Permit CITY OF TIGARD ELECTRICAL PERMIT
° . COMMUNITY
PERMIT D: ELC2007-00631
DATE ISSUED: 9/11/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 105DD - 01600
SITE ADDRESS: 14825 SW SUNRISE LN ZONING: R -7
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: DR HORTON
Project Description: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
DR HORTON, INC. - PORTLAND
4386 SW MACADAM AVE #102
PORTLAND, OR 97239
Phone: 503 - 222 - 4151 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 9/11/2007 $66.85
[TAX] 8% State Surcharge 9/11/2007 $5.35
Total $72.20 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 enaccordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more n 180 days. ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
0 952 - 001 -0010 throu h 0 9 2-001-0100. / You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
&
I ued By: - 444 (2, ; Permittee Signatu • i i' !
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.
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,J - ` M
/10 it
Electrical Permit Application oval
s . Washington County, 155 N. 1" AV, Suite 350, MS 12, Hillsboro, OR 97124, Projet+*
Phone: Fax: 503. 846 -3993,
o4rai,i Permit # ELL ?-DOS -T o3 I 51-......N) Inspection Requests: 503- 846 -3699, www.co.washinaton.or.us "r { CT
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement ❑ Other: Please check all that apply:
❑ Service or feeder 400 amps ❑ Hazardous locations
or more where the available ❑ Service or feeder 600 amps or more
CATEGORY OF CONSTRUCTION fault current exceeds
❑ Building over three stories
$.1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 10,000 amps at 150 volts or L.11-1 Marinas and boatyards
Multi-family M builder Oth less to ground, or exceeds
❑ y ❑ ❑ 14,000 amps for all other ❑ Floating buildings
JOB SITE INFORMATION AND LOCATION installations. ❑ Commercial -use agricultural
buildings
2 St..1 5 n r. S e. l ^G ❑ Installation of 75 KVA or larger ❑ Fire pump
Job no.: Job address: I
`i s 0 system separately derived system
Ci City/State/ZIP: Ot� ❑ Addition of new motor
tY t r t rc l ❑ «A,„ „ E," ..1 -2 „ "1-3" up
load o 100HP or more
Suite/bldg. /apt. no.: Project name: ❑ Six or more residential units ❑ Recreational vehicle parks
❑ Health -care facilities ❑ Supply voltage for more than
Cross street/directions to job site:30 BA ,A4..,, it.,, � LA -t'o 5. ISO }w 600 volts nominal
FEE SCHEDULE
50,) 5 r t $C (.r. Description I Qty. I Fee I Total I*
Subdivision: Lot no.: Residential single- or multi - family dwelling unit.
Includes attached garage.
Tax map /parcel no.: 2 5 1 0 s DD 0 ((,OD 1,000 sq. ft. or less 150.00 4
DESCRIPTION OF WORK Ea. add'I 500 sq. ft. or portion 42.00
Limited energy, residential 60.00 2
¢t cap r.-iee4 - i.• . 1 Meer 1,n plii.Ct (with abovesq.ft.)
Limited energy, multi - family 66.00 2
residential (with above sq. ft.) _
aJ PROPERTY OWNER I ❑ TENANT Services or feeders installation, alteration, and/or relocation
200 amps or less 90.00 2
Name: D Q k1 r 4 p A i l r c , • ?o r+1 e- 201 amps to 400 amps 120.00 2
Address: t.11 $ si 61,4 M6! c e4a ...A Aev6 4 ' I fl Z 401 amps to 600 amps 180.00 2
601 amps to 1,000 amps 270.00 2
City/State /ZIP: ?p r41 R ro et pta q l 2 3 9 Over 1,000 amps or volts 504.00 2
Phone: (603 ) Z22 utS Fax: (5o3 ) 2.22 t 3 co4 Temporary services or feeders installation, alteration, and /or
relocation
Owner installation: This installation is being made on re ' ntial or farm property owned by me or a member of 200 amps or less 78.00 2
my immediate family. This property
i trn t change or rent. (ORS 479.540(1) and 479.560(1).
°r � 1 0 201 amps to 400 amps 108.00 2
`0
Owner signature: Date: 401 amps to 599 amps 1 50.00 2
❑ APPLICANT I ❑ CONTACT PERSON Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
Business name: above service or feeder fee, 8.50
each branch circuit 2
Contact name: B. Fee for branch circuits
Address: without service or feeder 60.00
fee, first branch circuit 2
City/State /ZIP: Each add'l branch circuit 8.50
Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ( ) Each manufactured or modular
dwelling, service, and/or feeder 102.00 2
E -mail: Reconnect only X -80O' (a,. 2.5 1
CONTRACTOR Pump or irrigation circle 60.00 2
Business name: Sign or outline lighting 60.00 2
Signal circuit(s) or limited -
Address: energy panel, alteration, or
60.00
extension. Describe:
City/State /ZIP: 2
Phone: ( ) Fax: ( ) Each additional inspection over allowable in any of the above
Per inspection 90.00
E -mail: CCB lie. no.: Investigation fee (See compliance)
Electrical lie. no.: City or metro lie.: Other:
ELECTRICAL PERMIT FEES
Supervising
gnat e electrician
r e quied:
signature, Subtotal �$c�- . 7S
gnature, rquired:
Print name: I Date: Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized 5'
signature: TOTAL PERMIT FEE -+f
This permit application expires if a permit is not obtained
Print name: I Date: within 180 days after it has been accepted as complete
• Number of inspections allowed per permit. Revision 06/26/06
CITY OF TIGARD
BUILDING DIVISION ' PERMIT #W\.3 f
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 zgoM
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 17 IAA) S .)NKI S1 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: its_
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
° ‘ ° k F�c1�aL
Corrections /Comments /Instructions:
MO CI sue. i r3V--14 1 C tsav .s (NO
a■r:l. vST LS
60 'mu fl •.0 - tope.
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IN FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G`1 N0CS L Date: ell �{ rsr- Phone #: (503) 718 -1-
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CITY OF TIGARD
BUILDING DIVISION " PERMIT #: ELC2007 -00631
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/12/2007 TIME: 7:01AM PAGE: 44
SITE ADDRESS: 14825 SW SUNRISE LN CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: DR HORTON
DESCRIPTION: Reconnect only.
OWNER: DR HORTON, INC. - PORTLAND, PHONE #: 501222-4151
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 9/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 055546-01 503-317 -6500 Y
Corrections /Comments /Instructions:
� ; S /V / -, _ i ro' . L Ay
/4" M &3r #P
,4r7 -- R i Imp ,tea cuee
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
(FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 ' - //t/ Date: // /0 Phone #: (503) 718-