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Permit
J. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00496 hitt,., . I I, , DEVELOPMENT SERVICES DATE ISSUED: 7/14/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103AA - 01909 SITE ADDRESS: 12385 SW 106TH DR ZONING: R - 4.5 SUBDIVISION: COTTONWOOD PLACE LOT : 012 JURISDICTION: TIG Project Description: Panel change. Job #905 - 1299. 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: 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: FLATTERS, JAMES G T & T ELECTRIC LORAINE M 4120 SE INTERNATIONAL WAY 12385 SW 106TH AVE SUITE A-105 TIGARD, OR 97223 MILWAUKIE, OR 97222 Phone: 503 - 639 -1435 Phone: 503 -652 -7610 FEES Reg #: LIC 150973 ELE 26 -1105C Description Date Amount SUP 2184S [ELPRMT] ELC Permit 7/14/2005 $80.30 [TAX] 8% State Surcharge 7/14/2005 $6.42 REQUIRED ITEMS AND REPORTS Total $86.72 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 se r t h in R 95 101 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rul- . or direct questions to OUNC at 503 -246 -6 99 o 1 -800 3 / Issued y: / /� Permittee Signatu =: _ �. ,` _, - 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: 7—IA o DATE: LICENSE NO: y 73/5 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. 10/13/2013 13:31 FAX aJ001 /002 Electri Permit Apulication volt OFFICE l 'SL ONL17 City of Tigard Received ��, 13125 SW Hall Blvd., Tigard, OR (99 Pl vi e ' Os Perndr No. 'V� -�� �o �7 Phone: 503.639.4171 Fax: 03,59891 o� ' " 1 N Da 1443 Other Permit: ` I� Inspection Line: 503.639.4 �O le ' I •i Date Ready/By: rj: la See Page 2 for Internet: www.ci.tigard.or.us o, �` � � Notified/Method; , Jinni , Supplemental Information ❑ New construction Additioii /ilteration/replacement Please check all that apply: V'" ['Service over ❑ w : ©M 225 amps, comm azard Demolition � rnP . '1 ['Hazardous location ;/• ` � s x ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft • ., te,' , • E, ; " 1 ;/'•" of 1 - and 2 -fa mily dwellings 4 or more new residential :4, 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi fami[y ❑ Master builder ❑Other. ['Building over three stories ❑Feeders, 400 amps or more : t iUi;;::,: Occupant l o ad over 4 � � �'X � 9 persons ['Manufactured structures of t gl � ,yk � L f r 1 ,irQ ::2. ::::' ,rl. ' ❑ Egress lighting plan RV park Job no,: q b ,LGi/ dab site address: , • O�� � (]Healthc ❑ Other: are facility , Submit _L sets of plans with any of the above. City /State/ZIP: ` , • ,,1 • 1 The above are not applicable to temporary construction service. Suite/b1dg. /apt- no,: Project name: Newt:t en Qty Fee, Total Cross street/directions to job site: New residential aingle- or multi - family dwelling unit, Includes attached garage, 1,000 sq, fl. or less 145.15 4 Subdivision: • Lot no,; Ea. add'I 500 sq. ft or portion 33.40 I Tax map /parcel no.: - Limited energy, residential 75.00 2 , ++� Limited energy, non-residential 7$.00 2 : ` `Wc` ,`, "•I "" : • " ' ir' "' i -.. W ^I Each manufactured or modular — LA �' ,, dwelling, service and /or feeder 90 -90 2 , Services or feeders installation, alteration, and/or relocation 200 ampa or less J g0.30 FD j 'i` ,,r ' , ,.; . : - 201 amps to 400 amps 106.85 r, 2 • '1 401 amps to 600 amps 160.60 2 A . / 601 amps to 1,000 amps 240,60 2 Address: Over 1,000 amps or volts 454,65 2 Reconnect only 66.85 2 City /Staie/ZIP: Temporary services or feeders lnstallation, alteration, and/or Phone: relocation L�� ) Fax: ( ) 200 amps or less 66.85 l 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, arid 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, extension, per panel n or e:tt 0 net • 4 y ' ' • . , . , r . , : A. Fee for branch Circuits with • '. ' °' " service or feeder fee, each Business name: branch circuit 6.65 2 B. Fee for branch circuits Contact name: without service or feeder fee, Address; each branch circuit 46.85 2 Each add'I branch circuit 6.65 2 City /State /ZIP: _Miscellaneous (service or feeder not included) Phone: ( ) Fax ; ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: � * Signal circuit(s) or limited- '���t !` •` • • A energy panel, alteration, or Business name; T & T Electrical, LLC extension. Describe: Page 2 ' 2 Address: 4120 SE International Way, Suite A105 Each additional Inspection over allowable In any of the above Per inspection 62.50 City/State/ZIP: Mllwaukle, OR- 97222 Investigation per hour (1 hr min) 62,50 Phone: (503) 652 -7610 Fax: (503) 652 -7612 Industrial plant per hour _ 73,75 • CCB Lie.: 1611 7 Electrical 'c.: µ.., ;` ' I :i.r , '. r,:' ,o � i" 1'?oR , 8 4 Suprv. L ie.: 4731S Subtotal go r� Suprv. Electrician signature, required: , . r f� Plan review (25% of permit fee) . Print name: State surcharge (8% of permit fee) 6, !� M ARK u NC)V LL— Date `7 • / I . p 5 TOTAL PERMIT FEE 8'6, Authorized signature: Thh permit application aspires If a permit Is not obtained within 1 BD Print name: �j \I / days after It Mu been accepted as complete 'Te i - r pate_ - 7 - / 1 • D Fee methodology set by Tri County Building Industry Service Board Number of inspections per permit allowed. i 'auitdinglPemalsELC.Pamd,App,s 12/03 440-46f5Ttt0/02/COM/WEa F DI ISION RD 1111 ING PERMIT #: ELC 00 � B j 25 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2005 I Phone: (503) 639 -4171 / mu��lhu i1If° Inspection Requests (24 Hrs.): (503) 639- 4175�g'I1.. INSPECTION WORKSHEET FOR DATE: 9/19/2005 TIME: 7:06AM PAGE: 62 SITE ADDRESS: 12385 SW 106TH DR CLASS OF WORK: SUBDIVISION: COTTONWOOD PLACE LOT #: 012 TYPE OF USE: PROJECT NAME: FLATTERS 1 DESCRIPTION: Panel change. Job #905 -1299. OWNER: FLATTERS, JAMES G, .. PHONE #: 503- 639 -1436 CONTRACTOR: T & T ELECTRIC 0 ' j Li PHONE #: 603 -652 -7610 Inspection Request Scheduled For: Date: 9/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 19. Electrical final 015944 -01 503-652-7610 N Corrections /Comments /Instructions: ki ALN 0 -c - ok/ , 5c ,, l. 1 43 C , H, ,.. )6 PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I FAIS_ I I CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED i l---- — � Inspector: // 1/1;- Date: Phone #: (503) 718 -