Permit CITY OETIGARD ELECTRICAL PERMIT
q COMMUNITY DEVELOPMENT DATE PERMIT #: ISSUED: 5/30/2008 ELC2008 - 00303
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102BC - 01702
SITE ADDRESS: 12680 SW WATKINS AVE ZONING: R -4.5
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 027 JURISDICTION: TIG
PROJECT: FIELD -EATON
Project Description: Bathroom remodel - (3) 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: 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:
FRED FIELD -EATON ELECTRICAL INNOVATIONS
12680 SW WATKINS 22300 S LEWELLEN RD
TIGARD, OR 97223 BEAVERCREEK, OR 97004 -8733
Phone: 503 - 620 -5630 Contact #: PRI 503 - 358 -6989
FAX 503 - 632 -6564
FEES
Description Date Amount Reg #: ELE 26 -699C
[ELPRMT] ELC Permit 5/30/2008 $60.15 LIC 66412
[TAX] 12% State Surchar 5/30/2008 $7.22 SUP 3621S
Total $67.37 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 -0s i s • • ough OAR 952 - 001 -0100 You may obtain copies of these rules or direct questions to OUNC at 503.246 6699 ors 800 332 2344
Issued :y: / /).1 I Permittee Signature. ''A7.
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:
CNTRACTOR INSTAL TION ONLY
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SIGNATURE OF SUPR. ELEC'N: T I %,L 4/60 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 Received Date,j a Permit No &,.CttS' —DDS
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
` t3 Phone 503 639 4171 Fax 503 598.1960 Date/By Other Permit
T I G A R D Inspection Line 503.639 4175 Date Ready/By . 11 . 14 ® See Page 2 for
Internet: www tigard- or.gov Notified/Method• 4 Supplemental information
TYPE OF WORK PLAN REVIEW
❑ New construction w Addition /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 ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
�
cb.t I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
El Multi- family ❑ Master builder ❑ Other: ❑ Fire 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 -2 ", "I -3 ",
Job no.: Job site address: ' C g O 5 co I ki h s Six or or more residential R occupancy
4 i A t� ❑ Six or more residential units ❑Recreational vehicle parks
City/State /ZIP: — \---1•1 ti ✓ 1 ❑ Health -care facilities ❑ Supply voltage for more than
❑ 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 I Qty. 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
DESCRIPTION OF WORK (with above sq ft ) 75 00 2
1- Limited energy, multi - family 75 00 2
1r w i le—e- 6 ct` v \ ✓d 0.... L 0 .� / residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
S c.t ti t.• ■.e ,l- tl C w ` 200 amps or less 80 30 2
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: F v ., ` � e _ ( 4 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240 60 2
Address: 1 2 b 6 0 S ( ,J LA...9 Cl.. -{"' ■: 5 Over 1,000 amps or volts 454 65 2
Temporary services or feeders installation, alteration, and/or
City/State /ZIP:
— 71,... c.1 a.„ t ( D ck relocation
Phone: (5 ( J 5 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 is'rth
tiO APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6 65 2
1 �� l each branch circuit
Business name: cA4A -- C B Fee for branch circuits
Contact name: n 1 ,
without r signa circuit
Address: . t,(... C S L..) F, v". t .- Each add'I branch circuit a, 665 /3 • Zd d 2
Miscellaneous (service or feeder not included)
City/State /ZIP: S V 0,1_0 t) 4 (_) 1\ C.I ( It 0 Each manufactured or modular
dwelling, service and/or feeder 90 90 2
i
Phone: (2 3) ( � ZS- 5.--/ ? L Fax: : ( ) Reconnect only 66 85 2
E -mail: Pump or imgation circle 53 40 2
CONTRACTOR Sign or outline lighting 53 40 2
Business name: 7` � r' . Signal circuit(s) or limtted-
{t, 1-1-1 H J JW .` din S energy panel, alteration, or
7_7_3 Q S extension Describe: Page 2 2
Address:
�, 1, 1 -e R 1
City/State /ZIP: 72 ecinrevc vie \ K 0k. c\---1° 0 4 Each additional inspection over allowable in any of the above
V3) 3 - (, c 1 g Fax: (3 ) ` 3 Per sti ion 62.50
Phone: (
5 � � 5� g 7 Investigation per hour (I hr min) 62 50
CCB Lic.: 6,4 q 0, Electrical Lic.: 4, - C Suprv. Lic.: 30A1 -5 lndustnal plant per hour 73 75
V f ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: --:-.3 Subtotal. /„ (� ? Plan review (25 % of permit fee) tX �!
Print name: —re r 8 M Date: / 3 Q State surcharge (12% of permit fee): 7. p;
Authorized signature: C !! TOTAL PERMIT FEE lei, 37
t
This permit application expires if a permit is not obtai ed within 180
Print name: L Date: `j V days after it has been accepted as complete.
• Number of inspections allowed per permit
I \Budding\Permits\ELC- PermitApp doc 05/23/06 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information •
LIMITED. ENERGY PERMIT FEES:
PRESIDENTIAL WORK'ONLYc • '
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:'. - j
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems •
❑. Data Telecommunication Installation
❑ Fire Alarm Installation
- ❑ HVAC
❑ Instrumentation
El 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 \Buddmg\Pertnns\ELC- PermttApp doc 03/23/06
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: ELC2008 -00303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5130/20Q8
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 M.
INSPECTION WORKSHEET FOR DATE: 6/2 /2008 TIME: 7:02AM PAGE: 8
SITE ADDRESS: 12680 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: NORTH TIGAROVILLE ADDITION LOT #: 027 TYPE OF USE:
PROJECT NAME: FIELDEATON
DESCRIPTION: Bathroom remodel - (3) branch circuits.
OWNER: FIELD - EATON, FRED PHONE #: 503-620 -5630
• CONTRACTOR: ELECTRICAL INNOVATIONS PHONE #: 503 - 358 - 6989
Inspection Request Scheduled For: Date: 6/2/2008 Pour Time:
Code # Inspection Description ( onfirm • Contact # Message
120 Electrical rough -in 070654 -01 503-880.8846 N
Corrections /Comments /Instructions:
2r� t;Lle \\ (\ ti
15 ',fvv . 6 CIO S ts►X) 4 J/
c.t) txs.11 w 11.\ Ps,. V' 2-O J
f\a,)i0.1(„ k/
,/
Pv.:c)\), Pastki N
•
. ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• /' FAIL M CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N b6 L Date: 6 ' v dt Phone #: (503) 718 - 1-
1
1 I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/200t3
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 ! I
INSPECTION WORKSHEET FOR DATE: 6/9/2008 TIME: 7:01AM PAGE: 12
SITE ADDRESS: 1268() SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 027 TYPE OF USE:
PROJECT NAME: FIELD•EATON
DESCRIPTION: Bathroom remodel - (3) branch circuit..
OWNER: FIELD - EATON, FRED PHONE #: ,03 -620 -5630
CONTRACTOR: ELECTRICAL INNOVATIONS PHONE #: 503356.6989
Inspection Request Scheduled For: Date: 6/9/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough- in 071099 -01 503 - 880-8846 N
Corrections /Comments /Instructions:
CM/di/41A
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL F S ASSESSED
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Inspector: it 7 Date:•!/ Phone #: (503) 718 -
i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2008
Phone: (503) 639- 4171 el°gi�lb
Inspection Requests (24 Hrs.): (503) 639 -4175
Alt
W "L
INSPECTION WORKSHEET FOR DATE: 9/6/2008 TIME: 7:00Aid1 PAGE: 4
SITE ADDRESS: 12680 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 027 TYPE OF USE:
PROJECT NAME: FIELD -EATON
DESCRIPTION: Bathroom remodel - (3) branch circuits.
OWNER: FIELDD.EATON, FRED PHONE #: 503. 620 -5630
CONTRACTOR: ELECTRICAL INNOVATIONS PHONE #: 503 -358 •6989
Inspection Request Scheduled For: Date: 9/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 076154 -01 603- 880 -8846 N
Corrections /Comments /Instructions:
G5 Pis ® v 0 4 W 4II C; ! c- IN) ft
6F P cL., . . 1 to . 21% ,
Pao.) Joe LL 7; .. 5hoiseA
Ass() NNtivf+IIM t ifeck. 0 N 4 6 Q.
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL . 7CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1\ 104131-6 Date: 1 .6r' 1 Phone #: (503) 718- VOA)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008- 003113
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51300000 Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639- 4175!i
INSPECTION WORKSHEET FOR DATE: 10f1012008 TIME: 7:00AMVI PAGE: J6
SITE ADDRESS: CLASS OF WORK:
S
1 2
SUBDIVISION: 1 2680 l 1NlNATKINS AVE
LOT #: TYPE OF USE:
PROJECT NAME: NORTH TIGARDVILLE ADDITION 027
DESCRIPTION: FIELD - EATON
Bathroom remodel - (3) branch circuits.
OWNER: FIELD - EATON, FRED
PHONE #: 50620 5630
CONTRACTOR: PHONE #:
ELECTRICAL 603-35R-6989
CTRICAL INNOVATIONS
Inspection Request Scheduled For: Date: 10/10/20118 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 07640641 503-620-5630 N
P'
Corrections /Comments /Instructions: '
•
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CA ( FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,
• i
Inspector: Date: f 6/(0 (01' Phone #: (503) 718-
— -