 TYPE OF USE:
PROJECT NAME: SWEARINGEN
DESCRIPTION: (4) branch circuits for spa.
OWNER: SWEARINGEN, GARRIT PHONE #: 70&217.5505
CONTRACTOR: RAFFAELL CONSTRUCTION INC, MICHAEL PHONE #: 503 632 - 6720
Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message ���
105 Underground /slab cover 056429 -01 503-781 -9857 Y j (� "
v ,�
Corrections /Comments /Instructions:
y .. ,
(/ • /
J /� ,, //�/
I I
• / emu/ A-. C O j.
J 7 / ? /
i i �� I / • _ d i I mo. A'i i/ .Id 3 I "
�. Wr %'.W.• , . - ■ - .
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ', Date: 37 67 Phone #: (503) 718-
CITY OF TIGARD 0 .
BUILDING DIVISION • - PERMIT #: ELC2007.00668
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9126/2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 � 11.
INSPECTION WORKSHEET FOR DATE: 4/29/2008 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 11067 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: AMART SUMMERLAKE LOT #: 039 TYPE OF USE:
PROJECT NAME: S1NEARINGEN
DESCRIPTION: (4) branch circuits for spa.
OWNER: SWEARINGEN, {3ARRIT PHONE #: 706-217 -5565
CONTRACTOR: RAFFAELL CONSTRUCTION INC, MICHAEL PHONE #: 503.632 -6720
Inspection Request Scheduled For: Date: 4/29/2008 Pour Time:
Code # Inspection Description fi ## Contact # Message
150 Hot tub/spa/pool l 069021 -01 503-781-9867 Y
1 C I ° k F.1 NA L---
m /Instructions:
'/ PAS' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ .IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G M N IY3 LE Date: 1 4(15/I Ai _ Phone #: (503) 718- 2446