Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00159
COMMUNITY DEVELOPMENT DATE ISSUED: 3/14/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BB - 14500
SITE ADDRESS: 10498 SW KENT ST ZONING: R -
SUBDIVISION: SWANSONS GLEN NO.2 LOT : 086 JURISDICTION: TIG
PROJECT: JACKSON
Project Description: Kitchen branching from existing ctr. lite to 9 cans. Office: Branching from center box to 2 lites. 1 outlet in
hallway.
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: 3 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:
CHAD JACKSON OWNER
10498 SW KENT STREET
TIGARD, OR 97224
Phone: 503 - 890 -2600 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 3/14/2007 $66.80
[TAX] 8% State Surcharge 3/14/2007 $5.35
Total $72.15 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:
____
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 Permit Applici ; . 3 ' FOR OFFICE USE ONLY
City of Tigard Received r Permit No.� , ..... — , - .�i
° 13125 SW Hall Blvd., Tigard, ORI ' 3 1 :.t 2007 Plan Revre
C • Phone: 503.639.4171 Fax: 503.598.1966 Date/B . Other Permit:
- I C'A R I) Inspection Line: 503.639.417 yg � Date Ready/By: ® See Page 2 for • •
Internet: www.tigard- or.go - 41 V.i .' 13'a. ilitYl Notified/Method IIIM Supplemental Information
E OF WORK I 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
1 - 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 derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 1 o L\ck b 5„" VC Q, \- S Six or or more residential Recreational ❑ Six or more residential units. ❑Recreational vehicle parks.
City /State/ZIP: `,� ,i1 C) V_ 9 -('ZZ ❑ Health-care facilities. ❑ Supply voltage for more than
y ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: Project name: -g - G ot:) ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: '0 vs , \,, _> \o — \ 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'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.)
Limited energy, multi - family 75.00 2
1,11 Co „ A \ �� -k� I �Q✓ue t''.. residential (with above sq. ft.)
S ervices or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
0.PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: c L ,.\ A C 401 amps to 600 amps 160.60 2
�� 1 601 amps to 1,000 amps 240.60 2
Address: \U`{ tii S k. ,.._, k,„ „,.\. S _. Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
a 6 12_ 477 -2- relocation
Phone: (So3) 89 o Z 6 o v 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
ature: /J
Branch circuits - new, alteration, or extension, per panel
Owner si
gn t �L 7 Date: 3 - � � '� A. . Fee for r branch circuits with
❑ PLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee / 46.85 ; / 2
first branch circuit T l�
Address: Each add'I branch circuit 3 6.65 /9 0 2
Miscellaneous (service or feeder not included)
City/Statc/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- or
Business name: � J r L ` energy p
y pann el, alteration, or
Address: extension. Describe: Page 2 2
City/State/ZIP: 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. Lie.: Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES • �
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): 5.3f
Authorized signature: TOTAL PERMIT FEE: .
tl
Print name: Date: This permit application expires if a permit is not obtained within
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PennitApp.doc 05/23/06 440.4615T(I I/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page .2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
I RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
I 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
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06
- ELECTRICAL PERMIT
Er
CITY OF TIGARD -
PERMIT #: ELC2007 -00159
COMMUNITY DEVELOPMENT DATE ISSUED: 3/14/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S114BB - 14500
SITE ADDRESS: 10498 SW KENT ST ZONING: R -
SUBDIVISION: SWANSONS GLEN NO.2 LOT : 086 JURISDICTION .,� . •
PROJECT: JACKSON
�; - 0
Project Description: Kitchen branching from existing ctr. lite to 9 cans. Office: Branching from center box to 2 lites. 1 outlet in
hallway.
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: 3 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:
CHAD JACKSON OWNER
10498 SW KENT STREET (�
TIGARD, OR 97224 Lt IT- II e E l�E
Phone: 503 - 890 -2600 Contact #: S' I ` . ols
-- • 1
FEES ` p
Description Date Amount Reg #:
I
[ELPRMT] ELC Permit 3/14/2007 $66.80 v
[TAX] 8% State Surcharge 3/14/2007 $5.35 0
Total $72.15 REQUIRED ITEMS AND REPORTS kri
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 B Permittee Signature:''
___
.i
OWNER INSTALLATION ONLY e -` J
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for. ELC2007 -00159 - REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing X 120 Electrical rough -in
805 MFG-Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set - up _ MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection _ 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test
995 Misc. inspection: _ 315 Post/beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation _ 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\ B uilding \Forms \InspCard- AOP- Blankdoc 02/02/07
. CITY OF TIGARD
BUILDING DIVISION PERMIT # aC,2.Dn9' OQ 1sq
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1.I 01 TIME: PAGE:
SITE ADDRESS: I 0 5 W KIT CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: LA-29_ or) Pour Time:
Code # Inspection Description Confirm # Contact # Message
20 Ro \)c\\
Corrections /Comments /Instructions:
� CZo\i►rbt 6`' rniN c-(zwocni-
■‘K \ ?off .
i4S�A� NS iratAl 160 UtiQut RED •
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918-271-0030
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
,FAIL \ k CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:. \ L Date: 1 1 11 1 0 7 Phone #: (503) 718 - ..
jr
CITY OF TIGARD w �►
BUILDING DIVISION PERMIT #: ELC2007 -00 69
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/27/2007 TIME: 7:00AM PAGE: 64
SITE ADDRESS: 10498 SW KENT ST CLASS OF WORK:
SUBDIVISION: SWANSONS GLEN NO.2 LOT #: 086 TYPE OF USE:
PROJECT NAME: JACKSON
DESCRIPTION: Kitchen branching from existing ctr. lite to 9 cans. Office: Branching from center box to 2 lites. 1
outlet in hallway.
OWNER: JACKSON, CHAD PHONE #: 503- 890.2600
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 0472501 N 503-890-2600 N
Corrections /Comments /Instructions:
W o 4NS6 ■ Al tte.
I I PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
A FAIL , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' ` `�'�J `--�+ Date: L 27 01 Phone #: (503) 718 - 7•
I