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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00545 i4 DE VELOPMENT SERVICES DA TE ISSUED: 8/26/2004 1 II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 111 AC -00400 SITE ADDRESS: 14600 SW 91ST AVE SUBDIVISION: PINEBROOK TERRACE ZONING: R-4.5 BLOCK: LOT : 045 JURISDICTION: TIG Project Description: Panel change & wiring for remodel. 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: 10 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: VINTAGE CUSTOM HOMES WEST SIDE ELECTRIC CO INC 609 SE AN KENY ST 1834 SE 8TH AVE PORTLAND, OR 97214 PORTLAND, OR 97214 Phone: 503 -235 -7231 Phone: 231 -1548 Reg #: LIC 13306 SUP 2663S FEES ELE 26 -135c Description Date Amount Required Inspections [ELPRMT] ELC Permit 8/26/2004 $146.80 [TAX] 8% State Surcharge 8/26/2004 $11.74 Rough -in Elect'I Final Total $158.54 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: , • _ 4� Permit Signature: _3 j .,e_, ■c 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 Electlrical J Applis .�iti I� --- "-;_.. _ -� I nlz oz;'r uti>� ONLY of Tigard [tocciv _ • OAte/B ' r' 1�` . ° / (� PennitNn„ V 7 tJ4 �� � ✓ /' /r J 13125 SW Hall Blvd., Tigard, 0 ' • .3 '. t - 2� �oo� /C ._, r A," Plan Review P,4171 I'ax; 5U .598.1960 , C Q 1r1' 10 hone_ 50°+.639 y: Other Permit: Inspection Line: 503.634,4175 w PS ��ff, ri Date � G RI See Page L (or WWW- Ci.tipprd,Or,US Q� ` `, �\f a Notified/Method. S1 ( Su,,,,I. tonfat Information tE�Q (9voluc _ PLAN REVIEW ❑ Ncw construction i kton/alteration /replaeetrient Please check all that apply: r ❑Service over 225 amps, comm'I ❑1- Iazardous location Q Derrlolition 0 Other: ""° • ❑ 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 0 Comrnercial /indusirial ❑ Accessory building ❑Systenl over 600 volts nominal units in one structure • Multi - family ❑ Master builder ❑ Other: ❑Huilding over three stories ❑Hecdcrs, 400 amps or more [Occupant load over 99 persons ❑Manufactured structures or _ JOB SITE TNFORNIATION AND: - LOCATION ❑E plan RV pack Job no.: 'q,> j Job site address: )(.4 60 p C � ,,J eq I r = � dflCal[h - cart facility QUther Submit sets of plans with any of the above. City/State/ZIP: (f,_ f. c ,, r . C/ q -. `2 • j Li The above are not applicable to temporary construction service. Suitc/bldgJapt. no.: Project name; C7d k, / IA �� . L1 �� � FEE SCHEDULE 1 1 DcacriTnnn , QtY. l Re4, I Tutut � Cross street/directions to job site: New residential single- or m ulti - family dwelling unit. —.. "" ' — Includes attached garage. l ,000 sq. tt, or less _ 145.15 4 Subdivision: Lot no.: _ Ea. add'I 500 sq. ft. or portion 33.40 1 Tax ma eel no.: µ - --- -- '— Lirrrited energy, residential _ 75. 2 o Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular _ f dwelling, service and /or feeder 90,90 2 ?`k 44) \ C `"\ S . €C ' �-'. ✓; �,1 a ,,.. ,t' v�+ . 1 Services or feeders installation, alteration, and/or relocation 200 amps or leas C 80.30 ge. 50 2 PROPERTY OWNER i 0 TENANT 201 amps to 400 amps 106.85 2 _ 401 amps to 600 amps 160.60 2 Name: (r . -'C C . 7 - N. • 4 inn 4-- r ,,a4.4" 601 amps to 1,000 amps . 240.60 - 2 Address: ` r ! ` C.--1- ..- Over 1.000 amps or vo 454.65 2 7C _ City/State/ZIP: � `/? 1 Reconnect only 66.85 2 v t Temporary services or feeders ipstallation, alteration, and/or • Phone: (" Z S._. ` 5 ) Fax: ( ) relocation — 200 amps or less 66.85 1 Owner installation: This installation is being made an property that I own which is not 201 amps to 400 amps 100:30 2 intended for salt, lease, rent, or exchange, according to O1tS 447, 449, 670, and 701. 401 amps to 600 amps P" P 133.75 2 Owner signature: Date: _ Branch circuits -- new, alteration, or extension, per panel ❑ APPLICANT © ca - ac . Y'asON • A. Pee for branch circuits with ^---- service or feeder fee, each Business name: branch circuit 1 6,65 G �,�© 2 13. Fee for branch circuits Contact name: '- without service or feeder foe, each branch circuit 46.8,5 2 Address: _ Each x44'1 branch cit�cuit 6.65 �� 2 City /State/ZIP: V Miscellaneous (service or feeder not included) • Phone: Pump of irrigation circle 53:40 2 ( ) I F ( ) Sign or outline lighting 53.40 2 E-mail: _ Signal circuit _ s) or limited- ' CONTRACTOR . . energy panel, alteration, or Business name: WEST SIDE ELECTRIC CO. extension. Describe: Page 2 2 Address: I834 SE 8 AVE. ...w_ Each additional inspection over allowable in any of the above ^ - �• Per inspection 62.50 City /State/ZIP: PORTLAND, OR 97214 investigation per hour 0 h min) 62.5 Phone; (503) 231 1 Fax; (503) 736 - 0677 Industrial plant per hour 73,75 t ^T ELECTRICAL PLRIVIXT FEES* CCB Lie.: 13306 _ Electrical L • 26 -135C Suprv. Lich: L * SL) S � Subtotal )L L' iv v Suprv. Electrician signature, required: /� I Qt? Plan review (25% of permit fee) • Prim name: 'CZ e „ ` ��t P - 0 • Date; State surcharge ($ °/, of permit fee); j , L - TOTAL PERMIT FEE `. Authorized signature: r� Tht prrnelt application expires tr a permit la not obtained within 180 days after It has been accepted as complete Print name: Date: - Fee methodology set by Tri- County i3uildiog Industry Service Board ^-^ ^• •• Number of inspections per permit allowed. ctIluilding tPemardEl.C- aertlritAoo.doc 1 2/03 4404615r(10l02/COM/WEII 2 c 1 LL90 -9EL (EDS • 00 o t.,loa 19 ap i S zsar eB I : LD +.0 92 2nd CITY OF TIGARD 24 -Hour . BUILDING Inspection Line: (03) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP o Received Date Re t � nested /d—f AM BUP Location ,0 � s74 Suite EC - JO 1 QU sq7 Contact Person V' Ph ( ) 7 k9'i6 ?oat 1 a®y Contractor Ph ( ) SWR _ BUILDING Tenant/Owner 6 00 S 7 r Footing Foundation / ELC Ftg Drain Access: l�l'+.� Art. Lei USA 30 9 ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL P MBG Pos Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan • Ot cfn - W - S PART FAIL ECHANi 'L Post &beam Rough -In Gas Line S9 ampers - SS PART FAIL • CTRI AL Service Rough -In UG /Slab Low Voltage r)© Fire A arm na Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. -;';'" PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line / ADA ��p Approach/Sidewalk Date Y0 0 2 1/ 3 / Inspector p ig at Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL