Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00019
— .� DEVELOPMENT SERVICES DATE ISSUED: 1/12/2005
wi 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110AD 05500
SITE ADDRESS: 14868 SW 106TH AVE
SUBDIVISION: LANG HILL NO.2 ZONING: R-12
BLOCK: LOT : 048 JURISDICTION: TIG
Project Description: Meter base repair, reconnect only.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
HETLAGE, RAYMOND F + ABC ELECTRIC
LOPER- HETLAGE, DEE E 135 NE 9TH
14868 SW 106TH AVE PORTLAND, OR 97232
TIGARD, OR 97224
Phone: Phone: 233 - 7551
Reg #: LIC 26 -1226C
SUP 5096S
FEES ELE 161501
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/12/2005 $66.85
[TAX] 8% State Surcharge 1/12/2005 $5.35 Elect'l Final
Total $72.20
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: 7" j /Y,t, Permit Signature: �-�
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
JAN -11 -2005 05:48 PM P. 01
+' Electrical Perini A► i t
I(
I vE Illl)1I l( I ill. ti N o:
City of Tigard — R
•
13125 SW Hall Blvd., Tigard, OR 97223 �� A Pem1ICN,;6 �I .� f �t
P an Review
Phone: 503.639.4171 Fax: 503.598.1960 % I D ; Other Permit:
^
Inspection Line' 503.639.4175 JAN 11 200 `�
y : y ; Pa ! [o
Internet: www,ei,tigard.or.us NonedMte(hod: Supplemeatale Inr formatlon
❑ New construction �'t apply;
' • Please check all that " i 11 `rf l : �i;i :.
Ll l���lt�?! -rf iY
❑ Demolition O t Cr: ❑Service over 225 amps, comm'! ❑Hazardous location
❑Service over 320 amps - rating OBuildng over 10,000 sq. ft
of 1. and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ►`Commercial /industrial ■ Accessory building ❑System over 600 volts nominal units in one structure
0 Multi -famil 0 Master builder 0 Other: ❑Building over three stories []Feeders, 400 amps or marl
[Occupant load over 99 persons ❑Manufactured structures Cr
❑Egresa/lighting plan RV park
Job no.: r Job site address: • r • ❑Health facility ❑Other; • r • •. Submit 2 sets of plans with any of the above.
r v . \_ ti The above are not applicable to temporary construction service.
Suite/bldg./apt, no.: r••
Pro ject nam e: e s , ' .: ,'I 1 LI
Description Qty. Fee 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.: ga. add'I 500 aq. ft. or portion 33.40 I
Tax map/parcel no.: Limited energy, residential 75.00
Limited energy, non - residen
Each manufactured or modular
1111111.111111- 111.11 "MINIM!' dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 j 2
G .. 201 amps mP amps 106,85 2
Name: tZ ' 401 amps to 600 amps 160.60 2
V + , 601 amps to 1,000 amps _ 240.60 2
Address: _ Over 1,000 amps or volts 454.65
City /State/ZIP: Reconnect only 1 66,85 tp( gh 2
Temporary services or feeders installation, alteration, and/or
Phone: (3a7) l''‘ - 9 � 6 relocation
Owner installations This installation is being made on property that I own which is not 20 amps to or
ls 00.30 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 1 amps to 600 amps 1 2
Owner signature: 401 amps to 600 amps 133,75
Date: Branch circuits new, alteration, or extension, per panel
A. Fee for branch circuits with
Business name: service or feeder fee, each
_ branch circuit
6,65 2
—
Contact name: B. Fee for branch circuits
without service or feeder fee; .
Address: each branch circuit 46.85 2
Each add'! branch circuit 6.65
City /State/ZIP: Miscellaneou■ (service or feeder not Included)
Phone: ( ) Pump or irrigation cir
53.40
Sign or outline lighting 53.40 2
mall Signal circuit(s) or limited -
energy panel, alteration, or
EZ extension. Describe: Page 2 2
Address: Ise � f Each additional Inspection over allowable In any of she above
■r ��� 1 Per inspection 62.50
• Ar / 1 : • _ Investigation per hour (1 hr min) 62.10
Industrial plant . - hour 73 -75
II
/�O/ l' 4 h: t ;'..
i t Suprv, Lic.: Subtotal L io
Suprv. Electrician signature, required: „�% .L� Plan review (25% of permit fee)
State surcharge (8% of / ,36!
4' :. ....t / / mil
Date: �8 ( permit fee)
Authorized signature: TOTAL, PERMIT FEE 72 a o
T his p ermit application expires If a permit is not obtained within ISO
days after It has been accepted is compiste
l Date: • Pea methodology set by Tri- County Building Industry Service Biwa
" Number of inspections per permit allowed.
1. tau ildina'Pvrmits\ELC.Pern,IMpp. doc 11!01 440.461ST(I D/02/C0M/Waa
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lin€ (503) 63 -4175
INSPECTION DIVISION Business Line: (503) 9 - 4171 MST
/ BUP
l
Received Date Requested _ — l 3 A PM BUP
/
Location / /(ke, �'� Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 3 3 - 7 SWR
BUILDING Tenant/Owner ELC .;?D,/) 5 000 /
Footing
Foundation Access: ELC
Ftg Drain 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
PLUMBING
I It • \t/
Post & Beam
Under Slab
Rough -In
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
; L Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
) ART FAIL
Please call for reinspection RE: ❑ Un. • - • • I spect — no access
Fire Supply Line - /
ADA D Ins ector Ext
Approach/Sidewalk � P
Other:
Final DO NOT REMOVE this inspection record from e job site.
PASS PART FAIL