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13556 SW MICHELLE CT
CITY OF TIGAF:® ELECTRICAL PERMIT
PERMIT 0: ELC2004-00456
DEVELOPMENT SERVICES DATE ISSUED: 7/23/2004
131'25 SW Hail Blvd.,Tigard. OR 97223 (503)639.4171 PARCEL.: 2S104CA-01600
SITE ADnRESii: 13556 SW MICHELLE CT ZOWNG: R-7
SUBDIVISION: HILLSHIRE
BLOCK. LOT: 046 JURISDICTION: TIG
Project Description: New branch circuits(2)for hot tub.
_ RESICIENTIAL UNIT TEMP SRVC_/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
F:.^.H ADD'L 500SF: 201 - 400 amp: '_:::N/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: :JGNAL/PANEL:
MANF HM/SVC/FDR: 60++amps-1000 volts: MINOR LABEL (1t)):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 • 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O:'RVC OR FDR: ' PER HOUR:
401 - 600 nmp: EA AOD'L NRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVCIFDR>=225 AMPS: CLASS AREAISPEC OCC:
(iwner: Contractor:
t ORGAN,STEPHEN T&CHERYL L DI PAULAS FIELD ENGINEERING TECH IN
13556 SW MICHELLE CT 8532 N IVANHOE STE 202
TIGARD,OR 97223 PORTLAND, OR 97203
Phone: 503-332-1984 Phone: 971-570-5197
Reg tlt: LIC 154961
ELE 26.1163C.
FEES SUP 48195
Description Date Amount Rewired Inspections _
(FLPRM1'1 ELC Permit 7/23/2004 $53.50 _
[TAX)8%State Surcharge 7/2312004 $4.28
Elect't Final
Total $57.78 -
This Permit is issued subject to the regulations contsrn«,d in the Tgard 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 r^t started within days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregun iaw requires you to follow rules adopted b :re o tility Notifi_-ation Center. Those
r;jles are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies o`the ru s 'e t gvasiio o OUNC at(563)
246-0699 or 14300-332-2344
Issued / Permit Si nature: , ----
ssued By: Y - _ 9
tr
OWNER INSTALLATION ONLY
The installation is being made on property I own which is riot intended for sale, lease, or rent.
J
La OWNER'S SIGNATURE: DATE
to
_J CONTRACTOR INSTALLATION ONLY
SIt311ATURE OF SUPR. ELEC'N: _ DATE:,-----,
NO: _--
Call 6394175 by 7:00pm for an Inspection the next btrsaness day
Electrical Permit A Hcation
CitiCi of Tigard Received
g Wawa : Oy ' - Perttut No. s
13125"'7 Hall Blvd,Tigard,OR 97223 — rCd 'V L uy r
Plan Review Other Permit:
Phone: 503.634.4171 Fax: 303.598.1960 DatdB : _ _
Internet: ww. 3036.oirus 5 Date Readyied/M By
thod ftl See ant l Information Internet: www.e;.ti rd.or.w Notified/Method _(C Supplemental Informat!on
for
❑New construction JR Addition/alterationireplacement 4 Please check all thPt apply
❑Demolition [3 Other: ❑Serv;ce over 225 snips,comm'l ❑Hazardous location
❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft
r' of I-and 2-family dwellings 4 or more new residential 1l
Ii-and family dwelling ❑Cottutlereial/indtutrial Accessory building [jSystern over 606 volts nominal units in one structure
Multi-favWy ❑Master brtilder []Other; ❑Building over hree stories ❑Feeders•400 ampE or more
(]Occupant load over 99 persons ❑Manufactured structures or
❑Egress/lighting plan RV park
lob no ` Job site tlddres � -sr���f,} _.t ❑Health care tac;liry ❑Other:
lr-=_ Subrrlit-L sets of plena with any of the ebcve.
City/State/ZIP: T, !x,d �, 1 �t The above are not Ii6cable to temporary construction service.
Suite/bidg./apt.no.: 1=` Project name: I t
nassrl/tlsa Qty. ►ate Teter _
Cross street/directions tc job site: Now residential single-or multi-family dwelling unit.
- -- Includes attached garage.
1,000 sq.ft.or less 145.15 4
Subdivision: of no.: Ea.add'f 500 sq.ft.or portion 33.40 1
Tax map/parcel no.: Limited energy,residential 75.00 2
Limited energy,non-residentirl 75.00 2
Limited
manufactured or nWular
dwelling,service and/or feeder 00.90 2
Services or feeders Installation,alteration,and/or relocation
200 snips or less 80.30 2
201 snips to 400 autos _-- 106.95 2]
401 amps to 600 amps 16060 -��1
Name: j 1 601 snips to 1,000 amps 240.60 2
Address: Over 1,000 amps or vol a 454.65 2
Reconnect only _ 66.85 2
City/State/ZiP: Temporary services or feeders Installation,alteration,and/or
Phone:( "j}7)) 33 Z•A��� Fax:( ) relocation
_ 200 amps or less _ 66.85 1
Owner installation:This installation'is being made on propert• ',-t:own which is not 201 amps to 400 amps_ 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 44/,449,670,and 701. 401 amps to 600 amps _ 133.75 2
Owner signature: Date til s.:ca circults-new,alteration,or extension,per panel
l11-1 All
A.Fee for branch circuits with
Business name: t �- + y - ` j service or feeder fee,each 6.65 2
! ►v tog t /Q �/ branch circuit
Contact name: ,' y B.Fee for branch circuits
y- without service or feederLfeeA, ( 46.85 y ,g 2
Address: i / . etch branch circuit 1
Z �/i_ '9 o f _� Q Each add'i branch circuit 6.65 2
City/State/ZIP: LO ecellaneous(service or fader not Inducted)
-- --� MiPump or irrigation circle _ 53.40 1
Phone:0 V ) D O �9�� Fax: :(��)�-91` � d Sign to outline lighting � 53 40 2
a. _
E-m:il: Signal circuit(s)or limited-
F- energy panel,alteration,or
U) _ _ r extension Describe: Page 2 2
Business name:
J Address: Each additional inspection over allowable in any of the above
W Per inspection 62.50
W City/State/ZIP: Investigation per hour(1 hr nein) 62.50
6V Phone:( ) Fax:( ) =v' industrial lent boon 73.75
CCB Lic.:I9'6 f Electrical Lic - {y3 I Su rv. Lic.: !9y
Subtotal
Suprv.Electrician signature,required: Plan review(25%of permit fee)
Print name _ 1 Dater State surcharge(898 of permit fee)
TOTAL PERMIT FEE
Authorized signature. Tea -
permit application expires It■permit is not obtained within 180
days after It bee been accepted as complete
Print name: Date: • Fee methodology se!by Tr'-County Building industry Service Board
"Number e f inspections per permit allowed.
i\auilding\Perniu\ELC-PermitA v dx 12101 44"613r(IQM/C0bUWEa
Electrical Permit Application - City of Tigard
Page 2 -Supplemental Information '
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined........ $79.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Otuer:
Fee for each commercial system....................... $75.00
(SEE OAR 915-260-260)
Check'Type of Work Involved:
❑ Audio and Stereo Systems
[1 Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
IL
❑ Landscape Irrigation Control*
u ',1.4edical
ED ❑ Nurse Calls
W ❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other Installations
i.\Auildinj\Pemhs\P.LC Pe—oApp dm W1
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Li � (503)639-41.71• MST -
BUP _
Received ___. —_Date Requested___. _Y �� M_ PM _ BUP
Location U suite _ MEC
Contact PersonPh( ) 3 �!1 PLM
C(,t;tractor_ Ph( ) SWR �f —
BUILDING T)nant/Owner
Footing ELC
Foundation Access: —
Ftg Drain CLR
Crawl Drain —
Slab Inspection Notes: SIT _
Post&Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear —
Framing �— -- -------- -------
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ---_____--_---__----__—_-- ___-- -- —
Fire Alarm I
Susp'd Ceiling ___--
Roof
Other:
Final ---�_-- ---___--
PASS PART FAIL ---_- �— --� ---
F!.0MS Ika
Post&Beam —
Under Slab —
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain --- m------ - -- __
Showe, Pa i
Jt-,or: ---- -----
Final
PASS PART FAIL — _ - ---._..__----- - ------ ---------- _.
MECHANICAL
Post&Beam
Rough-In ---------- --- -- ---- --_ . —.` -
Gas Line
W6 Smoke Dampers -W ----- - -------- —.�_
In Final
PASS PART FAIL ...-.._------_----_.__---_._----
J ELECTRICAL
Service
a Rough-'.i
U UG/Slab
Low Voltage
Fire Alarm
m Reinspection fee of$—a�_ ro'q uired before next ins
ASS PART FAIT. pection. Pay at City Hell, 13125 SW ball Blvd.
SITE _—_ Please call for reinspection RE:---- __. Unable to inspect-no access
Fire Supply Line
ADA -� .
Approach/Sidewalk (trate---� � - --- lesp�ct�a►r--� N6A LJG._____�!
Other:
Final - -- DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL