Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00690
1A DEVELOPMENT SERVICES DATE ISSUED: 11/25/03
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136AA-02201
SITE ADDRESS: 11153 SW 65TH AVE
ZONING: R -4.5
SUBDIVISION: -
BLOCK: LOT : JURISDICTION: TIG
Project Description: JOB NO 77337 DSL site, install power ped and ground halo. Wire for 52E stinger
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: 1 W /SERVICE OR FEEDER: 4 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
NACHTIGAL, FRED C SUC PERS REP + OREGON ELECTRIC CONST /GROUP
KESSLER, JULES E 1010 SE 11TH AVE
101 SW WASHINGTON ST PORTLAND, OR 97214
HILLSBORO, OR 97123 •
Phone: Phone: 503 - 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date , Amount
Required Inspections
[ELPRMT] ELC Permit 11/25/03 $106.90
[TAX] 8% State Surcharge 11/25/03 $8.55 Elect'I Service
Elect'I Final
Total $115.45
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: /c64711 Permit Signature; i ,/ �� ,
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 639 - 4175 by 7:OOpm for an inspection the next business day
NOV -24-03 03:44PM FROM - Oregon Electric Estimating 5032313587 T -457 P.001 /002 F -309
(Ele ctrical Permit - •_ ' tied
1 . ,3' ^ 1- OFFICE' ONL
I
�` 'Pk' f 1 7 r
City of Tigard' i Date received: Permit no / _OD i C)
13125 SW Hall Blvd ProjeCt/appl. no.: Expire date:
t i Internet a ddre ss FA/4(10)
www.cl.tIgard.or.us 414803 Date issued:
rd r us Casefi a no.: Payment type:
no.:
24 ins •ection 'i -,;t.4 - 0•'r3401 5
11 &2 family dwelling or accessory �� , ' 8 a' m Muhl- family ❑ Tenant Improvement
ID New construction oiV I:1 alterationireplacement Other ❑ Partial
BU
JOB SITE INEORh1ATION . „ , ..
Job Address; 11163 SW 65thiAve Bldg No.: Tax map /tax lot/account no,:
Lot Block: Subdivision -
Protect Name: Qwest DSL site Description and location of work on premises: install power ped and ground halo. Wire for
Estimated Date of com Ip etionrinspection: , 52E 5Z stinger
Will ou call for Ins ection within 24 hours? Yes ❑ No ❑ Project Contact Scott Bolster S032 849-3290 Phone
S �.'i• „t ., CONTRACTOR '' APPLICATION . ..: .. S DUL 1
t Fri SCHEDULE b :,.
Job No.: 77337 _ Descrlpdon eW residential - single or _ qty Fee (ea.) , Total map
multi- family per dwelling
Business nama: Oration Electric Group unit. Included attached
I gsrage. Service Included;
Address: 1010 SE 19th Ave. _ _ 1000 se. fr. or I $ 145.15 $ - u
City: Portland I State: OR Zip: 97214 Ea Addl 500 SF or Portion $ 33.40 $
Phone: (503) 234.9900 Fax: (503) 234 -1001 E - mail: _ Limited Energ 1 & 2 Ferny $ 75.00 $ - 2
GCB no.: 203 Elec. bus. IIc. no.: 26 -95C Limited Energy, foloto gemly $ 75.00 , $ - 2
Ci /metro lie. No.: 1995 Each manufactured home or
modular dwelling. Service
�,�� , . , rR „ Sate 11/24/2003 androrfeodcr, $ 90.90 3 - z
�/Sgrir ' /' air m Service or Feeders -
- �� "� (11t11t�LL11r li no: 4460S installation, Alteration or
Su ► Relocation;
. { PRO 'ERT'L
' OWNER, 200 amps or lase 1 $ 60.30 3 80.30 a
Name • rint : 201am0s - 4009mps $ 106.85 $ - 2
MailingAddress: 4otamps- 600amps $ 160.60 $ z
Ci State: Zi • : 601amps • 100oamps $ 240,60 $ - z
Phone: Fax: E -mail Over 1000A or Volts $ 454.65 $ - 2
Owner Installation: The installation Is being made on property I own which is ROCOnn°d' mora/5 ° Servi e k i 5 66.35 $ - ,
Tep r
not intended for sale. lease, rent, or exchange according to ORS 447. 455, Feeders aila ctres o
on, —
479. 670, 701, Alteration or Relocation:
Owner's signature: . Date: . 200 3111.9 Or less 5 66.65 $ -
0 ENGINEER - 201amps - 400amps 5 100.30 $ 2
Name: Over 401omps- 600amos 5 133.76 $ - 2
rant t Circuits - Now,
Alteration or Extension Per
Address: panel; A. Fee for branch
Ci : State: Zi • : circuits with purchase of service
or fccdcr fee, each branch
Phone: Fax: E -mall: circuit 4 $ 6.65 $ 26.60 2
B,
Fce kr Drench drcults
r W/Out Purchase of $crvice or
Feeder. 1st Brancn Ckt
PLAN REVIEW ' 5 46.85 $ • 2
❑ Service over 225 amps -comm O Health -care facility Each addtdonal branch circuit $ 6.65 $ -
❑ Service over 320 amps -rating of 0 Hazardous location Miscollancous • (service or
seeder not Included)
18.2 family dwellings ❑ Building over 10,000 square feet four or Each pump or initiation code _ 53.40 $ - 2
❑ System over 600 volts nominal more residential units in one structure Edell Sinn or Outline LUOhtinp S 53.40 S
❑ Building over three stories ❑ Feeders, 400 amps or more Signal Circuit(a) or Limped Energy
Panel Alteration or Extension'
❑ Occupant load over 99 persons ❑Manufactured structures or RV P0IR s 75.00 $ -
❑ Egress/llghting plan 0 Other: 'Description:
Submit 2 sets of plans with any of the above -
The above are not appiicabte to temporary construction service. Each Additional Inspection over
the Allawabfa in any of Me
. Notate: This permif vocation Above. Per Inspection -
expires if permit is not _ 5 62.50 $
eptalnad within 180 days eater It Inve8tt¢9Ii0n 199: ,
has peon occoptod as Omer
complete. Permit Fee $106,90
Plan review 25% $0_00
State Surcharge 8% $8 55 '
Total $115.45