Permit ir ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2006 -00386
14'L DEVELOPMENT SERVICES DATE ISSUED: 7/14/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103DB -01200
SITE ADDRESS: 13445 SW 110TH AVE ZONING: R - 4.5
SUBDIVISION: MIRA PARK LOT : 008 JURISDICTION: TIG
Project Description: (3) branch circuits for A/C & furnace reconnect. Job # 24582.
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: 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:
JIM LANGE OREGON ELECTRIC GROUP
13445 SW 110TH AVE 1010 SE 11TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: 503 - 351 -9402 Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 7/14/2006 $60.15 LIC 203
[TAX] 8% State Surcharge 7/14/2006 $4.81 SUP 44605
Total $64.96 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: a Permittee Signature: Q `F \n�6
Y
J \
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 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.
MUL -13 -2006 03:24PM FROM -OR ELECTRIC SVC 5035352763 T -4B2 P.001 /002 F -839
'E
M lectrmmat Yermllt Applicatl hOR (Wl lc l; 1 tit: <)v1.1
• City of Tigard RE `V
13125 SW Hail Blvd., Tigard, OR 97223 00 6 Plan Review , MM
Phone: 501639.4171 Fax: 503598.1960 u\_ 1 4 } `s t y .i' , casein _ Other Permit:
Inspection Line: 503.639.4175 c n:, -'1_I Date Ready/By: RI See Page 2 for
Internee www.ei.ligaarrI.or.us CITY OF TIGA' Notified/Method Nra
4 Supplemental Information
, UILDING DIVISI
OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply:
1::1 Demolition ❑Other ['Service over 225 amps. com'1 ❑liazardous location
OService over 320 amps - rating DBuildn 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 0 Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family El Master builder ❑ Other: DBuilding ovm- three stories [Weeders, 400 amps or more
. ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/ligbting plan RV park
Job no.: 24582 1 Job site address: 13445 SW II0 A'VE ❑Health -care facility El Other:
Submit 2 sets of plans with any of the above,
City / State/ZIP: TIGARD, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: SHC24582 FEE* SCHEDULE
Detariptian I Qry. I Fee I Tani I
Cross street/directions t0 job Rite: Now re idential single - or multi- family dwelling unit.
• Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Es. add'I 500 sq. ft- or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.; Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
A/C AND FURNACE RECONNECT dwelling, service and/or feeder 90.90_ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ..0 TENANT ' 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: \ 0 , ` `: \,,...., 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 / State/ZIP: Temporary services or feeders installation, alteration, and /or
Phone: (503) 75) q I Fax: ( ) relocation
240 amps or has 66,85 I 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 - now, alteration, or extension, per panel _
0 APPLICANT [ ❑ 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, I 46.85 lill' 2
_ each branch circuit
Address: —
- Each add'I branch circuit o, 6.65 13. 31) 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 -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Oregon Electric Group
Address: 1010 SE 11th Ave Each additional inspection over allowable In any of the above
- Per inspection 6230
City/State/21P: Portland, OR 97214 Investigation per hour (1 hr min) 62.50 ,
Phone: (503) 234-9900 _I Fax: (503) 535 - 2763 Industrial plant per hour 73.75 ,
ELECTRICAL PERMIT FEES•
CCB Lic.: 203 Ele ctrical Lie.; 26 - 95C Suprv. Lie.: LI t ' f 1 S Subtotal 6 ( 5'
Suprv. Electrician signature, required' • • Plan review (25% of permit fee)
/ State surcharge (8% of permit fee) U U. e i
Print name: IR I CIA etyck Mr I I o. ate: - ! / 13 f O TOTAL PERMIT FEE (a `t . 9 iy
A1.IthoriZe This permit application expires If a permit to not obtained within 180
� days after It has been accepted as complete
Print name : ' j c k a Irc ► ,/ v A t c - E I l � v i - } - I Date: ` , /i 3/04 • Pee methodology set by Tri- County Building Industry Service Bored
** Number of inspections per permit allowed.
1:\ Building \PCnnits\ELC- pamltnpp.dac 12/03 44046l5T(10/02/CQM/WE[I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00386
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7114/2005
Phone: (503) 639 -4171
A v �4 ,
Inspection Requests (24 Hrs.): (503) 639 -4175 i1 �..
INSPECTION WORKSHEET FOR DATE: 10/212006 TIME: 7 :03AM PAGE: 45
SITE ADDRESS: 13445 SW 110TH AVE CLASS OF WORK:
SUBDIVISION: MIRA PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: LANGE
DESCRIPTION: (3) branch circuits for NC & furnace reconnect. Job # 24582.
OWNER: LANGE, JIM PHONE #: 503 - 361 -9402
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 -234 -9900
Inspection Request Scheduled For: Date: /0/212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037479 -01 603- 367 -4013 1'
Corrections /Comments/ Instructions:
K PASS ( I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
( G A/a Inspector: �� Date: Phone #: (503) 718-R T