Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00699
COMMUNITY DEVELOPMENT DATE ISSUED: 12/7/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114AC -01100
SITE ADDRESS: 09118 SW WAVERLY DR ZONING: R -12
SUBDIVISION: WAVERLY ESTATES LOT : 044 JURISDICTION: TIG
Project Description: Add feeder and (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:
MATT ENGEN OWNER
9118 SW WAVERLY DR
TIGARD, OR 97224
Phone: 503 - 620 -4054 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 12/7/2006 $106.90
[TAX] 8% State Surcharge 12/7/2006 $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 • • e 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 • -n 180 days. :TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OA' 952 - 001 -0010 thro •h 0. - - 111 -0100. You may obtain copies of these rules or direct questions to OUN at 503.246.6699 or 1.800.332.2344.
/
Is ued By: k� Permittee Signature: X
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: 44/7
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.
I I ect � cal Permit Application i of ui i lc.l USI ONLY
City of Tigard e ,� e d / � 7 d - "
• % Permit C� � 4~ ((%9
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B Other Pemut:
if I G It D Inspection Line: 503.639.4175 Date Ready/By: Jun /l ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method / / �+ Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ 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 stones.
❑ 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
❑ 1- and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building amps for all other installations. buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
loop or more. occupancy. Job no.: Job site address:
l 1 8 s...) I JAU l,-y2Ly 72 ❑ Six or more residential units ❑ Recreational vehicle parks.
City/State/ZIP: 2 C� f, , Z LI� ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: G. A- L L�zr2.i [At. ❑ 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
Tax map /parcel no.: Ea. add'I 500 sq. ft or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
2 x' Limited energy, multi - family 75.00 2
F St)1 , j4s.: rl_ Li G t - rues ( - Ci & co i sY ?L t1 4 - G 11,_(:,...) 1 r ( I IO 4).22 residential (with above sq ft )
Services feed installation, alteration, and/or relocation
I /J Cr I' Crt 7 (� ti ► .Y-& -- --! t I Vi — / S 1 - 711 6" j�(T�.t �t 200 amps or or less i 80.30 30.50 2
' ❑ PROPERTY OWNER . I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: M F� �� 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 911 8 s . 1 wi4v i - Ly Over Ova 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
�7 6,0,/ ) o(L 91)22y relocation
Phone: (S 0 - 2 ) ) 62_ as y 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, ren 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: 1 2 'h J o 6 A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
I service each branch circuit 6.65 ;ik 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 • 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
Business name: Signal circuit(s) or limited -
�� energy panel, alteration, or
Address: ` , extension. Describe: Page 2 2
City/State/ZIP:
(),/,,,)f-_, Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone:( ) 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: /) (p , 97.)
Plan review (25% of permit fee):
Print name: Date: State surcharge (8% of permit fee): . ,
Authorized signature: TOTAL PERMIT FEE: 1 .- -- ; - , /
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.
1 \Building\Pennits\ELC- PennnApp doc 0523/06 410.4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
E RESIDENTIAL 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.
1 WORK ONLY:
Fee for each commercial $75.00
system
•
(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\Pdmib\ELC- PmmWpp doc 03/23/06
CITY OF TIGARD . _
BUILDING DIVISION ~� PERMIT #: ELC200 00699
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2006
Phone: (503) 639 -4171 � �"°1W�l'
Inspection Requests (24 Hrs.): (503) 639 -4175 "LL
INSPECTION WORKSHEET FOR DATE: 1211//2006 TIME: 7:00AM - PAGE: 16
SITE ADDRESS: 09118 SW WAVERLY DR CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 044 TYPE OF USE:
PROJECT NAME: ENGEN
DESCRIPTION: Add feeder and (4) branch circuits.
OWNER: ENGEN, MATT PHONE #: 503- 62(1-4054
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 040908-01 503-620.4054 N
Corrections/Comments/Instructions:
ons:
k ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
A R 068 uf D ate: 4 V 6° Inspector: � Phone #: (503) 718-
CITY OF TIGARD
T
w _
BUILDING DIVISION L 0 ,� PERMIT #: ELC2006-00699
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2006
Phone: (503) 639 -4171 r!a
Inspection Requests (24 Hrs.): (503) 639 -4175 "'II
INSPECTION WORKSHEET FOR DATE: 12718/2006 TIME: 7 :05AM PAGE: 14
SITE ADDRESS: 09118 SW WAVERLY DR CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 044 TYPE OF US E:
PROJECT NAME: ENGEN
DESCRIPTION: Add feeder and (4) branch circuits.
OWNER: ENGEN, MATT PHONE #: 503 4;20.4054
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 121187200E Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 04'1219.01 503 - 620 -4054 N
Corrections /Comments /Instructions:
r�
(C______,
•
f g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ r ALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
2 z 0-4) Inspector:
Date: ( �� Phone #: (503) 718 -
t