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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00547 -- :.14 DEVELOPMENT SERVICES DATE ISSUED: 9/28/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109AD - 14300 SITE ADDRESS: 12927 SW TAKENA CT ZONING: R - SUBDIVISION: ARBOR SUMMIT NO. 2 LOT : 039 JURISDICTION: TIG Project Description: (2) 200 amp service, (4) branch circuits. 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: 1 W /SERVICE OR FEEDER: 4 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: BRAD & SHE MCCOLLUM OWNER 12927 SW TAKENA CT TIGARD, OR 97224 Phone: 503 - 639 -2509 Contact #: FEES Description Date Amount Reg #: [ELPRMT] ELC Permit 9/28/2006 $106.90 [TAX] 8% State Surcharge 9/28/2006 $8.55 Total $115.45 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 332 - 2344. Issue &.4c ' C fg Permittee Signature: a 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. . electrical Permit Application RECEIVED FOR OFFICE USE ONLY RECEIVED Received � , City of Tigard Dae/B . i g'—p \ 1 Permit No.: �- ° 13125 SW Hall Blvd., Tigard, OR 97223 S E P 2 8 2006 Plan Review • Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD D Ready/By: � ® See Page 2 for • Internet: www.tigard - or.gov BUILDING DIVISION Nolifed/Method Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction JAddition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): . ❑ 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 10,000 amps at 150 volts or 0 Floating buildings. dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1 -and 2-family g ❑ CommerciaVindustrial ❑ Accessory building amps for all other installations. buildings. • ' ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 "1 -3 Job no.: Job site address: / a ! Z7 ) '7 ,4/04 cr 10011P or more. occupancy. ❑ ❑ Six or more residential units. Recreational vehicle parks. City /State/ZIP. 771 111J 1) CA 7-72.-Z4 ❑ Health -care facilities. ❑ Supply voltage for more than (IV/ ` ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description l Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: R e. SO r Sl yj CT Lot no.:3? 1,000 sq. ft. or less I I 145.15 I 14 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: • Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) .)0 � - ' - F9N /A) ( 4 1 - Wl* Limited energy, multi- family 75.00 2 ���71/f ice` /7� -iG residential (with above sq. ft.) . © (iTz_E1S 1 L 16 6175 ; :1:1 OarSi )E ZI -` r- Services or feeders installation, alteration, and/or relocation • /v u ' 2 0 0 amps or less i 80.30 2 . [PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: ,i3R -_ S/i Lt4 a c c_cgLu i 401 amps to 600 amps 160.60 2 7 , `,4,f Over 1,000 to 1,000 amps 240.60 • 2 .2 c..7t�1 Address: � � i �/"T C Over 1,000 ammps or volts I I 454.65 I 12 • City/State/ZIP: /' `cam „v 6( q 7Z Z 4 Temporary services or feeders installation, alteration, and/or relocation Phone: c503) 4.5?- 25b7 I Fax: ( ) 200 amps or less 66.85 1 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 �,t,a /�'Z Date: -0� Branch circuits — new, alteration, or extension, per panel Owner signature: A. Fee for branch circuits with IK APPLICANT I ' ❑ CONTACT PERSON above service or feeder fee, each branch circuit L/ 6.65 2 Business name: B. Fee for branch circuits Contact name: D i,t - iv/ CC6 Lc.V AA without service or feeder fee, 46.85 2 first branch circuit Address: I 21 z - 7 Sw -7,11,62 4- �- , Each add'I branch circuit _ 6.65 2 Miscellaneous (service or feeder not included) City/ State/ZIP: G4 A-0 CA. L ? 7 Z 2.1 Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: (5f?3) 6? Fax: : ( ) Reconnect only 66.85 2 E- mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name Signal circuit(s) or limited- energy panel, alteration, or Address: extension. Describe: Page 2 2 . City/ State/ZIP: Each additional inspection over allowable in any of the above Phone: Per inspection 62.50 hone: ( ) I Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour _73.75 ELECTRICAL PERMIT FEES . ' Suprv. Electrician signature, required: Subtotal: i .Jc(_ 96 Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): . ".5"3 "-- ',, j 5 • Authorized signature: ' TOTAL PERMIT FEE: / / ) yj This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. . • Number of inspections allowed per permit. • ' I :\ Building \Pemits\ELC- PemitApp.doc 05/23/06 440-4615T(I I /05 /COM/WEB • Electrical Permit 'Application - City of Tigard 11, Page 2- Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: E l Audio and Stereo Systems* • 1:1 Burglar Alarm 0 Garage Door Opener* • 1:1 H eating, Ventilation and Air Conditioning System* Vacuum Systems* -1:1 O ther: , • • COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system • (SEE OAR 918-260-260) , • Check Type of Work Involved: fl 4 Audio and Stereo Systems . fi Boiler Controls t El Clock Systems O Data Telecommunication Installation ,•• • 0 Fire Alarm Installation • 1:1 HVAC • • O Instrumentation O Intercom and Paging Systems El Landscape Irrigation Control* El Medical • 0 Nurse Calls H • 0 Outdoor Landscape Lighting* El Protective Signaling D * Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.Vituilding\PermitsELC-PennitApp doc 03/23/06 CITY OF TIGARD BUILDING'DI SION PERMIT #: ELC2006-00&47 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/28/2006 Phone: (503) 639 -4171 IiIl Inspection Requests (24 Hrs.): (503) 639 -4175 p_ INSPECTION WORKSHEET FOR DATE: 2/212001 TIME: 7 :03AM PAGE: 70 SITE ADDRESS: 12927 SW TAKENA CT CLASS OF WORK: SUBDIVISION: ARBOR SUMMIT NO. 2 LOT #: 039 TYPE OF USE: PROJECT NAME: MCCOLLUM DESCRIPTION: (2) 2Q0 amp service, (4) branch circuits. OWNER: MCCOLLUM, BRAD & SHEILA PHONE #: 503.639 - 2509 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2/2/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 042884 -01 503-639 -2509 N Corrections /Comments /Instructions: n 1tJAl- END1 Uv AGgr r 6E 23 .a.. err! B k ' i t ,, , ' P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G---k2 t I L� Date: 2/2. 07 Phone #: (503) 718- 2'VA .