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Permit CITY OF TIGARD ELECTRICAL PERMIT ` PERMIT #: ELC2005 -00945 /� DEVELOPMENT SERVICES DATE ISSUED: 12/9/2005 '�J �! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134DA-05700 SITE ADDRESS: 11315 SW 105TH PL ZONING: R -4.5 SUBDIVISION: NODAK LOT : 005 JURISDICTION: TIG Project Description: 3 branch circuits. 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: 2 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: JOLLY PRECISION ELECTRIC 11315 SW 105TH PLACE 14842 SE REGNER TERR TIGARD, OR 97223 BORING, OR 97009 Phone: 503 - 330 -3440 Contact #: PRI 503 - 413 -9870 FAX 503 - 521 -1637 FEES Description Date Amount Reg #: LIC 105851 [ELPRMT] ELC Permit 12/9/2005 $60.15 ELE 26 -892C [TAX] 8% State Surcharge 12/9/2005 $4.82 SUP 4155S Total $64.97 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: 13f t4,0 /3 .. 4 L G Q'- K Permittee Signature: S % //' -/ 617/(2,A-- 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: S C jPPc / C42 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. Dec 07 05 07:04p Precision NW Electrical C 503 521 1637 p.2 • Electrical Permit Ap'p ;leatid_n D FOR OFFICE I. SE ONLY U 11 Permit No City of Tigard /%� k D ' Ll.t �9 13125 SW Hall Blvd., Tigard, OR 97223 ((�� (( ++ �] Pl Review it: � s0 . Other Perm Phone: 503.639.4171 Fax: 503.598.196 0 0 8 2.005 4 "t r.' > > ' Ready/By: t ` DatefBy. Inspection Line: 503.639.4175 ' Date Readyy: � C ag Internet: ww CITY OF TIGARD J Notifiedimethod I Z � / 6/ � ✓ s / y� L/! to /j . Supple men l 2 information i t, „F 'Yi O ° RK ,.- s4lN PLAN REVIEW ❑ New construction ,g Addition/alteration /replacement Please check all that apply: ❑Service over 225 amps, comm'l ['Hazardous location ❑ Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ I - and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure ❑Building over three stories El Feeders, 400 amps or more ❑ Multi- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or t RV park JOB SITE INFORMATION AND LOCATION i ©Egress/lighting p la n Job no.: I lob site address: i 1 J 3 5-.0 %,•..5 c L.. ❑ Heal th -care facility ❑Other: . I Submit 2 sets of plans with any of the above. City /State/ZIP: 'j'a �� Oa Q-112 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg. /apt no.: Project name: Je L k r 7 Description Qty. E Fen Total I ' - 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 1 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft or portion 33.40 I Limited energy, residential 75.00 2 Tax map /parcel no.: _ Limited energy, non residential 75.00 2 i DESCRIPTION OF WORK Each manufactured or modular ' dwelling, service and/or feeder 90.90 2 A I C. c w l •k v� r'T �.10 �v (5.)-1 ; . Services or feeders installation, alteration, and/or relocation C. ►' 3 ek 60 cxrn- ,T cla (.a^'O' 'r1, 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: � r 601 amps to 1,000 amps 240.60 2 Address: 1 \-3\ 5 �,,..„,, j vo S fit'` P 1 Over 1,000 amps or volts 454.65 2 ' Reconnect only 66.85 2 City /State/ZIP:'' ` n 1 1 2 - I .... ') Temporary services or feeders installation, alteration, and /or relocation Phone: (9903) -- 2, (> � Fax. L ( ) 200 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 ❑ APPLICANT I 0 CONTACT PERSON A. Fee for branch circuits with • service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 4611 each branch circuit 46.85 Address: Each add'I branch circuit Z 6.65 0.30 j 2 City /State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) p er , :: ) Pump or irrigation circle 53.40 2 , Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- ! CONTRACTOR ' energy panel, alteration, or extension. Describe: Page 2 2 Business name: , LC.-4 ;StX3rj \,eU',.� c_ c..., Address: 14434:2_.S-€. Q � Each additional inspection over allowable in any of the above ` Per inspection 62.50 I. City/State/ZIP: t,D1(.__ '211...j C `r Investigation per hour (1 hr min) 62.50 Phone: (3' ) 3 -c-14,7 0 Fax: ( 6'2_1 - Ito 9 i Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES"' CCB Lie.: 1(.633) to Electrical Lie.: C_,.1.�'7 Suprv. Lie.: i=.1.1 ti (5 Subtotal ( g o , I t- Suprv. Electrician signature, required: 1/44,11 �/ , Plan review (25 % of permit fee) J1 �'� C ln-f � P _ State surcharge (8% of permit fee) ` Print name: Date: I 2 - 01 -05 . TOTAL PERMIT FEE (4,.. e k . Authorized signature; This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: rrl \ /cc p v - v - \ \.L. ,,0 Date: `I -1 - f) f • Fee methodology set by Tri- County Building Industry Service Board - •• Number of inspections per permit allowed. i:\ Build :neermi &l3•LC•PermitApp.doc 12)03 440- 4615Tt I O/OV•OM/WEB • CITY OF TIGARD ., •1 BUILDING DIVISION PERMIT #: ELC200S-00945 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/9/2005 Phone: (503) 639-4171 ificoolitiiiii\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 12/14/2005 TIME: 7:01AM PAGE: 56 4.1k4=1 SITE ADDRESS: 11315 SW 105TH PL CLASS OF WORK: SUBDIVISION: NODAK LOT #: 006 TYPE OF USE: PROJECT NAME: JOLLY DESCRIPTION: 3 branch circuits. OWNER: JOLLY, PHONE #: 503 CONTRACTOR: PRECISION ELECTRIC PHONE #: 503-413-9070 Inspection Request Scheduled For: Date: 12/1412005 Pour Time: Code # Inspection Description Confirm # • Contact # Message 199 Electrical final 023404-01 503-649-1271 Y AM Corrections /Comments/ Instructions: 4 A— C ?ii/e__— S 12 4 /6---- ciik/ in 3 cr> AirAi / • , PASS FTARTIAL APPROVAL 0 CANCEL pi NO ACCESS / , FAIL IN - ALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED -.0■11111.ft. Inspector. AL Adill......., Date: / 2- 7 7- ° --- Phone #: (503) 718- • . ,