Permit CITY OF TIGARD G wH^ K D • ELECTRICAL PERMIT
r PERMIT #: ELC2007 -00533
COMMUNITY DEVELOPMENT DATE ISSUED: 8/1/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 104 DA -01900
SITE ADDRESS: 13344 SW 128TH PL ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - WEST LOT : 005 JURISDICTION: TIG
PROJECT: RIVANO
Project Description: (1) branch circuit for a/c unit.
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: 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:
ANTHONY RIVANO COHO ELECTRIC INC
13344 SW 128TH PL PO BOX 40
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503 - 747 - 0779 Contact #: PRI 503 - 582 - 9774 •
FAX 503 - 582 -9840
FEES
Description Date Amount Reg #: ELE 3 - 575C
[ELPRMT] ELC Permit 8/1/2007 $46.85 LIC 157169
[TAX] 8% State Surcharge 8/1/2007 $3.75 SUP 5255S
Total $50.60 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 -01. 0. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B ihniA t . Permittee Signature: S a e_ l; 6 4,77 /pi
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.
F.ROM. :.1, ELECtR I C a� FAX NO. : 5035829840 Jul. 31 2007 03: 09PM P2
t t � "i q e .1 4 r I 111
Electrical Permit.Apphcat 'ND ' FOR OFFICE USE ONLY
City of Tigard JUL 3 1 J) Received e> r ,�09- _ LJV Pctmiirto.: Zdd�t
13125 SW Hall Blvd., Tigard, OR 97223 I Plan Review Otter Permit:
Phono: 503.639.4171 Fax: 503. 598.196''' - k - -. P Date/B :
'
Inspection Line: 503.639.4175 �'1. v Y -'P Al Date Ready/By: JI � See Page 2 for
Internet: www.ci:tigard.or.us 'J^'„ _ . - - ' q ` -, ottfie "'
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0 New construction 1 Addition /alteration/replacement Please check all that apply:
❑Service over 225 amps, con m'l ❑Hazardous location
Demolition ❑ Other: , Oyer 320 amps - rating . 013uitdng over 10,000 sq. ft.,
1 ,. ,:,.. ...�,. Y „,.,:, ,..,.,, 21;LI':rt+` ta'dlI,ty s. y °: C '” Ij
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tuL :' ! {- t i 1 ! ,, .. . . Y , 1- , ,; 11 9 ... ;:' i i , !...' - }!: 1 yh f iVilt llll ii I x.∎04 ° of 1 - and 2•flamilydwellings 4 or more new residential
� ��� -� ` � - "' � ,,:i,:.2...;!..'
- ['System over 600 volts nominal units in one structure
d I - and 2 dwelling Commercial/industrial 0 Accessory building Building over three stories [Weeders, 400 amps or more
Multi fhmily ❑ Master builder 0 Other: DOccupant load over 99 persons ❑Manufactured structures or
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, '' Y: =:, : �..,' t, :i .. ..:' 1 ;: 4 !, , i 1,. . ,4 E ,! ri ❑Egress/lighting PI¢n
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f' v :' :..,, . y a : , :- .:::: a!:. a.S, ... „:::; :: Health -Caro facility ❑Other.
Job no.: ‘,3 ‘,3 . Job site Address: 1 33 4 W `„. r 'd Su bmit seta of plans with any of the above,
City/State /ZIP: \ - The.above are not applicable to temporary construction service_
J •`!r l �, • tMS'liii�.i i •6'a�S ", "if4'la�'i OF .�i>',. v.i:, .': ' ,
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Suite /bld /apt. no.: Project name: r `l paerlptl Qty. Fte. Tatar '
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Close street/directions to job site: New residential single- or multi - family dwelling unit.
_ - ,. Includes . attached garage. ..
. ' 1,000 sq. ft. or less MI 145.15 U
Subdivision: Lot no.: . , Ea. add' 1500 sq. R. or portion MN 33.40 mon
. Limited energy, residential 75,00 Ell
Tax map/parcel no.: . �� l' _ l:, Limited energy, non-residential 75.00
: •'p:i iy. a ',aC;Ii '•i'. , ''7.• i: >�$ „';'L .f .
l ;I , + I 01I :*11,, vv ,, r nll. ,.?iJ ' d 1 . 1' ; ', • (' ; I t I t I„ ' ': u ( '�j' fit Each manufactured or modular
S l , >. !a _t., t,. ,i; ii; .t,;, ., ,., tri,.'.. ,irk.'i „ 90.90 ' dwotiin_ service slid /or feeder 90-
l. 0 - ` k C., ..w , Services or feeders installation, alteration, and/or relocation
200 amps or less • M .:,. :,. r ,,,: .:. .. . . . . .�.: ..:“......"44z4:„.; aa,p'r,4 :'G..,:i
FIi iig, I1 201 amps to 400 amps '
: .. .. .r.,.. , - . r'.. L.r. . , ., ,} � I r, � ! '. Yis'�id ,�II,..
$0 30
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l06 85 EllEll
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' ,,11 .0 �, f t; a•: , ih L1, 1 1�'c � ` f ri�.i�,111:� 160,G0 ES
. .. t ;,:,. :, x „�R ,.. ` '>.. ,...,;;,� ::........:.lal ., ,. . ..,.,,::.,Ra,t..,, ..:..,i:s..,.,,,..,x!�,,:E. 401 amps to 600 amps
A
Name: J, , _ • 601 amps t o 1,000 amps OM 240.60
� � A , vaQ " Over 1,000 amps or volts 454.65 an
Address: \ W L> � q e.4 Reconnect only 66.85 EN
City /State/ZIP: —7, �• A 0'a. Temporary services or feeders installation, alteration, and/or
. relocation
'1
Phone: ( ) 4'1 -• Q1 ^ 7 ° 1 Find: ( ) • 200 amps or less ® 66,85 1
____________...,..____
Owner installation; This installation is being made on property that I own which is not 201 amps to 406 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps _ 132,75 El
Owner signature: Date; • Branch circuits — , new, alteration, extension, per panel __
._' r , ..• '..!A ! i:a , ,:i ; .r I! & A. Fee for branch circuits wilt t
y
inn, or ext n e a e
r r �„ r d1Illfl rU , •' .µ .. Ill .t''t I .i i
ti I' `� ^ ���i;1 ; `ll � h' ' � r , Tau �:,,' �lr,. ,:, • �.!a...,:, � I ..:. .. r �'. �• . , ..,dr� .. .., .,,, . .,- serv or feeder foe each 6. 65
Business name: branch circuit
i 13, Foe for branch circuits
Contact name: without service or feeder fee, 1 46:85 4 b
"T” each branch circuit 1 ' �~
Address: Each add'l branch circuit 6.65 2
-
City /State/Z1P: Miscellaneous (service or feeder not included)
— - Pum. or irrigation circle 53,40 �
Phone: ( ) Fax: ( ) Sign or outline lighting 5 3 : 40
E -mail: Signal circuits) or limited-
:•.•,,•.;.,:.;:,... •:• . ...:...........t:•:.- • :. r;;, 5 "k' „ .. r' 111 energy ,! •:• ,! i:at• . it ^,b ,:; , , -:. - rt';; ,,{{II',- .,� {•`::1f4: �r!�..��. I .. „y alteration, or
r1 '' + 1 � 1 , , 't . ! _ t i r, .. S 1 I ,O ' Y . , I ,�'x r r S 5$t:1 10, is °, i ,.t { {.k!a.! ?l0jakri ". cave,
ea.. ,a,� .:r, .,. .,:, „.r..� ..`.t ^.i ,v A .. .. �li! ..IJl1..1 . extension. Describe: Page 2
Business name:
• ' e_. - us t .., ti!
Each additional inspection over allowable In any of the above
Addrrss: Per inspection NI 62.50 —
City /:itate W y,o ca"� � C3fk � 1 O ' i Investigation per hour (1 hr nun) 62.50 �T
5 t "' `� Industrial plant per hour 'x'73.75 ��
Phone:(5t1:5) y� � ,. ���� Fax: C1�1 I rn ! ii.: .ir F �if';'�if?'1I��Ia�a'S', il�t t �af111,',diag �lw,�qn'��,..'t , r� ''' ' ,
V Jiyy1.� �..'F,: ',e;,i;,;lii�!;t ,Q.- ..�rr.:..,.r,:rti�i�al, ?r. a�.�r, ,�:.��!'�`. ' Fr - "
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CCB Lic.: \51I VI Electrical 'c.i • . ,,' (_•, Suprv. Lic.: - • ¶. Subtotal y t Q -
�� I
Suprv. Electrician signature, required: �!/ ✓ 1011 /r” Plan review (2590 or permit fee) _
State surcharge (8% o permit fee) , 1
Print name: tmi � ' Date: „' (- a ThTAL PERMIT FEE Q, iGjQ
Authorized signature: ' ' s permit application expire. it a permit Is not obtained within 1110
' '' TM days after it has been accepted at complete
Print name: 11111 , \ il, Date: --1_ e, ' Bee methodology Yet by Tri -County rsuilding Industry Service Board
`• Number of inspections per permit allowed.
it\ euildlna \Permitiar PennitApp.doe 12/nt 440- 4613r(1W03/COMfWBB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: i 1 02007.00533
Alilk■ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/ 1 / 2 0 07
Phone: (503) 639 -4171 �4 +��i� "�
Inspection Requests (24 Hrs.): (503) 639 -4175 -�!�i i 11:.
INSPECTION WORKSHEET FOR DATE: 11!7/2007 TIME: 7 :00AM PAGE: 53
SITE ADDRESS: 13344 SW 128TH PL CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW WEST LOT #: 005 TYPE OF USE:
PROJECT NAME: RIVANO
DESCRIPTION: (1) branch circuit for a/c unit.
OWNER: RIVANO, ANTHONY PHONE #: 503 -717 -07
CONTRACTOR: COHO ELECTRIC INC PHONE #: 503-582-9774
Inspection Request Scheduled For: Date: 11!7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message Q
199 Electrical final 059138 -01 \ 503 -582 -9774 Y (4 I� t °' , � ,
00
Corrections /Comments /Instructions:
a G %or --004 f ` pa_55
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11 PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CA FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�I I 6
Inspector: Date: U I Phone #: (503) 718- I 7