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Permit ' r ' ELECTRICAL PERMIT 'C t OF TIGARD' i { PERMIT #: ELC2007 -00045 COMMUNITY DEVELOPMENT DATE ISSUED: 1/22/2007 ',TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110BD -00400 SITE ADDRESS: 11750 SW WILDWOOD ST ZONING: R - SUBDIVISION: SHADOW HILLS LOT : 002 JURISDICTION: TIG Project Description: 100amp sub panel with 5 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: 5 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: BARRY CARLEY EMERALD ELECTRIC 11750 SW WILDWOOD ST. • 40264 SE TRUBLE TIGARD, OR 97224 SANDY, OR 97055 Phone: 503 - 620 -2478 Contact #: PRI 503 - 887 - 3630 FAX 503 - 826 -1377 FEES' Description Date Amount Reg #: ELE 3 -425c [ELPRMT] ELC Permit 1/22/2007 $113.55 LIC 115333 • [TAX] 8% State Surcharge 1/22/2007 $9,08 SUP 4395s Total $122.63 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 Cerjer. 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.. • • • • .8032.2344. • Issued By: 'b 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. Electrical Pehilit UVED FOR OFFICE USE ONLY III City of Tigard JAN 2 22007 em j —p9.,3 - -07 gig) Permit No� a a ... DO0 A. " 13125 SW Hall Blvd., Tigard, 7 2 Plan Review ' Phone: 503.639.4171 Fax: g91,1481) T IliARD DateB . Other Permit p Ins ection Line: 503.639.41 (WING DIVISION Date Ready/By: Juris LB See Paget for TIGAR 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 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 A t- and 2- family dwelling ❑ Commercial /industrial ❑ 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 denved system _ ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: r^ 100HP or more. occupancy. / . �L/ _$ 4 WJ /U'LAVI, � ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: ,�, yyii rA a/ ❑ 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 Qty. I Fee. I Total 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'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 ) /A 4 4� / Limited energy, multi -family hi]) ` residential (with above sq. ft.) 75.00 2 I O(' S ���` Services or feeders installation, alteration, and/or relocation V 200 amps or less / AO Ali. 80.30 ¥0.80 2 - ' . ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: / 4 01 amps to 600 amps 160.60 2 �'` � � — a •^ 601 amps to 1,000 amps 240.60 2 Address: ' 1 1 7 � ��14) " % I A (1 Job D Over 1,000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: () (Alb — a 7 g I 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, 6.65 13s 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, Contact name: 46.85 2 . e, ..ti ....w, ....uvc.�v 4- first branch circuit _ Address: Each add'l branch circuit 1.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 90.90 2 dwelling, 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 r (� Signal circuit(s) or limited © Business name: h ( �( ` l $ energy panel, alteration, or ,. I Address: iD ,' 1 -- extension. Describe: Page 2 - k City/State/ZIP: ``�� 3 � r,L/ t f 7 V Each additional inspection over allowable in any of the above Per inspection 62.50 Phont ) TV 7 - 7J 6 3D I Fax: 61;;S) '( - / 3 .7 7 Investigation per hour (1 hr min) 62.50 L CCB Lic.: / 1 4333 I Electrical Lic.: 5. yi r I Suprv. Lic.: r S Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES _ % Suprv. Electrician signature, required: Subtotal: 3.55 Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): 9,06 Authorized signature :. TOTAL PERMIT FEE: /aa ( ....(..\, Print name: permit application expires if a permit is not ohtarnea nt wtrn loo Date' days after it has been accepted as complete. • Number of inspections allowed per permit I. \Building\Permits\ELC- PennitApp doc 0523/06 440-4615T(I I /05 /COM/WEB 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 $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 1 . \13uildmg\Permits\ELC- PermitApp doc 0323/06 CITY OF TIGARD ° COMMUNITY DEVELdPMENT TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 . kr _ , IMPORTANT PERMIT NOTICE 'CklEittAr JQN ) EMERALD ELECTRIC Cht 20 40264 SE TRUBLE SANDY, OR 97055 Electrical Signature Form Permit #: ELC2007 -00045 Date Issued: Parcel: 2S110BD - 00400 Site Address: 11750 SW WILDWOOD ST Subdivision: SHADOW HILLS Block: Lot: 002 Jurisdiction: TIG Zoning: R -2 Remarks: 100amp sub panel with 5 branch circuits. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: BARRY CARLEY EMERALD ELECTRIC 11750 SW WILDWOOD ST. 40264 SE TRUBLE TIGARD, OR 97224 SANDY, OR 97055 Phone #: 503 - 620 -2478 Phone #: 503 - 887 - 3630 Reg #: ELE 3 -425c LIC 115333 SUP 4395s AN INK SIGNATURE IS REQUIRED ON THIS FORM X igrtatur3' Suservising Electrician If you have any questions, please call 503.718.2433. • Please return this form by mail, or you may fax it to 503.624.3681. r, CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00045 ' 13125 SW Hall Blvd., Tigard, OR 97223 DATE' ISSUED: 1/22/ Phone: (503) 639 -4171 kba' ' t i ts Inspection Requests (24 Hrs.): (503) 639 -4175 I .. ' INSPECTION WORKSHEET FOR DATE: 2/13/2007 TIME: 7 :02AM PAGE: 41 SITE ADDRESS: 11750 SWWWLDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: 100amp sub panel with 5 branch circuits. • OWNER: CARLEY, BARRY PHONE #: 503 CONTRACTOR: EMERALD ELECTRIC PHONE #: 503 557 - 3630 Inspection Request Scheduled For: Date: 2/13/2007 Pour Time:, . Code # Inspection Description Confirm # Contact # Message 199 Electrical final 043306 -01 503-310-4404 N Corrections /Comments /Instructions: • • • • 4 • • IF -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO. ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • I nspector: • C / Date: ",Phone 7 / • Z � � d�] #: (503) 718- �6 • CITY OF TIGARD • • BUILDING DIVISION `` PERMIT #: ELC2007 -00045 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/22/2007 Phone: (503) 639- 4171 rl Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/23/2007 TIME: 7 :02AM • PAGE: 30` • SITE ADDRESS: 11750 SW WILDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 • TYPE OF USE: • PROJECT NAME: CARLEY • DESCRIPTION: 100amp sub panel with 6 branch circuits. OWNER: CARLEY, BARRY PHONE #: 503 - 620 - 2478 CONTRACTOR: EMERALD ELECTRIC PHONE #: 503 -887 -3630 • Inspection Request Scheduled For: - Date: 1/23/2007 Pour Time: • Code # Inspection Description Confirm # Contact # Message 115 Electrical service 042399-02 503-3'10-4404 N Corrections /Comments /Instructions: • b N Pta - `-\ • ial • • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Ins ector: Phone # 503 718 - p Date: o . ( ) I • • CITY OF TIGARD BUILDING DIVISION r ' - PERMIT #: ELC2007- 00045 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/22/2007 Phone: (503) 639 -4171 4P I1I1 Inspection Requests (24 Hrs.): (503) 639 -4175 F-_ • INSPECTION WORKSHEET FOR DATE: 1/23/2007 TIME: 7 :02AM PAGE: 39 SITE ADDRESS: 11750 SW WII.DWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: 100arnp sub panel with 5 branch circuits. OWNER: CARLEY, BARRY PHONE #: 503 -620 -2478 CONTRACTOR: EMERALD ELECTRIC PHONE #: 503687 -3630 • Inspection Request Scheduled For: Date: 1/23/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message • 120 Electrical rough -in 042399-01 503-310-4404 N Corrections /Comments% Instructions: 142 o$4 PA S -- ANCa • Rc -1k) Nci1�g) � ' • • ,X PASS ' ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I " Date: I z a 6 Phone #: (503) 718_144) _..„ •