Permit CITY OF TIGARD
- ELECTRICAL PERMIT
PERMIT #: ELC2002 -00347
"�I�I. DEVELOPMENT SERVICES DATE ISSUED: 8/22/02
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 112DB -00600
SITE ADDRESS: 15205 SW 74TH AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: TI Electrical
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: 2 W /SERVICE OR FEEDER: 50 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: 1 PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: X CLASS AREA/SPEC OCC:
Owner: Contractor:
DENNY MEYER ROBERT HAUSER ELECTRICAL INC
7340-SW LANDMARK LANE 1091 NW CORPORATE DR
TIGARD, OR 97223 TROUTDALE, OR 97060
Phone: 503 - 620 -2086 Phone: 503 - 674 -0147
Reg #: ELE 26 - 402c
LIC 13476
SUP 1553S
1 FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PLCK CTR 7/25/02 $183.28 2720020000( Wall Cover
Underground Cover
PRMT CTR 8/22/02 $733.10 2720020000( Elect'I Service
5PCT CTR 8/22/02 $58.65 2720020000( Elect'I Service
Rough -in
Total $975.03 Elect'I Final
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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification
Center. Those rules are set forth i n OAR 52- 001 -0010 th • ' g h OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to
Permit Signatur- • C Issued By: ,if n. Ilk,
OWNER INSTALLATION ONLY
The installation is being made on pro ert o wn which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE DATE:
CO TRA•' OR- jNSTA„LaION ONLY -- &-/Ak r• i 1 1 r
SIGNATURE OF SUPR .E ELEC' I l � J DATE: ? �9" - c
LICENSE NO: /5 3 3 ^ 3
Call 639 - 4175 by 7:OOpm for an inspection the next business day
•
L 1) i \() . . ,..„._ 'Al / 1(\17
S • ' k (CI 1)d\°\ <, ;
P
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Electrical Permit A p `
JUL 5 Da received:l/ �— permit no.E /e � — oa;g 7
.tl'.'II City of Tigard (� �� Project/appl.no.: Expire date:
Add 13125 SW Hall BLvd;rTigaud. O i e 972Z3�. ) Date issued: B Recei t no.:
CiryrtfTtgard •ad;,)i�I r s , Y• P
Phone: (503) 639 -4171 , P' T 1 �-
Fax: (503) 598-1960 ,s.1 Case file no.: Payment type:
0
Land use approval: •
TYPE OF PERMIT
•
O 1 & 2 family dwelling or accessory .Commercial /industrial 0 Multi - family 0 Tenant improvement
0 New +construction ❑ Addition/alteration/replacement 0 Other. 0 Partial
•
1, JOR SITE INFORMATION
Job address: / ',S , r Bldg. no.: Suite no.: Tax map/tax lot account no.:
Lot: Block: Subdivision:
Pro eat name; Ai .119119ffilli Descri • tion and location of work on remises: C6 f 0 L . •
E3t1. ieQrd -. Lo[tco _ . letion/inspection: 1 ... •
CONTRACTOR APPJ.,ICATION Ftil: S(:11E111111:
doll UOt ` , _ — // Q
Business name: ∎ s = Desert .. Qh. � .
New reddeatta -single or mrdti- family per
Address: r ' • dwelling unit Includes attached garage.
r _. Stater • ZIP. O , p • serrjoe:wham
Phones -.. G • .O t , Fax: E -mail. 1000 sq. ft, or less 4 \
t e t ,L im Each additional 500 sq. ft. or -onion thereof ���
CCB no.: Elec. bus. lie. no: „_ ' . � Limited ene :y,recidential 111111.1111111111 111111.1111111111 2
mett:ol•c. no: ' • `' Limited energy, non- residential ��� 2
�r g► I _ Each menu attired home or modular dwelling 111■
re of sta. - isin - electrician (required Date Service and/or feeder 2
no: 3 ^ Services Servio orfeedere- installation, Ilk
O + T ; a ' i Uoense *iteration or relocation:
PROPERTY OWNER 200 amps or less (06• 2
201 amps to 400 maps
Ntutie (� iint): 401 am • to 600 amps .11111.1111.11 2
• t s l 1 601 am. to 1000 amps t!111111!t.'Tl11 2
� ZIP: • vet 1000 amps or volts MilinliMilil 2
Phone: • psi— E - mail: Reconnect onl NOMMEM 1
Owner installation: The ' • .'At abort is bet _ , . • o on property I own empotary*errices or feeders '
which is not inte • • or sale, lease., rent. Or ex 1 ; • ccording to instillation alteration, orreloeatlost
200 amps or less 111111111 2
ORS 44 ' • • 479, 670, 701. 201 amps to 400 amps 2
! tell , Sl 7 : '
• - .- _ -. -- _ Date: . - !
401 to 600 am.. EE 2
. E!S (i L\ 1 I i ft Brands circuits - new, alteration, • or extension per panel:
• Name: it Fee for branch circuits with purchase of
Addteas: service or feeder fee, each branch circuit (0 2
City: I State: flIP: 8. Pee for branch circuits without purchase
of service or feeder fee. first branch circuit: 2
Phone:x Fax: E - mail: faclt additiotsel branch circuit:
I'1. 1111..V11111: (Please cliecl. :tar that appl) ) ' Ise. (Service or ceder not Mel ed):
Service over 223 ampecoreunctcial O health -dare facility Each • alp or int :aeon circle MIME 2
O Soviet over 120ampt•retlnrofI Oliazardouslocation Each sign or outline lightin. 11111.111.1111 2
family dwellings CI Building over 10,000 square feet four or Signal circuit(s) limited energy panel,
0 System over 600 volts nominal more te idential units in one structure alteration, orestlnsion° 2 • O Building over thaeeModel 0 Feeders. 400 ompsormorc * Dc cription: _ - ._
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allows . le la may of the a • let
0 Egrasrtightingpion 0 Other. Per inspection iiMi
Submit sets of plans w'kh soy of the above. lnvestl _ • don fee •
The above are not ., , livable to temporary corustractiols service. Other
Permit fee $ N,$) s % ?33. lO
'Not an ja ere
tadietiore swept dir cards. vied rea Jurisdiction for more Iafonnanoa Notice: This permit application .
. . 2 -J � � -
,
t] via* O MasterCard Flan review (atIo 46) $ ° - ,
expires if a permit is not obtained
Coedit cord eoatxr. / / within 180 days after it has been State surcharge 056) .... $ . _'a ? 5g. f 5
Expired accepted as complete. TOTAL $,-2 "0 , - 7 �—
N ante of cardholder a shown en eredir care C7
S Q 5 v-
Cerdbotder sigma= Amaral i 7 7 • U NOS615 ( ) —
T60V (INYr'LT, AO .ZJT.,� nnr:reR •rne {F.r ,r •�V