Permit CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00826
. 4440•A
i `Y DEVELOPMENT II ER CES 503 - 639 - 4171 DATE ISSUED: 10/21/2005
PARCEL: 2S1 12 BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 16 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer, water heater and heaters. Job No. R -05 -847
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:
PYOUNG & J PARK ABC ELECTRIC
17514 NW COUNTRY DR 135 NE 9TH AVE
PORTLAND, OR 97229 PORTLAND, OR 97232
Phone: Phone: 503 - 233 -7551
FEES Reg #: LIC 26 -1226C
SUP 5096S
Description Date Amount ELE 161501
[ELPRMT] ELC Permit 10/21/200` $66.80
[TAX] 8% State Surcharge 10/21/200` $5.34 REQUIRED ITEMS AND REPORTS
Total $72.14
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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 fo • - • -n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are : forth in OA •52- 001- 0010ou• h OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 - 246 -..99 or 1 - 800 -33 2344.
7 / Permittee Signatu 4Ii-
Issued �� y: � � � � �L- � / / / 9 y_. x
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
MOW
SIGNATURE OF SUPR. ELEC'N: =' ' ; +� %� DATE:
LICENSE NO: °l
Call 503 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.
OCT -20 -2005 12:28 PM
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' City of Tigard
]�ieC____ al Permit ADAliCatiOn I:( It( t 11 t It 1:,1 INI (IN . I
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L /0 O S - Permit No.: ,9605 - -- co
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13125 SW Hall Blvd -, Tigard, OR 9722. .
� % , Review Other Permit;
Phone: 503. 639.4171 Fax 503.598.1 `�' 1, 1' _ . _'tik . , !', fit i Date/n See Page 2 for
NoafiedlM
Inspection Lino: 503.639.4175 a Data iediMathod: Ready/By: Supplemental Inrortnadoa
Internet: www.citigard.or.us ,� r , n, (mr I' I o 1 Ifl( f j ;.'�
T e t + ii } F}lrl {j + t,, , jrI11 } ` 1 1 t 1 tl I I IO l + }}li' i 1 1, ,1 I,7�f t +!d
1 rt, : 1_ {I .or r +iii, a t .„, I l I 1 i t I x f . ,, .. I ! ..}, o F,,,,epA c l d.t4C.,,._ s$4 •,,,. .�'. � I k •: L � •'YI.4 ' t '-
I!:;,t , J ail t { ( f },{ + i i ii I , - � _...
t t
p, r 1 S1
� f i ... s., .......,, Please check all that apply:
❑ New construction Adci I 1 i At-ru nt (DServiee over 225 amps, comm'I QHazardous location
❑ Demolition 0 a . al • ► ❑Service over 320 amps — rating [IBuildng over 10,000 sq. n.,
} j}fLi�1 F l uj :i; :, i IS I+,l I II � + 71` `i l ,
. t{ � L I r ! " I ' r , �! „ _'. al al
j 11 3 of 1- and 2-amity dwellings 4 or more new rest enti
;S1 . ,,a „11.r. ulL ",,., &rl .�_....a ..F..,. + � { •.r,. ' ._._.... 1 I
.... - .....,� ❑System over 600 volts nominal unite in one structure
❑ 1 - and 2 family dwelling 1 61 Commercial /industrial ❑ Accessory building []Building over three storm °Feeders, 400 amps or more
❑ Multi ❑ Other ocupa
❑0nt load over 99 persons ❑Manufactured structures or
family C] Master builder RV park
f;� I v f 1'tl r°! t ! } {1G,�. { F , i "Ii-i. + r . i It. I t'i ' 1 t 1 L,. ,.. ., I 1' plan
i!t# !.34 . i t .,7:. : :'A ,1 .4...I , . , , ,... -.... , .. _ /; ❑Health-care facility ❑Other:
Job no.: �S • • Job site address: , i J •alIM Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construetlon service
City/State/ZIP: a � , , 1 , � ,y ,3, q i 4,` ,r,i`13� }h clay � , .. ,, r d r ..,h r ( j ( s f : }}(lii
-! Y. E I# i;'_::I ,1 ' a ,•. Ref. 0 Total ..
�,.. ,a.:� -` 1.. t. ,,.t ul }4 ., ,dl .n 1, «.: , 1 .,.
Suite/bldg. /apt no Project name:. ',
air I DeeodDitea Qty. / / New residential single- or multi - family dwelling unit
Cross street/directions to job site: . ,� _ � Li Includes attached garage. _
1,000 6q. ft. or loss 145.15 4
Ea. add'i 500 sq. ft. or portion 33.40 I 1 I
Subdivision: Lot no.: - 75.00 2
— Limited energy, residential
Tax map /parcel no.: Limited energy, non - residential , 75.00
0i t �, t(; ,(rl # (I I + ' ` f , l t a " I f �+ t; :''E #., I ,:,`, f' r� Each manufactured or modular 40,90 2
_- t.,,,t,,..�,.u. } W6UIn• aerVlCeand/0rfeedor
0 . / - / ' t/r -' • Services or feeders Installation, alteration, and/or relocation
200 .
amps or less 8030 l 2
' • / 20 amps to 400 amps •
l 80 30 2
( {} ( I 1 M r # l i t fl ] ,'.. I t 1 t #r' t rt
.lit, •:, t.l.,.,L.,r. ,...,, ... ,rz}_, ,._.,,, .,. , :'.,,,:'=: . „. r - 401 amps to 600 amps 160.60 2
G °i t rJ,3 `
S A a- 601 amps to 1,000 amps 240.60 2
r _r) -T� (� Over 1,000 amps or volts 454.65 2
Address: h S l COu . _1�� /T - Reconnect only 66.85 2
City/ State/ZIP: ,r1R� p b), eri a9`9 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 1 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 atinps to 600 amps 133.75 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
tt J ` , , A. Pee for breach circuits with
�' Py�l r t ty} I I 11 t Lr' it r 7r r I - • . , ` a} each ,
„# 1 ....;, ,,. {,ly 3rta_..,, ;:f,� ..i.l• t}„ 1 . , ,,.., _ .. . .. ..: .: .. ,e 66
. se or feeder ec 6.65 2
Business name: .? Q ^ branch circuit
f r J it - B. Pee for branch circuits
Contact name: CA. 1%
r without service or feeder fee, 85 �. 2
- each branch circuit
Address: 1, (n _ Each add'I branch circuit 6 .65 y , S 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
&mail: 4 i 66 Signal circuit(s) or limited -
11 �f iri � r� l!' 41. � L 7'II; �. ;.... i .,,.. + J l . energy panel alteration, or
tl .F �id C,. I to LYL ; La L extension. Describe: Page 2 2
Business name: 43 ki-- t 1 .
Each additional inspection over a In any of the above
Address: A j 4 f Al I Per inspection 62.50
City /State/ZIP: Poi..-14 0 CJ e 4 7.2 r3 c:D Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: ( ) �?, Fax: ( ) „v....3 } !,1 r' V r'II L(i i�i,3v ,i,`.ILik,,�'.Itj.1L`fi ,1 i 'i 1 i t li t tir t
CCB Lic.: Electrical Lie.• i Suprv. Lic.•, c Subtotal 66 gv
• Suprv. Electrician signature, required: - ' Plan review (25% of perrnit fee)
- 2 r- State surcharge (8% of permit fee) , 3 c/'
Print name: ' •
∎ ..'a __/ . /) � , A Date: 0 :� •
J TOTAL PERMIT FEE
Authorized signature:
This permit application eriplres If a permit is not obtained wllh,n 15
days after It has been accepted oil complete
Eli: Date' Fee methodology set 'by Tri County Building industry Service Board
1 ...:.• . Y •• Number of inapoetlone per permit allowed l e
,
t�„ndlea ern+kt...aremdu,ap.dee 12/03 4404615T(IaDVCOM/wEa .7 . •(