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Permit ' CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00401 r ;∎I DEVELOPMENT SERVICES DATE ISSUED: 6/9/2005 sAii- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1 S133AD - 11700 SITE ADDRESS: 10732 SW 127TH CT ZONING: R - SUBDIVISION: AMART SUMMER LAKE NO. 3 LOT : 173 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: 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: JUSTICE, CLARENCE J + PAULA S WEST SIDE ELECTRIC CO INC 10732 SW 127TH CT 1834 SE 8TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 524 -3737 Phone: 503 - 231 -1548 FEES Reg #: LIC 13306 tion Date Amount SUP 4654S Description ELE 26 - 135c [TAX] 8% State Surcharge 6/9/2005 $4.81 [ELPRMT] ELC Permit 6/9/2005 $60.15 REQUIRED ITEMS AND REPORTS Total $64.96 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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 1-8v!- 332 -2344. / -- Issued By: 0 Permittee 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 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. //Electrical Permit A licatif 1[1 FOR OFFICE USE ONLY City of 'Tigard E ® keccivod Pcn[ri! Nu �� / 13125 SW Hall Blvd., Tigard, OR 9 3 na� ny�65 'g.� t X /' 00'© t:� 7Y I • Plan Revi Phone: 503.639,4171 Pax: 503.598.1960 4nr,;y,9 l Dote/ Other Permit: Inspection Line: 503.639.4175 JUN 0 9 2005 .„.,,4- .4. f pare IteadyBy: j..urti: • 69 S !nee 2 for Internet: www,ci,tig,Ard.or.us Notified/Mctbod: `(L-q Supplemnntallnform,,iton t ' I; dg , �i4N(�N PLAN .REVIEW _ E New construction ►•< • i dditidn/alteration/rcplacement Please check all that apply: ❑ Demolition 0 Other; ❑Service over 225 amps, comm'1 [pliant location ❑Service over 3 amps • rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of l - and 2- family dwellings 4 or more new residential 1 - and 2- family dwelling ❑ Commercial /industriial CS Accessory building ❑System over 600 volts nominal units in one structure Multi family ❑ Master builder _ 0 Other: ❑Building over three stories ❑Feeders, 400 amps or more JOB SITE INFORMATION AND. LOCATION • ❑Occupant load over 99 persons ❑R lured structures or ❑ Fgl� s pa d< s/lighling plan l �vZ� t ; L _Lob site address: 10 ' SL✓ [ ' � . Job no.: - ❑Health -care facility pother ____,_ — - - _ Submit y 2 sets o} plans with any o the about. City / State/ZIP: ` ti_ ( ( -. J • -v k c/ - e. ` The above arc not applicable to temporary construction service, `.3 ' t l � FEE" SCTIEDULE Suite bldg, /apt. no.: P roject name: � c - r l ,- I "' , I . Vt.^A _. . . Decerlption I Qty. I Fee. I Tone Cross street/directions to job silt_ ^ (' t k .. J 0, t New residential single- or multi - family dwelling unit. - Includes attached garage. _ 1,000 s4. ft. or less 145.15 4 Subdivision: Lot no,: Fa. addl 500 ac . ft. or portion W _ 33.4() t Limited energy, residential 75.00 2 Tax map /parcel no,: Limited energy, (1y, non-residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular c in i` * 2 t jj _ dwellm service and /or feeder 90.90 1,,,./ _ teL.y I•, <r V !f 11f•Ll�... 1 Y { n ,O. 7S—el-vies B rat - . (� 1 , � .__ L� 3 , �t l or feeders installation, alteration, and/or relocation_ 200 amps or less - 80.30 2 • PROPERTY OWNER • 0 TE NANT 201 amps to 400 amps 106.85 2 �� -- - 401 amps to 600 amps 160.60 2 Nanlc' c) s. + ( ,7 t CC , i' 601 amps to 1.000 amps 240,60 2 Address: Over 1,000 amps or volts 454,65 2 C; c.1 v -— .� Reconnect only 66.85 2 City /Stare /ZIP; _ Temporary services or feeders installation, alteration, and/or W Phone: (') 3 ) c�L} — ?,'7 - . °� Fax: ( ) relocation 200 amps or less _ _ 66.85 1 Owner installation: This installation is being made on property that 1 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 60(1 amps _ 133.75 2 Owner signature: _ Date: Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT I :j 'Ct)NTAL'7' 'PltitSQN ' A. Fee for branch circuits with Business name; service or feeder fee, each 6 :65 2 branch circuit _ -- -- B. Fee for branch circuits Contact name; without service or feeder fee, .X5 4 , 2 Address: -- 46 each branch circu �� Lib- y Each trdd'1 branch circuit Z 6.65 L ' ll! City/State/ZIP: Miscellaneous (service or feeder not included) _ Phone; Pump or irrigation circic 53.40 2 ( ) • ( —_ Sign or outline lighting 53.40 2 E - mail; - Signal circuit(s) or limited - C07'JT IACTOR energy panel, al teratiun, or • Business name: WEST SIDE ELECTRIC CO_ extension, Describ Pugs 2 2 T Address: 1834 SE 8' AVE. Each additionnt inspection over allowable in any of the above -- .. Pea inspection _ 62.50 City /State/ZIP: PORTLAND, OR 97714 Investigation per hour (11w min) - 62,50 Y Phone: (503) 231 - 1548 Fax: (503) 736 - 0677 Industrial plant per hour _ 73.75 E LECTRiCAL PERMIT FEES• CCB Lie.: 13306 Electrical L' - 26 -135C • Suprv. Lic.: C, t) S _ Subtotal Suprv. Electrician signature, required: _ .4. "fu . i e y Plan review (25% of permit fee) Print name: D ate: 6 y / � State surcharge ( X% of permit fee). 4 , � �vr - TOTAL PERMrr FEE l L C ' . , Authorized siggnature; Ttris permit appllcntion expires if o permit tx not obtained within I On --- Prim name: Y dnyx after it has been accepted as complete Date: • Pet mcd,udulody act by Tri- County Building industry Service Board '" -- - '' " Number of inapcctiuns per permit allowed. lnuitdingkretmilslBLC.PermitApp doe. 12103 440 -4(1 i r(ro%ovcoM/wlt» a' d LL9O- 9ELfEOS) •03 ot.a4oaT3 a nts •sapi OTT SO 6O ant' CITY OF TIGARD \ \\ICE, IAAk'p BUILDING DIVISION . • PERMIT #: ELC2005"00401 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/9/2005 Phone: (503) 639 -4171 i m,„,4 1 11 P Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:08AM PAGE: 50 SITE ADDRESS: 10732 SW 127TH CT CLASS OF WORK: SUBDIVISION: MART SUMMER LAKE NO. 3 LOT #: 173 TYPE OF USE: PROJECT NAME: JUSTICE DESCRIPTION: 3 branch circuits. OWNER: JUSTICE, CLARENCE J + PAULA S, PHONE #: 503- 524 -3737 CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503 -231 -1548 Inspection Request Scheduled For: Date: 8/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 010426-01 503 - 231 -1548 N Corrections /Comments /Instructions: L PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G , N, fz z Date: 4-'2-- 9 Phone #: (503) 718-