Permit CI TY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00353
DEVELOPMENT B I E d.. Tiga a 97223 DATE ISSUED: 6/15/2004
13125 (503) 639 -4171
PARCEL: 2S 11486 -16700
SITE ADDRESS: 16312 SW 103RD AVE
SUBDIVISION: RIVERVIEW ESTATES ZONING. R -7
BLOCK: LOT : 013 JURISDICTION: TIG
Project Description: NC CIRCUIT AND W.P. PLUG
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: SIGNAUPANEL:
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:
ARTHUR, MIKE SOHLER ELECTRICAL CONSTRUCTION
16312 SW 103RD. AVE. 41131 SW BURGARSKY RD
TIGARD, OR 97224 GASTON, OR 97119
Phone: 503 - 696 -9916 Phone: 971- 832 -0807
Reg #: LIC 158285
ELE 34 -667C
FEES SUP 594S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/15/2004 $53.50
[TAX] 8% State Surcharge 6/15/2004 $4 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 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: J Permit Signature: „i / ��
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
Jun 14 04 04:OOp Joe Sohler 503 - 985 -1078 p.3
w .^ -
Electrical Permit Application lication FOR OFFICE USE ONLY
'City of Tigard R Eo Received
iv tD
Da Re Permit No. �/ {/ 4 ,,,33-3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 'f` L
Phone: 503.639.4171 Fax: 503.598.1960 20 01 , �.-,a i. _,..o/ f \ Date/By: Other Permit:O�
Inspection Line: 503.639.4175 1 ' t t Date Ready/By: ;wit: 511 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental information
-��.�. t .� � u 4 ..d �. F . � E rl
i c
.� �� 1'�.i � �.. . �.t?� gin '. .. ,� .i .Git �CxI . ` . .. ,. i '+' -� .!, ; ;PIE:0.1• REV1fEW
❑ New construction V Addition/alteration /replacement Please check all that apply:
El Demolition El Other: ❑Service over 225 amps, comm'l ❑Hazardous location
p r s ,,d,., . , ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
,,.,;;;; , , . ;i1 +s ! „ SAT,) 0*i ! ;pF C`0 4 TJCi, ION of 1- and 2- family dwellings 4 or more new residential
q i 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Buildin over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑Master builder ❑ O
tail { ,;,, , :. , KI , ,+
„ 0 Occupant load over 99 persons ❑Manufactured structures or
y � .:, a I a r `OB , SIF]� it * ik 14tTIQ1 41) L&AUO1?I , b � . ['E plan RV park
Job no.: f J ob site address: iL 31 a S� •l CJ H u. ❑Health -care facility ['Other:
J Submit 2 sets of plans with any of the above.
1 --- i
City /State /ZIP: a_r 6 _ 9 7 ,2.a L/ The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: !7. I ,F . a r , t " t RU?�E:;
Description I Qty. 1 Fee. I Total
Cross street/directions 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. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2 1
'
�t�� �C} Limited energy, non - residential 75.00 2
iH e .1 ;;,,^,'t` ti.! .n , .0`� titiQysl'" r Ntr.Otk' :. + p . (t,t 1 . ) ,i gY _
i. Each manufactured or modular
✓1 �^ 7 dwelling, service and /or feeder 90.90 _ 2
H ' (� G c I l L/ t 4 - G- 0 Q_ ti•)1 7 ' O p i/cJQ Services or feeders installation, alteration, and /or relocation
p 1 200 amps or less 80.30 2
s + It' 201 amps to 400 amps 106.85 2
' ' 401 amps to 600 amps 160.60 2
Name:
rdi t ! h' - � T F1 g - 601 amps to 1,000 amps 240.60 _ 2
Address: l ty 31 , s- I 0 3 Q� /f _ _ Over 1,000 amps or volts 454.65 2
� �"�� Reconnect only 66.85 2
City /State /ZIP: I /
e� df � U i< 9 7aa `r Temporary services or feeders installation, alteration, and /or
Phone: (5 , 34 1_ I, 200 7 / , Fax: ( ) 20 a
amps or less 66.85 1
Owner installation: This installation is being made 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 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
g 1 itx s- , s '' T' ,Is 'a 1I V ` i + A. Fee for branch circuits with
° ` ° lt' . < . riI WI t , ;. 1 ,4;, . ' . ' . ' 1 . ! V.••••'77•7: " A'CT t ' ' tJ , r t ' ' 4
/� service or feeder fee, each
Business name: �P .c . t r o ( C--en r y S --F, branch circuit 6.65 2
i�
Contact name:
B. Fee for branch circuits
T O --k without service or feeder fee, ' 46.85 y`, a 2
Address: 1 /f J each branch circuit
I 1 3 I s tr a .1 r, art k " ' ` pr Each add'l branch circuit i 6.65 2
City /State/ZIP: ::r 5 r...1 0 9 7/i Miscellaneous (service or feeder not included)
q7 (sb ) q / ,Q Pump or irrigation circle 53.40 2
Phone:
( I) �� _ 0 G Fax: 3 / �- v Sign or outline lighting 53.40 2
E Signal circuit(s) or limited
r rs. ..
;, - e ` , t ,4 : r ,. ,. . . dt olf:: + , 1 , ' energy panel, alteration, or
+ extension. Describe: Page 2 2
Business name: Si5 LI laz E l e cJ r r c,o, I C-o N S f
Address: Each additional inspection over allowable in any of the above I
Per inspection _ 62.50 I I
City /State /ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax ( ) Industrial plant per hour 73.75
6., .l c 'cal Lic.: u / ► Su ic.: i **C77,RIC I lM[T,
CCB Lic.:
�� tO 1 4" 5 Subtotal 5 7 t 5 U
Suprv. Electrician signat r , de - ' Plan review (25% of permit fee) -14
Print name: / Date: State surcharge (8% of permit fee) 1,r o 2 8
A. l TOTAL PERMIT FEE S ,78
Authorized signature: This application expires if a permit Is not obtained within 180
M t _ L s permit days after it has been accepted as complete
Print name: i - t i " iNik 1 S d IV Date: • Fee methodology set by Tri County Building Industry Service Board
'" Number of inspections per permit allowed.
is 1 Building 1PerrnvsiELC- PennitApp. doe 12/03 440- 4615TO0 /02/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Requested - 1 — I/O A fdl BUP
Location / 3 1 a— 10 3 Aid Sui MEC — v
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR //
BUILDING Tenant/ ELC o�OO`� — d 6 , 5
Footing 63 6 - 9 ELC
Foundation Access: '\_
Ftg Drain g \ `C ELR
Crawl Drain yy`°
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear sLi
Framing
Insulation 1-4*))
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P T FAIL
E
Post & Beam
Rough -In
Gas Line
Hoke Dampers
PART FAIL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
ina ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / l
Approach/Sidewalk Date l b / Inspector �� Oct
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL