Permit •
•
ELECTRICAL PERMIT •
CITY OF TIGARD f Y,
I PERMIT #: ELC2005 -00530
DEVELOPMENT SERVICES DATE ISSUED: 7/26/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103AC -04200
SITE ADDRESS: 12636 SW 114TH TERR ZONING: R -4.5
SUBDIVISION: WALNUT GROVE LOT : 011 JURISDICTION: TIG
Project Description: (2) branch circuits for kitchen.
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: 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:
LIBERT, SCOTT A AND CYNTHIA M REDS ELECTRIC CO INC
12636 SW 114TH TERRACE 2002 SE CLINTON ST
TIGARD, OR 97223 PORTLAND, OR 97202 -2245
Phone: 503 - 590 - 9888 Phone: 503 - 233 - 6467
FEES Reg #: SUP 5010S
LIC 4443
Description Date Amount ELE 26 -152C
[ELPRMT] ELC Permit 7/26/2005 $53.50
[TAX] 8% State Surcharge 7/26/2005 $4.28 REQUIRED ITEMS AND REPORTS
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: _ Permittee Signature: � A`r)
OWNER INSTALLATION ONLY l
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.
Jul. 26. 2005 8 : 46AM No. 2584 P. 1
Elecrica Permit Ap a ><o
■ City of Tigard JUL n �a i�� 73 ) '�- permit /D 7�'v5 - d
13125 SW Hall Blvd., Tigard, OR 97223 JUL 2 6 2005 Plan w Other
, ,, Dete1B , Permit:
Inspection 503.639A171
5 03. 6399.4 503.548,1960 175 CITY OF TIGA • I • i Date iteady/ny ® See Page 2 for
Ir�petine; 03..4 � � � -y• Supplemental Information
www.ci•flgard,or.a5 BUILDING b1VI Ioytl4 Notified/Method; pp
"i , .. a ,> 7 u : s . Rw-,,, :7,�: ,, t, rigic :•,, ,c -T r •
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;:.. •:E ' ''s • >d � . ) ..,aw :: a�1,' "c' '' l :. ; a � '' +,, , ' - : . ! i'X ' C ' ,{ c1�r ,, y r. " ! , ,:r
t r + i.� ' s^, .O �i "+ , lirt., �N.t °3: .. ' ^�. i 1;�; S ,. „y,:�,e':,,.�,.!t54,•:.;.. :.�,�,•, v1 , < :' .F"n?r�+a.,...,,.c::
..,. � • 'rr.: „ �w1 i ��` ir { 's t" �.,�. „ • .,42;;, � r' ; ' ' . ., '"� ..............::(: .._ .,�'- , � -
❑ New construction ks_4- :, • dition/alteration/replaceinent Please check all that apply:
❑ ['Service over 225 amps, comm'l ['Hazardous location
Demolition ID ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft,
c;�; ?• a ∎ + { ;.,t ! " a=, : :l NWr,�.'� `: +. r'V ,, 4‘,,k47,4' , .:?, s z • ,,,.. ' dwellings 4 or more ne residential
.4 t , , . ` : ezy �: a.: + ir �`'' 'v; Of l and 2 -tflml! duel n w r identi al
_;:�:. .'3' 'i�,_g' t, t r. � � i � . ^ s . ��rr4�Q ��r�,.pp a f , 4 ' ' '$r,i. }5 ^; Y �`
k:;i.� ."ri` r+e�;x .. �.l i�+;:�� y fri?!';�r.' � !T:L:1�� » �:�.��.5;¢ a.V• +T:i „ �bi , rs:•.� ° 1
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Building over three stories ❑Feeders, 400 amps or more
El Multi - family ❑ Master builder ❑ Other: ❑Occupant 1 sect over 99 persons ❑Manufactured structures or
ons
park
d. = f£2!.' ,. �. c �.et; s . v ' u:f'4f. ',. ` .tl ., ` .': d', '� :'r' 1W t(
{,' .: : A' , . : ;? 7` ii , 04 �”: rah 4 �” E ess/li htin plan 1
�;r.. ' ° ` Y `i:',q ' �y: ��% •k. x. ' �,' !�! • �s .Y:a�?S1':lr; .�.�i�A'.� � A ' ❑ P>r J3 8 p
❑ Health -care facility ❑Other:
Job no.: /45o ( Job site address :���� 3�0 � l �v��
V Submit ? seta of plans with any of the above.
City/State/ZIP: , The above are not applicable to temporary construction service. ,
Suite/bldg ap I Project name: ' ` . ..
Description QtY• 1 /M Tataf
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. R. or portion 33.40 1
•
Limited energy, residential 75,00 2
Tax map /parcel no Li mited energy, non - res 75.00 2
+r f;,�I+' :y PI `vii tW A ` � F ' .'� .. "` a'aY lh, r 1 c_1
Each manufactured or modular
. ati;�armz�: � ,. \. .� x ��) o,�l � � ° � �� ; � � 4 � "�63
r
... _..... ......._ dwclliitg,aei iirid/or tdcdcr .� "90:'90 ' ' 2
v l/!_ J_' Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
-r '`;` N r . , a y;/ ` gyvv m 25, { t 201 amps to 400 amps �^ 106.85 2
" s+ + � 401 amps to 600 amps _ _ 160.60 2
Name: A , ' L / . 4 ' ji / 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
- reloca
Phone: (1 ) �"' -�`7 - 9 9 k y Fax: ( ) 200 amp or less 66 .85 I
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:� Brauch circuits - new, alteration, or extension, per panel
4 Y �' "` - � F r, C r. ' 2 - '3 , c f I a Gl w7 ' 91 W $ w . , i ' A , Fe@ for branch cirLLLitS
service or feeder fee, each 6.65 2
Business name: branch circuit
. B. Pee for' branch circuits
Contact name: without service or feeder fee, i
each branch circuit 46.85 4/5 2
Address:
., Each add'I branch circuit / 6.65 r�je6 2
City /State/ZIP: Miscellaneous (service or (ceder not included)
Pump or irrigation circle . 53.40 2
Phone: ( ) Fax : : ( ) Sign or outline lighting 53,40 2
E - mail: signal circuit(s) or limited -
'r ta µ: , ,T. , ; e :;team:: ? :: I , d'' : ,,,,£ •' ri > ; iY ; ene pane!, alteration, or
extension. Describe; I Paget 2
Business Red's Electric Company ' • _ - —
Address 2002 SE Clinton Each additional inspection over allowable in any of the above
Portland, OR 97202 Per inspection _ 62.50
City /Stn (503)233 -6467 Fax (503)233 - 1281 Investigation per hour (I hr nun) 62.50 _
Phone: ( CCB# 4443 Elec. Lic# 28 - 152C Supry Lic.# 5010 - S Industrial plant per hour
�j �a��, ,t,,��. y�p* 73. yEC
'18,;. i:'1�':+:.1 err "- . iaY'Al4,at.IS,W341WL' ,.,,'[ye? ! ,r` tT 1i' 1ky'
CCB Lit Subtotal 53. . 5 b
Suprv. Electrician signature, required: 'N Plan review (25% of permit fee)
`� r .61.4/1 c: State surcharge (8% of perm
Print name: it fcc)
s+f r rn S Dat � Z�/ TOTAL PERMIT FEE .5-9. 23
Authorized signature: This permit application expires it's permit is not obtained withld 180
- - - - days after it has been accepted as complete
Print name: Date: ' • Per methodology set by Tri -County Building Industry Service Board
00 Number of inspections per petnlit allowed.
ossvi tdi.socrmir9_c- pmnitApp.doc 12/0) 440-460Tt1onnicoM/WEa
CITY OF TIGARD
BUILDING DIVISION ., :,
.... PERMIT #: ELC2005-00530
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2005
Phone: (503) 639 -4171 ' I
Inspection Requests (24 Hrs.): (503) 639 -4175 ' W '' ..
INSPECTION WORKSHEET FOR DATE: 8/31/2005 TIME: 7 :03Am PAGE: 24
SITE ADDRESS: 12636 SW 114TH TERR CLASS OF WORK:
SUBDIVISION: WALNUT GROVE LOT #: 011 TYPE OF USE:
PROJECT NAME: LIBERT
DESCRIPTION: (2) branch circuits for kitchen.
OWNER: LIBERT, SCOTT A AND CYNTHIA M, PHONE #: 503 - 590.9888
CONTRACTOR: REDS ELECTRIC CO INC PHONE #: 503 - 233 -6467
I ,
Inspection Request Scheduled For: Date: 8131/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 014692-01 503-233-6467 N
Corrections /Comments/ Instructions:
..)-----.'-''
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
; q'---3/'1)5- .
Inspector: Date: Phone #: (503) 718-