Permit 4r ''' CITY OF TIGARD ELECTRICAL PERMIT
Il
t: �� PERMIT #: ELC2007 -00773
=i, COMMUNITY DEVELOPMENT DATE ISSUED: 11/15/2007
• -TIGARD: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 108 B -05500
SITE ADDRESS: 14210 SW 121ST AVE ZONING: R - 3.5
SUBDIVISION: ARLINGTON RIDGE LOT : 032 JURISDICTION: TIG
PROJECT: HOSMAN
Project Description: Install a transfer switch, (6) branch circuits. Job No. 1363
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 HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 5 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:
ROBERT & DARCI HOSMAN WILLAMETTE ELECTRIC INC
14210 SW 121ST AVE PO BOX 230547
TIGARD, OR 97224 TIGARD, OR 97281
Phone: 503 - 701 -1015 Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
IELPRMTJ ELC Permit 11/15/200" $80.10 LIC 75059
!TAX) 8% State Surcharge 1 1/15/200" $6.40 SUP 4226S
Total $86.50 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 thro gh 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: -
Signature: �t i �1 C z` „-/
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.
..„NOV •
15 2007 1:O1PM WILLAMETTE ELECTRIC INC. 5555555555 p.2
i
www.tigard or goy
electrical Permit A lice '. 4
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City of Tigard �""°
13125 SW HaII Blvd., Tigard, OR 97223 Datemy: // /S 07 Permit No.. fLC �Q,_ 0Q 77
16 a •, Plan Review
I °r`P Phone: 503.639.4171 Fax: 503.598.1960 Da Othe: Permit
i I i n R u' Inspection Line: 503.639.4175 ��� 2U thy'
Date Ready/By:
.r, ,ri Internet: t: furs: S See Pent 2 information
for
Y � _r� f S ed/hth �(� Supplemental i
�,;I`��8 #� II U1t' " f I i(INII I l���p }t""C "r1f, +rtn - ac�m tuli two a t�
N151 �l' 1111(Ull11111� it llR it �s ��, � �lii�iapiii + 11,.. ' _ li �i. t tl U! { td>Ij((1dIt8(�I.. if it i, gl'tifli iii }(}iti ��� 1 `1
i�1:1' y� }q�;.���1p , ti �xn ¢ : «,pour II �� l w o yy. 1 )1' y)1
�3�31A -. Jiafnilillllt- •�.,,F:fm..l iL.t.�4. la . � �i.'f {��lllglj�l�6�.91�. t71 �. f{:kiLY ��n u 11C71�ILLIL1 WU��10h�J��eadL�Ml�I ���r }t�hjTq.i: °INnl�dieii�aP1�!Illl l Ij3�'l�Illlflll LL,���IItR7lU1
❑ New construction 15 '. dditto al era ion/repl: W . ° ' "ir 1 Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Other; where the available fault current
� '"� All f}Ip'{ 1 . Ilu srlpa +augtls } ^rrw rapsar�+N itgtu tAr}°ua; 1 e ,,.. ❑Marines and boatyards.
},��QI� "Jl #�� l';7 it �(0A tl I Ile diltlt;f,�� l�f (,! I1I' 1I ����7 { exceeds 10000 am
(� , sat 150 v oILS o r
ilnr i6r `Itl�stas?a •1 'I'.1 rf § :siu illtr it Iu,:w?si .l ` �I wv73� alllmu 3r I , 1 ` P ❑ Floating buildings.
L 1- and 2-family dwelling less to ground, or exceeds 14,000 ❑Commercial•use agricultural
Y g 0 Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
I, � U l� � � lliu m nt 1i � » w i a u
art i , s t o w , r i t n r Is tt
fa s i 111 U ❑ Eme enc
I' ( � 1 i6, ; _ , , � t o e } E f s 1 5i } F ( ��u nryq � t t ,� t�!«, � i I NMI , (� B Y system. larger separately derived system.
11111 ifiriII 1 �,1 41.4 ..,,4 r sfal 1 Gl.tmarlfnl6 L,4t klAtng cat .., 5rial � : ,bail ,.. u ❑ Addition of new motor load of ❑ "•A" "E" "1 °•1 - 3•
Job no.: J 39 3 Job site address: �. 1 f I HPor mo. occupancy.
�' ! `� e v 1 r 1/6' � ❑ Six SOO or more res unite. ❑ Recreational vehicle parks.
City /State/ZIP: / / 1 ,„,,,i fig. ❑ Healthcare Pecibties. ❑ Supply voltage for more than
�/ /`� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: jt ® s ,Gp-) ❑ Service pp or a�l1 feeder 60 or �t� � } }'It p
lifdiNla};lt��lli 1G,�{4L1�t�r; '� ��ltH� i «s��� ltlt�z'ljj� l ;nlid IH��Illflll�l1 }
Cross street/directions to job site:
Description
Qty. Pee. - Total •
New residential single- or multi- family dwelling unit,
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
T / I''' } i' �gy Ea.add'l500sq.11.orportion 33.40 I
dJl'-1Nfjliltii1111 F f1:ii 1ll1�f1��utt } r�nlit uul , ,urt�� }t/n ? � °ytkiS161 �JIS 111111 1 f f 1� 1 11131 Lt (with above g sq . ft) idential 75.00 2
Limited energy, multi- family 75.00 2
residential (with above sq. tt.)
,} 'ES TI i j Services or feeders installation, alteration, and/or relocation
4 1 13l`>gn 111146:31
: 3n'dri.�4a3 a 6lls7 ' 191111-'E Iii I illllVlil tair G1;�t,„ i��+ti it I 1 201 amps to 400 amps 106.85 2
Name: �'b /i � ,e. h 401 amps to 600 amps 16060 2
601 amps to 1,000 amps 240.60 2
Address: 1 L/Z• jQ ,.yuj i& J 5 / guie Over 1,000 amps or volts 454.65 2
City /State/ZIP: T 1 r " /) 2, Temporary services or feeders installation, alteration, and/or
�� /! v relocation
Phone: (6-113) ;2 —) A F ax: ( ) 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
Owner signature: Date: Branch circuits — new, alteratio, or extension, per panel
�; a (rtl vn; t to �s nU vrnmy g P r p j his } to It n u l�p1 A. Fee for branch circuits with
't ulf H101U l II I ii E7 ' °gltrwY irA ° ta> a °rte 111 !I i ,a h6t a aiu Y llin }tint t st : 1 above service or feeder fee,
Business name:
each branch circuit 6.65 2
B. Fee for branch circuits
without
Contact riame:
first branch service or
circuit
fee, I 46.85 4f b, g5 2
Address: Each add'I branch circuit
6.65 33,76' 2
' City/State/7.TP: Miscellaneous (service or feeder not included)
Each manufactured or modular 90.90 2
Phone: dwelling, service and /or feeder
( ) Fax: ( ) Reconnect only 66.85 2 _
3 E-mail: ���t 61 6 !a,,� I 'g ��p�� ��t� Pump or irrigation circle 53.40 2
33{"11�Nttlltill� IlfsliY tiniilaiS111ielaiu ,� °I,t ° i (li 1�, I a 8} NM RM Sign or outline lighting 53.40 2
Business name: Willamette Electric Inc Signal circuit(s) or limited-
energy panel, alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City/ State/ZIP: Tigard, OR 97281 Each additional inspection over allowable in any the above
Phone: (503) 624 - 3631 Per inspection 62.50
( ) I Fax: (503) 624 -2938 Investigation per hour hr min) 62 50
CCB Lic.: 75059 Electrical Lic.: 34 -283C Suprv. Lic.: 4226S Industrial plant per hour 73.75
1 j 11,11i (11PEi> ani. ,.aA.,or L :l h Ll!. f fililliallI IIM
Suprv. Electrician signature, required: - 'f" _ Subtotal: , / , /
Print name: David Fife Date: 4 . , r, Plan review (25% of permit fee):
`
O State surcharge (8% of permit fee): 6,q0
Authorized signature: TOTAL PERMIT FEE: e6 • 50
This permit application expires if permit is not obtained within 180
Print name: Date:
days after it has been accepted as complete.
L 1 Building\pamaELC• r
'n\ App.doc 05!73/06 ' Number of inspections allowed per permit.
mu 440- 4615T(I r/MS/COM/WEB