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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00365 DEVELOPMENT SERVICES DATE ISSUED: 6/21/2004 ..--I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25111 DD -09000 SITE ADDRESS: 15877 SW 87TH AVE SUBDIVISION: CHESSMAN DOWNS ZONING. R -7 BLOCK: LOT : 016 JURISDICTION: TIG Project Description: Wire for AC and furnace. 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: 1 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: MICHAEL COUGHELL WEST SIDE ELECTRIC CO INC 15877 SW 87TH AVE 1834 SE 8TH AVE TIGARD, OR 97224 PORTLAND, OR 97214 Phone: 503 - 684 -3954 Phone: 231 -1548 Reg #: LIC 13306 SUP 2663S FEES ELE 26 -135c Description Date Amount Required Inspections [TAX] 8% State Surcharge 6/21/2004 $4.28 [ELPRMT] ELC Permit 6/21/2004 $53.50 Rough -in Elect'I Final Total $57.78 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 a re 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- . Issued By: Permit Signature: / I / I s ail 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 7:00pm for an inspection the next business day Eftc'tr�icaI Permit Application i of (crick: list: U`1,‘ City of Tigard " `l * i •*M all _.� - 1 0i 8 - 13125 SW Hall Blvd., Tigard, OR 97223 S Plea Revie - Yhoi►e: 503,639A171 Fax 501598.1960 ��GA t , •.� O. ' ) 4 t)a�ny Other Permit: Inspection Line: 503.639.4175 GO i OF t _ , r� Date RoadyBy: 0 See Page 2 for Internet: www.ei.tigard.or.us y1L01 D N Notified/Method: Supplemental Information .' TYPE OF WORK PLAN REVIEW % , ew construction Addition /alteration/replacement Please check all that apply: Demolition Other: ❑Service over 225 am mm ps, co'l O l- lazardous location • ©Sc•vicc over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential 1 - and 2- family dwelling ❑ Commcrciat/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi - family ❑ Master builder ❑ Other: 013uilJing over three stories Orcedus, 400 amps or more ❑Occupant load over 99 persons QManufacturcd structures or YOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no. :s )ZG 1(C)) ( Job site address: ) J' 777 .s" p i l 4 ` -, ❑Health -care facility ❑Otter: �.. eT _ Submit • j, - sets of plans with any of the above. City/State/ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: , Project name: FEIi, SCHEDULE -• �_... — Description W tr. Q Pee. I Total l Cross street/direetions to job site: New residential single- or multi - family dwelling unit. - - Includes attached garage. 1,000 sq. ft. or less 145.15 4 _� Subdivision: Lot no.: Ea. add'l 500 sq.11. or portion 33.40 1 Tax map/parcel no.: - -. Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OP WORK Each manufactured or modular `� c ''''e L1 L( dwelling, service and/or feeder 90.90 2 \ > � ; mot- c t C Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 IIOROPERTY OWNER I O TENANT 201 amps to 400 amps 106.$5 2 401 amps to 600 amps 160.60 2 Name: M S ( L • 1 C_ • i as C l ( 601 amps to 1,000 amps 240.60 2 •—t j . Address: C c- Over 1,000 amps Or volts 454.65 2 ' _ L Reconnect only 66.85 2 City / State/ZIP: Temporary services or feeders installation, Alteration, and/or Phone: [[ �) C::. d �� relocation _ ___ _ Lt �� S , —� Ems ( ) 200 amps or less 66.85 1 Owner installation: This installation is being [Wade on property that I own which is not 201 amps 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 amps - 13175 2 Owner signature: _ I Date: Branch circuits - new, alteration, or extension, per panel APPLCANT -I_ - Q 'CONTACT" ' A. Nee for branch circuits with service or feeder foe, each 6,65 2 Business name: branch circuit ,_ - D. Fee fo branch circuits Contact name: whhou service or feeder fee, 46.85 -) t ` 2 Address: each b�anch circuit 3? Each add'l branch circuit 1 6,65 (_, ; &'s 2 City / State/ZIP: r~ Miscellaneous (service or feeder not included) _ Pump or irrigation eirele 53,40 2 Phone: ( ) ( tax:: ( ) • Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACCOIt energy panel, alteration, or extension_ Describe: Page 2 2 Business name: WEST SIDE ELECTRIC CO. Address: 1834 SE 8 AVE. Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: PORTLAND, OR 97214 Investigation per hour (1 hr Rain) 62,50 _ 4 Phone: (503) 231 -1548 � iF'ax: (503) 736 -0677 Industrial plant per hour 73.75 _ itiacFRICAL PERMIT FEES" _ CCB Lie.: 13306 Electrical • L 26 - 135C Sup rv_ Lic.: 2663S Subtotal S3. S40 Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: , vi ce_ z' v,, vt Date: 6/7:77-67:17/7 State surcharge (11 of permit fee) L� ` TOTAL PERMIT FEE 'T 7 , 7. Authorized signature: This ;Jam application expires it a permit Is not obtained within Ina - days after it has been accepted as complete Print name: Date: - • Fee methodolugy got by Tri- Coanty Building Ind„atry Service Board •• Number or inspections per permit allowed• iU8u eQJ'ermitnE,LC- 'moitapp.doc 12(03 4•0.4615r(I0/07/COM/WEi1 2 ' d LL90- 9EL IEOS) •00 ot:.,lzoaI3 apt:g 'Isa0 eLS :LO 1,0 LI unr CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 6 175 INSPECTION DIVISION Business Line: (50 39 -4171 MST BUP Received Date Requested ` �° AM PM BUP Location 5-1 - 1 7 07 V- Suite MEC Contact Person nl e__e Ph ( ) F - sY PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC goo (( . Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing � r ` L, Aeyax1%D Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In c Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S Please call for reinspection RE: LI Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date , 7 / �� f Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL