Permit ���� ��� ELECTRICAL PERMIT
PERMIT #: ELC2005 -00676
�' � � I 14ry DEVELOPMENT SERVICES DATE ISSUED: 9/14/2005
°� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
. PARCEL: 2S104AA -01100
SITE ADDRESS: 12400 SW BELL CT ZONING: R -4.5
SUBDIVISION: BELLWOOD LOT : 060 JURISDICTION: TIG
Project Description: Circuit for hot tub.
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: 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:
BRIAN BEERS OLIVERS PRECISION ELECTRIC CO
12400 SW BELL CT 17035 SW HIGH HILL LN
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: 503 - 679 -8972 Phone: 503 - 579 -7747
FEES Reg #: LIC 41435
2539s
Description Date Amount SUP 34-52
ELE 34 -521 C
[ELPRMT] ELC Permit 9/14/2005 $46.85
[TAX] 8% State Surcharge 9/14/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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: , 0 . 7,� ... Permittee Signature: . 1171\e\c
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.
09/1,3/2005 14:31 5035795907 ® REVILO SAINTS PAGE 02 .. , . , . .„
1 '- iOR:►f'F1( 1.. 1 `l c1\1.� •
,Eteet� ic�tl Permit A t ,
City of Tigard P 1 1p05 , _ Permit No.: ' /
13125 SW Mall Blvd., Tigard, OR 01223 C Plan Review
Phone: 503439.4111 Fax: 503.598.1960 `� g • Other Permit:
Inspection Line; $
Internet www,citigard.or.us GV 0' 0 �S l't� •� -1i Date/8 N oaied/M B rbo4: - ( Supplemental
y sr}} t f ••-- 3 ,� ', K •e01't " M a, i -ii <4y , w ; t -- ',.: '•: ,.
.• .&`�_� x ,' : Llj i4 _CYJ!.� tt r....r :1.' .^t;.` ∎ ..a .*:.4:-1 05\ Y ala•U . : :•
❑ New construction I: • ddlition/altastion/replacemerlt Please check all that apply:
❑Service over 225 amps, comtn'l ❑Hazardous location
Q Demolition ■ Other
y • , 1� �. w� , o , r , (. r , ,r� + �, -•t !DSc-vice over 320 amps - feting [ BUlidng over 10,000 sq. ft..
{rR t i , . t' ' .
^, .'M6 of I. and 2- family dwellings 4 or more new residential
❑ i - and 2- family dwelling 0 Commercial/industrial 0 Accessory building OSystem over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders. 400 amps or more
❑ Multi 0 Master builder ❑ Other QO ccupant load over 99 peraoAS DManufacturod structures or
�,... jP , F h . 7 x , 4. Ui V perk
' . r .. `� F , : r . , „ ; -9 ; � ip4 ` ; i t D E greS S/ lighting plan R pa
zyc:i . . i ..t •,7 •G....1C Z•1 c,. : it__ .... .w .t.! x.ca...,', !.,
Job no.: Job site ss: • • , ` era so Dliealtlt - care facility ❑Otbcr: _
• Submit Z, sets of plans with any of the above,
City/State/ZIP: 1 L i�L • The above aro not applicable to temporary construction service.
• Suite/bldg./apt. no Project name: r , i . • Y K' ` j ..
<r _ LL nneNpmen Om Fee. row
Cross street/directions to job site New residential single- or multi- family dwelling unit.
/Deludes attached garage.
• 1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no Ea. add'l 500 sq. ft, or portion 33.40 1
-- Limited energy, residential 75.00 2
Tax map/parcel no [.irrt rod energy, non-residential 75.00 2
z!e ^ b , ,:.- ,,......7 -. fi �� 1 y r f -4, .. r r2+
r ., R , • � .. -. _ t . ;...,.'.. .. ( ' � Each manufactured Or mgdular
/ dwelling. service and/or feeder 90.90 2
services or feeders instaitation, alteration, and/or reloeatlo
2•0 amps or less 80.30 2
. .. r Ti r Tf: „x 00.E 4- t 1'• 7 .rc'y! 1 if w 4, ., .,Tp, 1 9. ... { ,y G 201 amps t0 400 amps . __ 106.85 2
m ' r n 4 Y . ! ilfaal
` �y `< „ . ' 401 amps to 600 amps 160,60 2
Naive: " Y lC./1/� 9,...e, 601 amps to 1,000 amps . 240.60 2
Address: 'Sig Q.� 1 Over i art>Ers or vo114 454.65 -
a
Reconnect on _ 66.85 2
City / State/ZIP: Temporary services or feeders inatalietton, alteration, and/or
Phone: ( P relocation
(S l� 7 u 7 ( ) 200 amps or less 66.85 1
,
Owner installation: This ' lat ion is being made on property that 1 own which is not 201 apps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 annps 133.75 2
Owner signature: Date: Branch circuits - sew, alteration, or extension, per panel
°',a, 7 r.:1 .::-,":. .. ,"- '' ' : ` : . . ,' i k err . t+e +p A. Fee far branch circuits with
-:014 y_ . , r . i .. , , =.7`,.'''. . ' . ' . .. ,1,111A .t J r ... OA '. .. ir* -Y! service or feeder fee, each
6•b5 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85
each branch circuit ,� j 2
Address: Each add'1 branch circuit 6.65 _ 2
City / State/ZIP: Miscellaneous (service or feeder not tndudad)
Pump or irrigation circle 1 _ 53.40 2
Phone. ( ) I Fax :: ( ) Sign or outline lighting _ _ 53.40 2
E- mail: Signal circuit(s) or limited-
',I 4 i ' ;i.. u . , .. �,, .,: 4 k ' st %1 � q i ' ', ' a.6 ene panel. alteration, or • .a -. ,A;. ' . r. e!„ . ' _ �
' n extension. Describe: Page 2 2
Business name: 9 / /J'' , ' / reglSi , / _ C ✓ .ee r rt..
Address: 3 1 N - J /' _ Each additional inspection over allowable in any of the above
� Per inspection 62.50
N City/ State/ZIP: .---7 / % / II -71 /� bmvesegation per hour t to !Oh)) 6250
i Pho (�' D ' S ) 5 7 Q 1 -71_ ax (S V 5 7 9 .s t/ 7 Industrial plant per hour
+. f�.., 73.75
CCB Lic.: / Electrical Lic.: , • ./ Suprv. Lic.: As. Subtotal , . , s
9 Suprv. Electrician signature, required. WA 1 1,11R121111111111111111114,_ Plan review (25% of permit fee)
� State surcharge (8% of permit fee) j t
1v) Print name: �� r Date: f MEM
TOTAJL PERMIT FEE
0 . (o a
Authorized signature: This penedt apptieanoa expires if a permit is one nbeaioed within 18V
days After it has been accepted as complete
I Print name: Date: • Pee methodology set by 'l'ri.County Building industry service Board
•• Number or inspections per permit 2iktWed.
is doc 12/03 440- 415T1insn/COM B