Permit I _
_ a
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00667
r DEVELOPMENT SERVICES DATE ISSUED: 2/24/03
t�
13125 SW Hall Blvd., Tislard, OR 97223 (503) 639 -4171
PARCEL: 1S136AD-06505
SITE ADDRESS: 10998 SW 68TH PKWY
SUBDIVISION: WAY LEE ZONING. C -G
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: E
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: 2
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: 2
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: 20 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:
BANK OF SALEM R + R ELECTRIC
PO BOX 847 PO BOX 52
SALEM, OR 97308 TURNER, OR 97392
Phone: 503 - 585 -5290 Phone: F- 743 -4044
Reg #: 151- 743 -259
ELE 24 -121C
FEES SUP 1673S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/21/03 $470.10
[TAX] 8% State Tax 2/21/03 $37.61 Elect'l Service
Rough -in
Total $507.71
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 O 524)01 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -800- 2 -2344.
Issue By: ` !��_ -� , 'At jA -! .? . Permit Signature: ,j"
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: 7Ac
Call 639 -4175 by 7:00pm for an inspection the next business day
12/04/2002 08:56 5037434044 RR ELECTRIC PAGE 02/03
• . i
1111 ElectricalPennitApplic alion 1 1 1 1 1 1 ,
Data /received: p 5' ,02- Permit no. c t!1/09,/ - e04 i
,; ''' i . City o f Tigard v 1 CEIVED
Prvjeakopl. no.: Expire date:
City of rd Address: 13125 SW Hag B d, OR 97223 Date issued: B I Receipt no,:
F
Phone: (503) �� 0��l DEC , 0 4 2002 Case Deno.: Payment type: _
Land use approval: CJTY OF TIGARD j lu ? 7F— pct 2 2-
. , . . . _ a1,
I 'i Pt (11 I'I.1t\11 I
01 at 2 family dwelling or accessory eikCAummercial/industrird O Multi- family 0 Tenant improvement
New construction Cl Addition/altetation/replacement O Other: Cl Partial
It)R 'III I \14)101,110\
Job address: / 99S' sk f • LO Bldg. no.: Suite no.: Tax map/tax lot/aecotmt no.:
Lot: (B locic !Subdivision:
Project name: Stx..l, ni: Te tcw d !Description dad location of work on premises: 1i .12Cr,vi --
Estimated date of "on/inspection: ,
( ( 1 \ it: \ ( 1 i ) I t \ I ' I ' 1 I ( \ I I ( 1 \ I I I `i 1 1 1 1 ) 1 I
Job Inn Pao Mira
Business name: ! A- ' _ ; c La Toad nanny
, Newedeeeed -> ar pe
Address: ?\ . 0 . `it 0 5 2 dtfemopinit.Udadeeatausedaa ete.
C i t y : - t - h'e,4... I state:OR I ZIP: 'i 1 39 a tiaremisekdedg
6 o 3 Phone:1 *3 .? S Ie Fax: - 143- yogitt. E1nail: rr 46...A.4 4 c M iza,... 1000 eq. a or ii _ 4
CCB no.: x-.) Li S q Elec. bus. lie. no: 4 — / c. energy, A. t dune ,
,� 1 daub residers/al 2
City/metro lit. no.: At to / sited a t 2
� Fat* maw biome or medl r dwelling
Saapiaaa:e of sopeavi:slsar electrician ( fired) Daps 1� pg, CX Service and/or beds 2
Sup. elect. male (WmA . £• / ,• . License no: / . S ervices or begun - Immmffiition,
uleeretboorre ore
1'Ita)I'1 li I) (1\\ 11 200 ens ar fess / 2
201 amps to 400 ewe 2
Nerve (Fin*: 201
amps to 600 amps - 2
M 601 amps to 1000 says 2
City: State: ZIP: over loon , or vole 2
Phone: Fax: E -mail: lteaaaeset only I
Owner ion cos: The installation is being made on property I own Tspros y ernlmaaorfeeden-
which is not intended for sale, lease, rent, or exchange according to hniagetton,allentliesterrdocalleat
ORS 447, 455, 479, 670, 701. 200 maps cr lea 2 ■
201 amps to 400 coops 2
Owner's Date: 401 .o 600 2
\ II I It E ni behead s- aew,adteretloa,
Name: m es�don an paaiel:
A. Fee At breach circuits with purchase of
Address: _ mice or >' eder be, each Wanda ® . 21j 2
City: I State: I ZIP: B. Fee for blench circuits widest purchase
Phone: Pax: Ismail: of se:vioe or wader fee, fast t eech circuit 2
Ebb additional barb de*
I ' I l• R I \ I I \\ i I'lr: , het I. AI 11ia1 I I t 1 !►Dsc.( mwr{eederenthldded)r
O service over 22S erusiscoununcial O tiealthroare Ibalty Es* pump or irrigation circle 2
O Senior over 320 runpwrating of Ida O Aarndous location Each sign or otgtiee Wag 2 .. 2
fazoily dwellings O Braiding over 10.000 ovate bet bur or Sigaal Ciwaatis) or a limited neaps peeel, .t 2
O Systous over 600 sells salmi/ mac residential rah in are anestee alanutioa, or extension*
O Pc
O [ I v r ai . Building ow exec stadFoams, 400 amps or mac ,... _:. � , . � •..����.: �
O Occupant bed over 99 peons O M a m d a C t m e d structures or R V path lamada boss impoedon averdea tonable%gmyefdbeeboer
o Egteniabblog ptae ❑ vmsr: Per inspection I 1 - -
3albimg sets of pinr wtlh say of Me above. investigation See -
T4e *eve ore not ap llvllle to temporary emegtr taw mentiee. arm
Permit fee ................. $ a 430 ■ l 0
Not sill ialediotbsro accept credit cards, Pure call jo wind fee more irdbeeation. Notice: 'foils pen* a aAO e .. expires Win 0 MasterCard
s :L 0 �F/ S a Stare S e had (%) $
CAdit l /o3 w 37.(n I
K Less .8 I1 E x-e.. K.A. R €.1a1 r„.. ev' accepted as complete. TOTAL....... $ 50
!lathe of andio+aerm shown an erred cord
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Cardholder Menu= AmonK 440.4615 (6A0PCOM)