Permit CITY OF TIGARD ELECTRICAL PERMIT
I"° a‘ COMMUNITY DEVELOPMENT PERMIT #: ELC2008 - 00225
DATE ISSUED: 4/22/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 103CA -03000
SITE ADDRESS: 11515 SW TERRACE TRAILS DR ZONING: R - 4.5
SUBDIVISION: TERRACE TRAILS LOT : 002 JURISDICTION: TIG
PROJECT: THOMSEN
Project Description: Installing (7) branch circuits for kitchen remodel.
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 6 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:
GEOFF THOMSEN WINNER ELECTRIC INC
11515 SW TERRACE TRAILS DR. 5950 SW PROSPERITY PK
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: 503 - 577 -0715 Contact #: PRI 503 - 638 -5028
FAX 503- 638 -4242
FEES
Description Date Amount Reg #: ELE 34 -150C
[ELPRMT] ELC Permit 4/22/2008 $86.75 LIC 14794
[TAX] 12% State Surchar 4/22/2008 $10.41 SUP 2825S
Total $97.16 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.
Issued By: # /i / — �� Permittee Signature: j te 4 2 7S,1 r �
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 FOR OFFICE USE ONLY '
City of Tigard Date/By: (� U (?7, No.: 4 a (.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Phone: 503.639.4171 Fax: 503.5 _ 1 6 Date /By: Other Permit: ?a -- "CtX .45
•
T I G A R D Inspection Line: 503.639.417 Date Ready /By: turfs: H See Page 2 for
Internet: www.tigard or.gov ^ -1t` Notified/Method: Supplemental Information
1 I
TYPE OF WO1 0 AI ^^ D N PLAN REVIEW
El New construction E5Addition /alteration/ p� �i5 CJ��` 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 El Other: G \ �,G where the available fault current ❑ Marinas and boatyards.
CATEGORY OF COOTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
g
1- and 2- family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
Multi- family ❑ Master builder ❑ Other: less
pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
• ❑ Addition of new motor load of ❑ "A ", "E ", ' 1 - , 13 ,
Job no.: Job site address: // 5/ S SI...I " ' e c 4 C ' RA ii Or--- 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
Clty/State /ZIP: , � , �// rr�� rr�� ❑ Health -care facilities. ❑ Supply voltage for more than
7�5 � �rc'c' 9� Ot d ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 7- / eso,•J ❑ Service or feeder 600 amps or more.
J tM FEE SCHEDULE
�
Cross street/directions to job site: OPP / I� " 14 /( Description �l� I Q„ •. I Fee. I Total I
New residential single- or multi- family dwelling unit.
c g A g -c, Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 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.)
�t ',- 'y L' Limited energy, multi - family
irlr t to- 4.--. g�Mo j. L molt i��✓ �r" / � residential (with above sq. ft.) 75.00 2
t Services or feeders installation, alteration, and /or relocation
/ � S 1B 1,1 3 At d ,✓e> 200 amps or less 80.30 2
PROPERTY OWNER - ❑ TENANT 201 amps to 400 amps 106.85 2
Name: � 401 amps to 600 amps 160.60 2
�' ` ! � �`"I 601 amps to 1,000 amps 240.602
Address: Over 1,000 amps or volts 454.65 2
•
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) - ' 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit vP 6.65 „ yn 2
Business name: B. Fee for branch circuits
without service or feeder fe .
Contact name: first branch circuit / 46.35 e/ 6,2
Address: Each add'I branch circuit ( 6.65 I "/ 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
90.90 2
dwellin g, service and/or feeder
Phone: ( ) 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: win/ �Jen- Elm -/ jL Signal circuit(s) or limited -
energy panel, alteration. or
Address: 5 c. 51-6 3 6 f ,2, A fe, K ' �`1f extension. Describe: Page 2 . 2
City/State /ZIP: 77,0 L A "by Ott q 70‘ -. Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 533 ) 438 - 8-6 zg Fax: (6b3 ) 4,3S Lo y.2 Investigation per hour (t hr min) 62.50
CCB Lie.: /17/7gy Electrical Lic.: -- c_ Suprv. Lic.: B Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: m LILL _ r
_ Subtotal: �b' z b •
Print name: Q-C anal ( Date: 4/-16 (ye Plan review (25% of permit fee):
State surcharge (12% of permit fee): j0 4 -I/
Authorized signature: TOTAL PERMIT FEE: ( 7 � ` .6
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
a et..... t....., s :_.... II ..I .,..
e -
CITY OF TIGARD ..
BUILDING DIVISION PERMIT #: ELC2008 -00225
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2212008
Phone: (503) 639 -4171 avai,i� A i
Inspection Requests (24 Hrs.): (503) 639 -4175 A- I C/1---:-
INSPECTION WORKSHEET FOR DATE: 6/30/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 11515 SW TERRACE TRAILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 002 TYPE OF USE:
PROJECT NAME: THOMSEN ,n dA -
DESCRIPTION: Installing (7) branch circuits for kitchen remodel. A't'Y I I S
OWNER: THOMSEN, GEOFF PHONE #: 503. 577 -0715
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 503-638-5028
Inspection Request Scheduled For: Date: 6/30/2008 Pour Time:
Code # • Inspection Description Confirm # Contact # Message
199 Electrical final 072002 -01 503638 -5028 N
Corrections/Comments/Instructions:
.
fr=
� SS ❑ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 Inspector: Date: a --- ' Phone #: (503) 718-
1
CITY OF TIG ABD _
BUILDING DIVISION PERMIT #: ELC2008.00225
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/22/2008
Phone: (503) 639 -4171 jll'�
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 5/2/2000 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 11515 SW TERRACE TRAILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 002 TYPE OF USE:
PROJECT NAME: 1TiOMSEN
DESCRIPTION: Installing (7) branch circuits for kitchen remodel.
OWNER: THOMSEN, GEOFF PHONE #: 503-577-0715
CONTRACTOR: WINNER ELECTRIC INC V Nc \ PHONE #: 503-638-5028
Inspection Request Scheduled For: Date: 5/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 , Wall cover 069277 -01 503-638-5028 Y
3 b o ca.\ i.,,,,• 1 ca ..._,
Corrections /Comments / IrAtructions:
14 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: U----' ' 0 v L.. Date: 67 I 2- A Phone #: (503) 718- 1446.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E.ILC20 -032 &
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4, i2.i2O0 E
Phone: (503) 639 -4171 .I
Inspection Requests (24 Hrs.): (503) 639 -4175 E...
INSPECTION WORKSHEET FOR DATE: 4/30f7QO8 TIME: 7 :O6AM PAGE: 25
SITE ADDRESS: 1 i5 f , TF=r.RAi:'F' TRAILS AILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 002 TYPE OF USE:
PROJECT NAME: 1 HOMSfTh
DESCRIPTION: In;t4liing (/f 117:1rnch c Hi=s ro I:itchen remodel.
OWNER: THt M SEN, I EOI F PHONE #: 503-671-0715
-' "}71 -0715
CONTRACTOR: WINNER PHONE #: SO;3-6-38- 028
Inspection Request Scheduled For: Date: 41301"). COB Pour Time:
Code # Inspection Description infirm # Contact # Message
s r; Wail a o', er � v 69076 1 503 N
Corrections /Comments /Instructions:
41 ?RON tbkig.
t,,A , 210 z• 2 .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS •
FAIL tcl CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � I V 6Q Date: 3o at Phone #: (503) 718- 1LILN