Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 - 00243
r r DEVELOPMENT SERVICES DATE ISSUED: 5/5/2006
11. `�I I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133CD -10000
SITE ADDRESS: 11878 SW WILTON AVE ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT : 132 JURISDICTION: TIG
Project Description: Install hot tub circuit & GFI at front of house.
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: 1 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:
TYLER DAMS WINNER ELECTRIC INC
11878 SW WILTON AVE 5950 SW PROSPERITY PK
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: Contact #: FAX 503 - 638 - 4242
PRI 503 - 638 -5028
FEES
Description Date Amount Reg #: ELE 34 - 150C
[ELPRMT] ELC Permit 5/5/2006 $53.50 LIC 14794
[TAX] 8% State Surcharge 5/5/2006 $4.28 SUP 28255
Total $57,78 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 may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: S . it R,
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.
ul(zu/2004 09:38 FAX 5035981980 CITY OF TIGARD rt001
Electrical Permit Arwlicatioa 0 w,‘N
FOR OFFICE' USE ONI.V
City of Tigard Received _ _ _
....../ . •
13125 SW Hall Blvd.. Tigard, OR 97223C
, 1 - 1.040 DatrJ8 : _ U 4
PIII1RCVICW l—d
r112511 ,NIMOMMHZ/
Phone: 503.639.4171 Fax: 503.598.1960 .., / /A-,-.4 . ,...1,{ 0 DateJB Other Permit:
Inspection Line: 503 639.4175 ,- ,-.' -- I s.' t .7.1,11. •
c , --,-aA4.- ''a. - ' Date Ready/By: See Page 2 for
Internet: www.mtigarcLor us
s i C f 1 \ 1■11S\ . NotifietVM•thork WI °
Supptementni Information
"'lilt . ':;.. .: . :" •7 :::, j.jA11I;11 :..' ' I ". .i.1 :1111.,1,, ..:.:."!p1. !:1E■.r**P1!•.! • . :. ,,. ., . .
0 New construction • ./ .
Cil Additionfil eration replacement Please check all that apply
,
['Service over 225 amps, comm'l 0Hazardous location
:.:
0 Demolition 0 Other:
.. • , OServicc over 320 amps - rating 0Buildng over 10.000 sq, ft.,
1:5; i . : : i• li; ',1 .IiiliL, ' .i;I:.i, '.:... s i..... ' il *. '4..ii:90
.14 - ,: : ',. ft 110;i t. .:' of 1- and 2-family dwellings 4 or more new residential
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building 0System over 600 volts nominal units in one structure
0Building over three stories °Feeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
ElOecupant load over 99 persons DIvlanufactured structures or
4h1;IjI•hfr`...111I!::T:II.Iii.:Ii.14'0,1..:siT*L4ofooitiolpill;!*4-#.401...i:. P. .'. ciEgr.wighting Plan RV park
Job no.: I Job site address: n8 ,y(,) Loa-n,/ A v .2- OHealth-eare facility 00ther:
Submit a seta of plans with any of the above.
City/State/ZIP: e rill/MJ 0 ft- 9 7 )? The above are not applicable to temporary construction service.
,_ h I '.i'I'...'. •. 10:14P1ILEIIIII:III' ,:.. ; ; ;. !:. ...
Suite/bldg./apt. no.: Project name: D A /KZ" Description 1 Qrp I Pen j Total 1 ..
,.......
Cross-street/direction s to job site: 04' /33 561 New residential single- or multi-family dwelling unit.
Includes attached garage-
1,000 sq. ft. or less 145.15 LI_
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited mited energy, non•residential 75.00 2
N I . • ..1! ..1 .''' Each manufactured or modular
dwelling, service and/or feeder 90.90 2
go/Sig PI 4 1 -4)1e,p go 7 t i 8 C...)2C,..42 Services or feeders installation, alteration, and/or relocation
Akic Pt a F. tuPie,e 4 -1 rizo •', 01 A VS-4- 200 amps or less 80.30 2
.II II I I.1 ' IrI•I'.... 1 131 1 ,911**filf1 1 410141/0g; ";:•:; -' • ' ' it .. • .... 201 amps to 400 amps . 106.85 2
r.. '
k - - .. .. . • . - - -,... • '. • J,. . '"" '''''''' ' --;—j "" 401 amps to 600 amps 160.60 2
—
Name: — Dc, _ \ ,,,....
6. amps to 1.000 amps 240.60 2
1
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 7
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
. _T.:: ' :'. ;i1;I; IllIi■.1 41
--- ,I. ' .. . • :'.• .:,.. A. Fee for branch circuits wah
seivice or teeder fee. each i 6 65 ‘65 -...- 2
Business name:
branch circuit r
B. Fee for branch circuits
Contact name:
without service or feeder fee i 46.85 4
each branch circuit
Address:
Each add'I branch circuit I 6.65 2
City/State/ZIP Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 I 2
Phone: ( ) Fax. : ( )
Sign or outline lighting I 53.40 I - 2
E-mail:
Signal circuit(s) or limited.
ildI,I.: :I : • ,. I 7 fill'1::■ [•ii ; i l'' Ii • - • . ; :e 0 NTRACTOR , I . :,:; . :1 . : , ,' •
., ; ,' Ir :: • : .•,;',I,,,' energy panel, altcranon, or • extension. Describe. Page 2 1
Business name* (A) ;," E./et_IXt
Address P Each additional inspection over allowable in any of the above
: 31:1S0 S t, e 03 Pea/ 6 P4.11...K. ea
Per inspection 62 50
. ,
City/State/ZIP: b i
/Oa LA -/L) OA- 9706Z Investigation per hour (I lx mm) 62.50
Phone: (Sc 5 ) _L g so zi? Fax: (5 S) 6/8 z7l 2 4 / "z- industnal plant per hour 73.75
Alp!IY ;I i.. ': t ''I• vixernuclo.; PERMIT PEES■i"
CCB Lic.: ft.../791 Electrical Lie.: 3 6C. Suprv. Lie.: )gz‘s
Subtotal .53.5-6
Suprv. Electrician signature, required: \ , I Ikat Plan review (25% of permit fee)
• State surcharge (8% of permit fee) Li.Ag
Print name: c W 4 lit I/ Date:
TOTAL PERMIT FEE 57, 7
.
Authorized signature:
This permit application expires if a permit is not obtained within 180
,
days after it btu been accepted as complete
Print name: Date: • Fee methodology set by Trl-eauaty Building Industry Service Board
" Number of insneinion.,,,...........if ..n.......4
•
CITY OF TIGARD '
BUILDING DIVISION PERMIT #: ELC2006 -0 )2413
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/5/2.0:16
Phone: (503) 639 -4171 .. 11
Inspection Requests (24 Hrs.): (503) 639 -4175 _� . ^_
INSPECTION WORKSHEET FOR DATE: 5/15/2(106 TIME: 7:04AM PAGE: 100
SITE ADDRESS: 11878 SW WILTON AVE CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 132 TYPE OF USE:
PROJECT NAME: DAMS
DESCRIPTION: Install hot tub circuit & GFI at front of house.
OWNER: DAMS, TYLER PHONE #:
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 503 - 638 -5028
Inspection Request Sc -duled For: Date: 5/15/2006 Pour Time:
C• • - ; Inspection D- .cription Confirm # Contact # Message
199 Electrical final 029833.01 503.3 -3061 Y
Corrections /Comments /Instructions: /
30 M��
•
PASS 111 PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G IVE_)P) Date: z Phone #: (503) 718- 2446