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14941 SW Rosario Lane
ELECTRICAL PERMIT
CITY
OF
T I GA R D
PERMIT#: ELC2002-00255
DEVELOPMENT SERVICES) DATE ISSUED: 6/10/02
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 2S108DD-03000
SITE ADDRESS: 14941 SW ROSARIO LN
SUBDIVISION: ORCAS ESTATES ZONING: R-7
BLOCK: LOT : 002 JURISDICTION: URB
Proiect Description: Install 1 branch circuit to hot tub.
_RESIDENTIAL. UNIT TEMP SRVC/FEEDERS_ _ MISCELLANEOUS
1000 bi' OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF MMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
_ SERVICEIFEEDER _ _ 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 amt : EA ADD'L B INCH CIRC: IN PLANT:
601 - 1000 arnp: PLAN REVIEW SECTION__
1000+ amp/volt: �� —4 PES UNITS: > 600 VOLT NOMINAL:
Reconnect only:______ SVC/FDR >=225 AMPS: _ _CLASS AREA/SPEC OCC:
Owner: Contractor:
MCVICKER, BRIAN GERARD AND OWNER
YOLANDA MARIE
14941 SW ROSARIO LANE
TIGARD, OR 97223
Phone: Phone:
Reg#:
FEES Required Inspections
'Type By Date Amount Receipt Wall Cover
Elect'I Final
PRM3 CTR 6/10/02 $46.85 2720020000(
5PC2 CTR 6/10/02 $3.75 2720020000(
Total $50.60
This Permit is Issued subject to the regulations contained in the Tlga,d Municipal Code,State of OR. Specialty Codes and all othe,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 952-001-0080. You may obtain copies of these rules or direct questions to
Permit Signature: �l?l�OA4' -- Issued By: ,-' (l 1.L• '
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNEF:'S SIGNATURE: _ DATE: __
CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N: _—_ ____ DATE:__
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Date receiveg _JZ,
y' Permit no. o '• y,
City of Tigard Pr oject/appl. Expire date-
0t vrrfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dalt issued: By: Receipt no.:
Phone: (503) 639.4171
Fax: (503) 598-1960 l Vy_ Case talc no.: Payment type:
Land use approval: _.
t
L I &2 family dwelling or acces.;nq U Commercial/industrial U Multi-family U Tenant improvement
U New c )nstntction U Addition/alter
ation/replaccntcnt U Other: __ _- U Partial
Joh address: ;�, r o Bldti. no.: Suite no.; Tax neap/tax lot/account no.:
Lot: Block: Subdivision: _
Project name; �'} Jp -�. D'-wription and location of work on premises:
I bre e.�r. l��,.�
Estimated date of completion/inspecti-v, -- -- -
ION t
Job no: fcr 11th.
Description Qt/'. (en.) 'lotal no.hrsp
Business natne:
--- -- New tesldent6l-single or mu111-family per
Address: dwelling unit.ha ti des attached garage.
City' State: ZIP: Seniceinchuled:
Phone; I Fax: E-mail: 1000 sq.ft.or less l
CCB riot.; I:Irc.has.tic.no:
Each additional 500 sq.fll or portion thercof
_ I.irnitrrl energy,nshlcnturl 2
City/metro lit:.no.: Unaledenergy,non-residential 2
Fach manufactured home or modular dwelline
Signature of supervising elect i I required r ---- Service sncUor(ceder 2_
Sup.elect,mora•(print) Services or feeders-Installation,
alteration or relocation:
PROIPERTV OWNER 21x1 amps ar Icss 2
201 amps to 4tH)amps 2
Name(print): . ,�.. �'�` _ 2
4(11 amps to G(H)amps
Mailing address: f < ,�, r "e-ku 601 amps to 1000 amps 2
City: cN Slate:(!),Z 'LIP: c over 1000 amps or volts -- 2
Phone:$„ -�'rt,;. s l'ax: L-mail: Reconnect unly I
owner installation:The installation is being made on property 1 own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
200 amps or Icss 2
ORS 447,455,479,670,701.
A
201 amps to 4110 amps 2
ON'11er�s Si'nalure: !� %� `sf)ale: \��"� ` 401 to 600 ams 2
r Branch circuits-new,alteration,
or extenslon per panel:
NamC: _-_` - A. Fee for branch circuits with purchase ul
A,jdss; service or feeder fee,each branch circuit 2
City: Slate: (�Zl�l':� B Fee for branch circuits without purchase
- --- - 1 —__---- -- of service or feeder fee,first branch circuit: 2
Phone: I ,i E nutil: Each additional branch circuit:
Mlsc.(Service or feeder not Inclnded):
U Service over 125 ungs-a,uuncrrtal -1 l italth-care facility Each pump or irrigunon
U Service over120amps-rating of l&c2 U Hnr.ardoushxation F.achsign uroulline loomp '-
fnmilydwellings U Building over 10,000 square feet four or Cignal circuit(i)or a Innrted energy pant-1.
U system over Min volts nominal more residential units in one structure alletntiun,orexlension• 2
U Building over three stories U Fectlers,4M amps or more •M-scri tion.
U Occupant load over 99 persons U Manufactured structures or RV park -TA—ch additional Inspection over the allowable In any of the above:
U Fgress/lightingplan U Odor Perins ection
Submit.__sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not nn juar.cacnons accept credln cads,pleas call jurisdktion GK more inrurmalinn Notice:This permit application Pennit fee.....................$
U Visa U MasterCard expires il'a permit is not obtained Plan review(rat _ %) $
t iedn cad numGer ______ ___---__-_ —/_L_ within 180 days alter it has been State surcharge(8%)....$ _
tispirea accepted as complete.
- ---- TOTAL .......................
Nmnt of err-dht�der as a awn nn credo card-
t'mdholTer iianature Amount 440-4615(rSOnK'ttMl
ELECTRIrAL PERMIT FEES: LIMI TED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK— INVOLVED - RESIDENTIAL Ot.,LY
--
- --- --- -
/� Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost -rotal Check Type of Work Involved:
Residential-per unit
1000 sq It or loss 145 15 _ _ ❑ Audio and Stereo Systems'
Each additional 500 sq." c.
portion thereof _ $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manurd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $90.90 _
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 ❑
201 amps to 400 amps $108.85 2 Vacuum Systems'
401 amps to 600 amps $160,60 2 ❑
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts _ $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system.............................. ....................... ... $75.00
200 amps or less _ $66.85 (SEE OAR 918-260-260)
201 amps to 400 amps _ $100.30 _
401 amps to 600 amps �^ $133.75 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. F-1Audio and Stereo Systems
Branch Circuits ❑ 9oller Controls
New,alteration or extension per pane!
a)The fee for branch circuits rI
with purchase of service or u Clock Systems
feeder fee.
Each branch circuit $665 _ ❑ Das Telecommunication installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee. r
First branch circuit _� $46.85 HVAC
�__,T^ ❑
Each additional branch circuit $6.65_
Miscellaneous ❑ Instrumentation
(Service nr feeder not Included)
Each pump or Irrigation circle $53.40 _ ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circult(s)or a limited energy
panel,alteration or extension $75.00 ❑ Landscape Irrigation Control'
Minor Labels(10) $125.00
Medical
Each additional Inspection over ❑
the allowable In any of the above ❑
Per inspection $62.50 Nurse Calls
Per hour _ $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting`
Fees: �f��V�; ❑ Protective Signaling
Enter total of above fees $ ❑ Other _
9%State Surcharge $iew _ 1
_ 7 Number of Systems
25°h Plan RevFee :� �;�� _ _
See"Plan view F"section on $ Nu licenses are required Licenses are required for all other Installations
Revifront of application. —
Fees:
Total balance Due $
r�--� Enter total of above tees
l_I Trust Account$_ 8%State Surcharge S
Total Balance Due $
All New Commercirl Buildings require Z sets of plans.
i 1ets\forrrucrlc-l5CCS toc 08,30101
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP - ---__
Received Date Requested_____ r'7AM—____ PM BLIP --�
Location _ � � � !� -- Suite MEC.
Contact Person _ Ph PLM _
Contractor Ph( ) — _ __- SWR
_BUILDING Tenant/Owner 42'u� -----. _ ELr_
Footing ELC
Foundation ccess:
Ftg Drain EL
Crawl Dtain SIT
Slab Inspection Notes: ---
Post&Beam ------ - _ ------
Shear Anchors
Ext Sheath/Shear ---- —
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing
Firewall _
Fire Sprinkler - —--- —
Fire Alarm
Susp'd Ceiling
Roof — - — - ----_.
Other:--- --- .�
Final ------
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab - —
Rough-In
Water Service —
Sanitary Sewer _
Rain Drains —
Catch Basin/Manhole J
Storm Drain
Shower Pan
Other: --------- -- -
Final
_PASS PART FAIL
MECHANICAL --_—.
Post A Beam—
Rough-In
Gras Line
Smoke Dampers ---- ----- - -
Final
PASS PART FAIL --
ELECTRICAL
Service
UG/Slab
Low Voltage ----- -------- — --- _—
Fire Alarm
a Reinspection fee of$ _—__ requited before next inspection. Pay at Cly Hall, 13125 SW Hall Blvd
S PART FAIL r
Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA Date� Inspector �C".3 Ext ---
Approach/Sidewalk
Other
Final Del' NOT REMOVE this Inspection record frorn the Job olte.
PASS PART FAIL.