Permit f r „ * CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: E - 00726
DATE ISSUED: 10/24/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DD-03700
SITE ADDRESS: 09875 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT : 045 JURISDICTION: TIG
PROJECT: SHREVE
Project Description: (3) branch circuits for A/C, GFCI & furnace.
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: 2 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:
SHREVE, THOMAS A + MARY B AFFORDABLE ELECTRIC WORKS LLC
9875 SW VENTURA COURT 545 COLLINS CREST
TIGARD, OR 97223 GLADSTONE, OR 97027
Phone: Contact #: PRI 503 - 722 - 1558
FEES
Description Date Amount Reg #: ELE 3 -595C
[ELPRMT] ELC Permit 10/24/200' $60.15 LIC 160305
[TAX] 8% State Surcharge 10/24/200' $4.81 SUP 4229S
Total $64.96 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 TTENTION• regon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in
OAR 9 - 001 -0010 thro gh OA 2- 01 -0100 You may obtain copies of these rules or direct questions to OUNC at 503.2'6.6699 or 1.800.332 2 44
/ % i
Issue By: ) Permittee 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:
CONTR TOR INSTALLATIO ONLY
// ; It
SIGNATURE OF SUPR. ELEC'N: A A- . 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.
Electlal Permit Application rol orI :lcI ,us1, obi l
Received E,� //- „ 7a) 7- '
City of Tigard Date/B 4 o Permit No �QJ
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 t%�: ;11 ; Date/B Other Permit «
Inspection Line: 503.639 4175 =IL Date Ready/By Duns ® See Page 2 for
Internet: www.ci.tigard.or.us N0h fied/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply:
ID Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family 11 Master builder ID Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
. JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
yQ7� . ) Veil/ e l- ❑Health -care facility ❑der:
Job no.: Job site address: ! 0 Q r u�/ I a' �- (' Submit 2 sets of plans with any of the above.
City /State/ZIP: -7 1 9 72.3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE
Description I Qty. I Fee. I Total I '.
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
3 K a.rt/ / C j�C-S dog A / G , G rci _ /J r dwelling service and/or feeder 90.90 2
�t 1 G�11� Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
ig PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 779) s t L e V,e_ 601 amps to 1,000 amps 240 60 2
Address: 9 ' 7$ s, ( 0, Ve1. -1t,4-i-a_ c_-f- Over 1,000 amps or volts 454.65 2
�- Reconnect only 66.85 2
City / State/ZIP: 7 G_l� - d.. p q ?2 Z3 Temporary services or feeders installation, alteration, and/or
) Z Y 3 S6 S ( ) relocation
Phone: Q 3 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
IEhAPPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
/,� � ervice or feeder fee, each
� Business name: A 0 ��� branch circuit 6.65 2
B. Fee for circuits L
Contact name: without service feeder service or fe fee, 46.85 f �6 .
first branch circuit
Address: 5 jiki a x,Q_S t Each add'l branch circuit ,**--- 6.65 / 3s.3 e 2
City /State/ZIP: s -La_ $ 6/ 0 2_7 Miscellaneous (service or feeder not included)
Phone: g'o3) 7 / s' S 8' Fax: : ( )
Pump or irrigation
tl i ne ti g circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
�. / J J r extension. Describe: Page 2 2
Business name: f •�/ ��V ,_ �pG e _ F L-Q..- G � ��p V
Address: S VS — C, kit- S C/ a S. Each additional inspection over allowable in any of the above
/) Per inspection 62.50
City / State/Z C�Q}C� ,� 70 T o$ Investigation per hour (I hr min) 62.50
\ S1'hone• (5 7�Z, f c�1 Fax: ( ) 'l it III V Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 1603 p3 Electrical Lic.: 3 9c$` Suprv. Lic.: GP 2 y f Subtotal 6 Q I 1
Suprv. Electrician signature, required: C/ . g / Plan review (25% of permit fee) d /
Print name: Date: State surcharge (8% of permit fee) F
TOTAL PERMIT FEE
Authorized signature: Lei This permit application aspires if a permit is not obtained within ISO
...0.
days after it has been accepted as co mplete
Print name: Date: • Fee methodology set by Tn- County Building Industry Service Board
•• Number of inspections per permit allowed.
I \Butlding\Permits\ELC- Perm itApp dot 12/03 440-4615T(l 0/02/COM/WEB
1
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system. $75.00
(SEE OAR 918-260-260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \ Buildmg\Pmnits\ELC- PamttAppdoc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ; LC2007..00726
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2007
Phone: (503) 639-4171 ' " ,, I '
Inspection Requests (24 Hrs.): (503) 639 -4175 ,„4:44.: ...
INSPECTION WORKSHEET FOR DATE: 10/25/2007 TIME: 7 :01AM PAGE: . )3
SITE ADDRESS: 091176 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASI - HING (ON SQUARE ESTATES NO LOT #: 045 TYPE OF USE:
PROJECT NAME: SHREVE
DESCRIPTION: (3) branch circuits foe NC, OF-CI & furnace.
OWNER: SHRE:VE :, THOMAS A -F MARY B, PHONE #:
CONTRACTOR: AFFORDABL E F.LF_CTRIC WORKS LLC PHONE #: 503-722-158
Inspection Request Scheduled For: Date: 10125/2007 Pour Time:
Code # Inspection Description Confirm_# Contact # Message
1 �0 E lecliical rough -in 068346-01 503701 -1100 Y
Corrections/Comments/Instructions:
eft, Ili. 3 00,
❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G.---: IA (YV Date: Mit " ) Phone #: (503) 718 - TPA
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00726
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10040007 Phone: (503) 639- 4171rf�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.'� II
INSPECTION WORKSHEET FOR DATE: 10/25/2007 TIME: 7:01AM PAGE: 22
SITE ADDRESS: Q9375 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 04E1 TYPE OF USE:
PROJECT NAME: SHREVE
DESCRIPTION: (3) branch circuits for NC, GFCI & furnace.
OWNER: SHREVE THOMAS A - MARY B, PHONE #:
CONTRACTOR: AFFORDABLE ELECTRIC WORKS LLC _ �,7 O G,... PHONE #: 503-727.-1558
Inspection Request Scheduled For: Date: 10125/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 058346 - 503 -701 -1100
a
Corrections /Comments /Instructions:
( �� 1 � v
lib 0.. II AN\
0 PctoN bza- lAu cK t3 RA C pat-
1e in)S7a.v Jf*6 Pa . 10 • 3 <g)
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
)S FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V'' -► 0 Le Date: 10 . 2-� Phone #: (503) 718- 1I11U
11
. _ . , !,,,, .
ma x_ •
CITY OF TIGARD
BUILDING DIVISION PER #: ; LC2007 -00178
13125 SW Hall Blvd., Tigard, OR 97223 `! DATE ISSUED: 10/24/201)7
Phone: (503) 639 -4171 ` .^.I�h
Inspection Requests (24 Hrs.): (503) 639 - 4175 -__
INSPECTION WORKSHEET FOR DATE: 10/28/ 200 TIME: 7 :00AM PAGE: 26
SITE ADDRESS: 09875 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 046 TYPE OF USE:
PROJECT NAME: SHREVE:
DESCRIPTION: (3) branch circuits for NC, GFCI & furnace.
OWNER: SHREVE,1HOMAS A + MARY 13, PHONE #:
CONTRACTOR: AFFORDABI. E ELECTRIC WORKS LLC PHONE #: 503 -722 -1558
Inspection Request Scheduled For: Date: 10/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electiical final 058446 -01 503-701-1100 N
Corrections /Comments/ Instructions:
CoN Fe cLWA ty 00.. WEAL, t�' t, a IJ
v�ti'g Vi sc-ite NN 5N1.
PASS P. 'TIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / 4 7 Phone #: (503) 718- Z'61/7