Permit CITY OF,TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: E 1/2008 00055
DATE ISSUED: 2/1/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136AA-00801
SITE ADDRESS: 10380 SW 71ST AVE ZONING: R - 4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: COLOMA
Project Description: re connect gas furnace. (1) branch circuit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0.00 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 0 201 - 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:
DALE & CHARLOTTE COLOMA BEN'S HEATING & NC
10380 SW 71ST AVE PO BOX 80607
TIGARD, OR 97223 PORTLAND, OR 97280
Phone: 503 - 244 -1246 Contact #: PRI 503 - 233 -1779
FAX 503 - 651 -3345
FEES
Description Date Amount Reg #: ELE 49LHR
[ELPRMT] ELC Permit 2/1/2008 $46.85 LIC 64597
(TAX] 12% State Surchar 2/1/2008 $5.62
Total $52.47 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 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: Perm ittee Signature: sec47Xf,U
OWNER INSTALLATION ONLY i'
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.
JAN-31-2008 08:57 AM BENS HEATING 503 6 5 1 3345 P . 0 2
Electricai Per Li i ; 1 • .L 1\1 Es iii•I•Ii 1.. i NI
.- .
Cit of Tigard
13125 y SW Hall Blvd., Tigard, Oli RBA 1 20OB Fitrir- now= Permit No,: .. . - • '
Phone: 503.639.4171 Pax: 5031/981960 ■,: ther Permit : m ac_..., Li
. A 03 70 . o a) (4) .
1 „.. ,, ,, „ Inspection Line: 503.639.4175
ARO O ,. See Pap 3 for
Internet: WWw.tigard-orgo iv OF T1G--
ER '
Supplementa l Info r matiOn
• 1 i
I I
....1-'. ..!:11NS,V.:.1.11"-i1.'1'.•'•''■:7rZ.Viti.V7X.ro•:.1:w•St0.•-•',`;';.-c.5PI'M ''IrfloTrkli47".
. • • . ••,, .!,• -. • . .,:t,. 11 ' , ...... 4,,,, : , ;. ,, Mito , ....a , Artt , 10..Larikat,■&/;41:1'.gttial git■':53agiatafil"MIMMEZIMMI
0 New construction II Addition/alteration/mplacernent
Masa check ell ene apply (ubmi, a sets of plans wiiteins chocked below):
0 Demolition 0 other: 0 SCI'ViCO Of rower 400 CMO Of more 0 Building over throe ithries.
whore the available MI, current 0 Marinas and boatyards
• '.."'.... : ... • .;"'.. : •••:' • CA#004003? .•,.• 77 • • CC& 10 000 ra • ' . .
. . . . . ,.0...t40 rE.,,i■Ja 4= ;V ' k!., ' i ' 2ty eiM • Mini" 130 v006 or Floating buildings.
( 1. and 2-family dwelling A Commercial/Industrial 0 Accessory building . lost to round. Of OXCCOCIS 14 .000 0 Commercial-use agricultural
amps for all other installations. buildings.
CI Multi-family 0 Master builder 0 Other 13 Fire pump. 0 Installation ,f7 KVA or
.. • ••• : i... '1: r,iNfrain,,,.4 ° Emer sYstan' larger separately derived systeini
4 diemAarkikrAmiql,P4Vigani.',..' ...tiAt': 0 Addition of new motor load of 0
Job no.: Job site address: /4 ID 5i4) °I- 100HP or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks. ;
City/State/ZIP: . 7 7
r 4 0 C4 5 7,2 V,-7 a Heahh•care flicilitles.
0 Nezardoue locations. 0 Supply voltage for more than
i
600 volts nominal,
Suite/bldg./apt. no.: 1 name: 0 service or feeder 600 amps or more.
iillakEn..:_r,Ar ' . a *;(,;,;...,::...:-'.'.... ' • .. . ..
Cross street/directions to job site:
. . -7 7 , 7=EMEN■miligitlINNECINii.MwilM
New residential single- or multi-family dwelling unit.
[Wades 'Birched garage.
Subdivision: .
I Lot no,: 1,000sq. ft or less = 145 11111111111:1
Tax map/ l Ea. WWI 300 sq. ft. or portion 111111 33.40 n
parce no.:
IMIIMESEENIZer Bi "" 1111111E1
Limited energy, multi-family III
III
(-7 75.00
iNe - Co rJi.4ci C 4r r A.) A- C. e residential with above • .. R.
Services or feeders installation, alteration and/or relocation
200 amps or less 11111 80.30 1E11
. .. ' 0 l 'it ; ' , 31~:,' iriffA.:; ;4 Sii 201 amps to 400 am .s = 106 11111111191
401 amps to 600 amps IN 160.60 EN
Name: a 1,,, ad , rs i er if... e. c . I co, 4
601 amps to 1.000 amps 11111 240.60 mmimn
kddress: 1 03 eo 5' ,.....) 7/5 Over 1.000 amps or volts =I 454.65 Ng
-Oty/State/Z1F: qP223
Temporary services or feeders Installation, alteration. and/or
' 7- oa
lepOra A / relocation
l ( 3.) Y y -124/ 4 I Fax: ( ) 200 amps or leas = 66,85 n
as IIIII 111111111111Ell
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 mp 100.30
intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am - 10 599 amps IM1 133.75 in
Inrrrfirt1AILLIAMO
Owner signature: Dale: A. Foe for branch circuits with
• - . . • . • .t... 'a•10 ::...!A*;; .. ..i; tlICZ:M=M above service or feeder fee.
6.65 11111
each branch circuit
Business name: r? )j.‘ t 14 . 4,, r„,a, rk L c C
i B. Fee fit branch circuits
without service or feeder fee,
`AP .8 111
Contact name: C1 [e e..., eh ei first branch circuit
Address: Each add'i branch circuit = 6.65 MI
Miscellaneous service or feeder not included
City/State/ZIP: • • Each manufactured or modular III 90.90 II
dwell in . service andior feeder
Phone: (07 ) 3 ),3 - 1 9 0 1 Fax: : (I's ) ) 4 r i - 3/ p 5- Reconnect on I mim 66.85 IS
L-mail: Pum . or irri . , tion circle 1111 53.40 n
•: , .:. •• • •.::!:.... •;•-. : ;.,,, ..-.:‘,:.: i.......;1;S:i. • ,, WRACtoft,.; •,t gingaMega Sign or outline li . tins am 53.40 EN
Si.. : circuit(s) or limited.
Business name: .- B e I 0 0 ,4 ( Aa .# Az eft A ,s1 rinL I v 4 1 -c-- energy panel, alteration. or
extension. Describe: Page 2
Address: e, 0. t i t , , 7
Each additional ins . Hon over allowable In an of the a hnvc
City/State/ZIP: ea e .+ 1 . 4 , 611 O A q7aio
, - Per inspection 1111. 62.50 n
Phone: (sD3 ) 4 3 ? 9 [ Fax: C573 / J/ Inv emi . hour (1 hr min) IIM 62.30 IN
Industrial hour n
Cell Lic.: 6 lip; 7 I Electrical Lic.: 1/9 tlfg i Suprv. Lic.: plant per IllinBil
ErigrigniEl=anal
Suprv. Electrician signature, requ' , .: mormin■Et=imaisocim
'rint name: i 1 r ,, e; '
- - Plan review (25% of permit fee):
State surcharge (12% of permit fee): IlMiell
,_ ....
VIP O 1 • 7 r1 - - 6, TOTAL PERMIT FEE: 111;1 i
Authorized signature:
mis permit application expires If a permit Is not obtained n ;thin i :' 1
Print name: ei e Nu r +0 fi. Date: //4//er day' after It has ken accepted as complete.
• Number of inspections allowed per permit.
I VluildIng \krudiaLC•Perro4App.464 05/23/06 4404615t( 1 liosicommes
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El_C
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/ 1/2008
Phone: (503) 639 -4171 Az tit
11
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/ ?1/2008 TIME: 7:00AM PAGE: 65
SITE ADDRESS: 10380 SW 71ST AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: COLOMA
DESCRIPTION: re- connect gas furnace. (1) branch circuit.
OWNER: COLOMA, DALE & CHARLOTTE PHONE #: 5O3- 244.1246
CONTRACTOR: E3EN'S HEATING & NC PHONE #: 503 -233 -1779
Inspection Request Scheduled For: Date: 2/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 E_loct.iical final 065126-01 503 -233 -1779 Y
Corrections /Comments /Instructions:
/1,( 1PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL f/ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
L%, Z( Z--6
Inspector: Date: ( Phone #: (503) 718-