Permit 111;.1? CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT : ELC2008-00489
DATE ISSUED: 8/25/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 125DC -02900
SITE ADDRESS: 07160 SW VENTURA DR ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES LOT : 022 JURISDICTION: TIG
PROJECT: JOHNSTON
Project Description: Installing (8) 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: 7 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:
MICHAEL & MARY JOHNSTON DAN CORRELL ELECTRIC INC
7160 SW VENTURA DR PO BOX 16785
TIGARD, OR 97223 PORTLAND, OR 97292
Phone: 503 - 235 - 5895 Contact #: PRI 503 761 - 7299
FAX 503 - 761 -2178
FEES
Description Date Amount Reg #: ELE 26 - 103C
[ELPRMT] ELC Permit 8/25/2008 $93.40 LIC 67336
[TAX] 12% State Surchar 8/25/2008 $11.21 SUP 4686S
Total $104.61 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 ma obt co ies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344
Issued 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:
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.
RUG 25 2008 2:06PM KP LRS'ERJE1` 3200 5037612178 p.1
Electrical Permit Application (DR ()I'M F. t. Ste O1:1 ' •
City of Tigard � r Permit No., 1 _
7 13 125 SW Hall Blv Tigard, OR 97 C�, Plat Review p�,, y ? c ? sp
'^° . 6
Phone: 503.639.4171 Fax: 503.598.1! 1 DatefBy' f)tlier Permit,
1' L G \'12 6 Inspection Line 503.639.4175 11 �� C ( O Date Ready/By / Juno 65 See Page 2 for
; J Supplemental Information
- Internet wvuw tigard- Or.gov �,`f_ It NntlliedR�tet -]��9
U t PLAN REVIEW ,
TYPE OF WORK � C3'
g05 Please check all that apply (suhaat 3 sets of plans w /hems checked below)
❑New construction Addition /alteration/ c I � ❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition � J� - J Other: OAXA ' where the evadable fault current ❑ Mamas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial - use agncultural
) 2 1 1- and 2- tkrnily dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or i
❑ Emergency system. larger separately denved system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E", "1 - ", "1 - 3",
100HP or more occupancy
Job no.: 1/ - - 3 (Job site address: 7/ =- A ..c• - . d ❑ Six or more residential units. 13 Recreational vehicle perks.
City/State/ZIP: / / � Gy �- / Pt? 97 ❑ Health -care facilities. ❑ Supply voltage for more than
C 7Z� ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.. Project name T s� —r0�) ❑
Siceor feeder 600 amps ormore
i `� FEE SCIIEDULF-
Cross streetrdirections to job site: Description ' J oo. I Fee. I Total 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 1
Tax map /parcel no.: Limited energy, residential
73 00 2
DESCRIPTION OF WORK (with above sq a)
Limited energy, multi- family
75.00 2
i i k.. 3 4/1 , 1 'rn27,1 residential (with above sq. ft.) -
Services or feeders installation, alteration, and /or relocation _
200 amps or less 80.30 2
❑ PROPERTY OWNER 0 TENANT 201 amps to 400 amps l06.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454 65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( - ) 1 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, r duel
Owner signature: Date: A. Fee for branch circuits with
in APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits 1 r-
Y
Contact name: without service or feeder fee, / 46.85 u ! 4- 2
first branch circuit
Address: Each add'1 branch circuit 7 6 65 yL cc 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66 85 2
E -mail. Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2 _
Signal circuit(s) or limited.
Business name: 77 ear — 410 1 s ` G : __ energy panel, alteration, or
Address: Reg. / ) t I� Ts extension. Describe' Page 2 2
City /State/ZIP: /460/././1 0/. ' � p 0 /460/././1 97..29,Z Each additional inspection over allowable in an of the above
Phone: ( J . 2- ! F ax : 3 — Per inspection 62.50
. / — 2 ! Investigation per hour (t hr min) 62.50
CCB Lie.: 4 s, Su Lie.:. "" Industrial plant per hour 73.75
�' � Suprv. ELECTRICAL PERMIT FEES
Suprv. Electrician signature, req �' Subtotal
"'
Print name: ,� J Date: ' . 5 i Plan review (25% of permit fee).
/0 i.
State surcharge /o of permit fee):
Authorized signature: TOTAL PERMIT FEE.
Print name: 11'7- /■_ This permit application expires if a permit Is not obtained within 1
Date: days sifter It Yas been accepted as complete.
. CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008- 004239
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2008
Phone: (503) 639 -4171 An04p
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �..
INSPECTION WORKSHEET FOR DATE: 12/4/2008 TIME: 7:00AM PAGE: 21
SITE ADDRESS: (17160 SW VFNTURA DR CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES LOT #: 022 TYPE OF USE:
PROJECT NAME: JOHNSTON
DESCRIPTION: Installing (8) branch circuits for kitchen remodel.
OWNER: JOHNSTON, MICHAEL & MARY PHONE #: 503.236.5855
CONTRACTOR: DAN CORRELL ELECTRIC INC PHONE #: 503.761.7299
. Inspection Request Scheduled For: Date: 1214/ 2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 078771 -01 503 -201 -7138
. i .
Corrections /Comments/ Instructions:
\ .
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X
\
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N '
•
•
` PASS 111. PARTIAL APPROVAL ❑ CANCEL [1] NO ACCESS
❑FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Cr 0 Ve Date: /2--" Phone #: (503) 718 - 144.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005- 004139
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2008
Phone: (503) 639 -4171 A l
Inspection Requests (24 Hrs.): (503) 639 -4175 '`11
INSPECTION WORKSHEET FOR DATE: 1115/2008 TIME: 7 :01AM PAGE: 8
SITE ADDRESS: 07160 SW VENTURA DR CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES LOT #: 022 TYPE OF USE:
PROJECT NAME: JOI-INSTON
DESCRIPTION: Installing (8) branch circuits for kitchen remodel.
OWNER: ,JOHNSTON, MICHAEL & MARY PHONE #: 603 - 235 -5895
CONTRACTOR: DAN CORRE=LI.. ELECTRIC INC PHONE #: 503 - 761 -7299
Inspection Request Scheduled For: Date: 11/51208 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 077690 -01 503.309 -0763 N
Corrections /Comments /Instructions: p
N - ZJO . i4 (g) .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
,FAIL X CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: a • 0 66 l-8 Date: «4 03 Phone #: (503) 718- 14
CITY OF TIGARD 1,
BUILDING DIVISION ,_. PERMIT #: ELC2008- 00489
13125 SW Hall Blvd., Tigard, OR 97223 °-' DATE ISSUED: 8125/2008
Phone: (503) 639 -4171 ICI '
Inspection Requests (24 Hrs.): (503) 639 -4175 �__..
INSPECTION WORKSHEET FOR DATE: 8/27/2008 TIME: 7:00AM PAGE: 25
SITE ADDRESS: 07160 SW VENTURA DR CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES LOT #: 022 TYPE OF USE:
PROJECT NAME: JOHNSTON
DESCRIPTION: Installing (8) branch circuits for kitchen remodel.
OWNER: JOHNSTON, MICHAEL & MARY PHONE #: 503-235.5695
CONTRACTOR: DAN CORRELL ELECTRIC INC PHONE #: 503 -761 -7299
Inspection Request Scheduled For: Date: 8127/2008 Pour Time:
Code # Inspection Description Confirm # ontact # Message
120 Electrical rough -in 074706-01 503.309 0763 N
Corrections/Comments/Instructions:
%/ r I I Or I , -y , vs V i i .4t)!� , 6‘L
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FO INSPECTION ❑ ADDITIONAL FEES ASSESSED
d o Inspector: Date: ) 0 Ph one #: (503) 718 - a �`