Permit CITY TIGARD ELECTRICAL PERMIT
�{ «- 00460
DEVELOPMENT SERVICES DATE ISSUED: % ED: 6 9/20 5
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 109AB -09600
SITE ADDRESS: 14264 SW 132ND PL ZONING: R -7
SUBDIVISION: RAVEN RIDGE LOT : 025 JURISDICTION: TIG
Project Description: Install (2) branch circuits, for a/c & outlet.
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
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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:
ANGELINE CHONG GRF ELECTRIC
14264 SW 132ND PL 15460 SE PARADISE LN
TIGARD, OR 97224 MULINO, OR 97042
Phone: 503 - 464 -7343 Phone: 503 - 829 - 4146
FEES Reg #: LIC 76751
SUP
Description Date Amount - 484
ELE 3 -484C
[ELPRMT] ELC Permit 6/29/2005 $53.50
[TAX] 8% State Surcharge 6/29/2005 $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 • • • a-.SAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questio - to OUNC at
503 -246: •99 or 1- 800 -;3 4
Issue. By: 4 i Permittee Signatur•:
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:
e k TRACTOR INSTALLATION ONLY
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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 Application FOR OFFICE USE ONLY
t � 1 pp Received t ,If -Electrical C , , DO
u U (I r ,l /�� Date /By: y s� �Jr Permit No.: C.I °� 60 I�/ Planning Approval Sige
City of Tigard Date/By: Permit No.:
% .': 13125 Hall Blvd. JUN 2 9 20 Plan Review Other
- . Tigard, Oregon 97223 • - D a t e / B y : Permit No.: Ngt✓/ 5 00 349
Phone: 503- 639 -4171 Fax: C503'598 -1960 Post - Review Land Use
.�■ t 1 /._, � 4R �.t, " Dat e/By:
Internet: w C ase o.:
v✓w.ci.tigard.or.us UfLbIIVG � L� Ile . Contact 1 � � ® See Page 2 for
24-hour Inspection Request: 503- 639 -4179 Name /Method: Supp Information.
• _.
r'r,: '} , i �'
, .'', r ::., 1 :' c: ; , t, ' PLN.REYIEW (Please checK alrtbat:apPlY)" •
-, �f< ��° �.- k. �, ���- �j :..:,,�,..:�- T,1'PE!. QE!�WORKr� . .
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■ New construction • fl Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
r - ddition/alteration/re •lacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
h
k��� jC• � $
o . ; s , i�':IDLY$x • ,C'I!X • N '•'.� •',� : ��
•' .- `• ; � :'
� •'1 I & 2 family dwellings four or more residential units in
rI 1 & 2- Family dwelling ■ Commercial/Industrial 1:3 System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
� ■ Accesso Buildin: IIII Multi7Fami1 ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
Iii Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
„ a !tl: r l. . „ ndwL ":O'GATION' '. ,; :! : :: • Submit sets of plans with any of the above.
t _ i �!' l o ';a , :
The above are not applicable o le to temporary construction service
Job site address: • J •Z (( '-f- ((.c) i Z P C .. .... , . �FEE E:..
SCHEDUL. ,,._ . ',,.-,
Suite #: I Bldg. /Apt. #: Number of inspections per permit allowed
- Dcbeription t Qty Fee (ca.) Tot 1 1
Project Name: New residential- single or multi - family per
Cross street/Directions to job site: dwelling unit. Includes attached garage.
Service Included:
•
1000 sq. ft• or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential '75.00 2
Subdivision: l Lot #: Limited energy, non residential 95.00 2
• Tax ma i/ ' arcel #: Each manufactured home or modular dwelling
�; ; service and/or feeder 90.90 Z?
�Fa , ;:fl�t` w ' eee l� � . 1.11.'s' 1' l i q hi °"4 1 O RK' ' • ' ' , '''' %'-i
S3 Services or feeders - installation,
c. -: ! ' A C/`
6,4_ - fi 4 c / � • alteration or relocation: 2
�" f } J 200 amps or less 80.30
201 amps to 400 amps 106.85 2
• 401 amps to 600 amps 160.60 2
�y � 601 amps to 1000 amps 240.60 2
7LL !'r. i.:W '�:: t t' <: r ' �4.a `� Over 1000 amps or volts 454.65 2 •`
Name: L in C �3 Reconnect only 66.85
Address: J 4 Z e. S L ) ) 3 Z f C. , Temporary services or feeders - installation,
_ / ` alteration, or relocation: 66.85 1
City /State /Zip: ) , Gr e ,/lam "/'? 2 - 2 - - y' 200 amps or less
J 201 amps to 400 amps 100.30 2
Phone: — 3 Fes: . ,, . .,,. 401 to 600 amps 133.75 2
��yy, • E/\ i _- ., a t,�; O: 'li '`:'''i64 :.. +< L1';CONT`ACT:'PE`RSON' ' .. :. -1 - ` Branch circuits -new, alteration, or
Name • extension per panel:
A. Fee for branch circuits with purchase of 6.65 2
' Address: �. service or feeder fee, each branch circuit
. City /St<1te/Zip: B. Fee for branch circuits without purchase of �5 2
service or feeder fee, first branch circuit 1 46.85 y(
Phone: . I Fax: Each additional branch circuit 6.65 11 • < 2
E-mail: - Misc.(Service or feeder not included): 53.40 2
i i1 H 7 ` " "� t . , 1 �lr° Each pump or irrigation circle
ii-- 14 , {OW. sk[:, ,�r Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel, 2
r alteration, or extension Page 2
Business N 6.94 0 ees}r j C. Description,
Address: • ' v o S, PA r (, (1-A4 -( 1 --r) r Each additional inspection over the allowable in any of the above:
City /State/Zip: M /.I t i., (j lt-- q, 19 L i - Per inspection per hour (min. I hour) I 62.50 I
Phone: 9) 3 e Q �GI .- / `t`( Fax: 1) 3 - 8 ei - S 7 °t-7 Investigation fee: f ! F
Other ,.. ,. . � .
CCB Lic. #: Lic. #: 3- '' ;.t` a-; iii ,ri.Ai!: ' lea trical :Peraiit:Fees * "r,�;r ;;1�'• ,-
Su ervis. electrician. r Subtotal $ <'i . i F $ `i b
P � mS r C c) t ' P ian Review (25% of Petmt ee)
signature required: " li�l l 2
L ic. #: t � State Surcharge (8% of Permit Fee) $ q Print Name: , , , _ . . _ TOTAL PERMIT FEE $ - 7
Authorized Notice: This permit application expires if a permit is not obtained within
D 180 days after it. has been accepted as complete.
SlgttaRue: *Fee methodology set. by Tri- County Building Industry Service Board.
.: ' • • • (Please print name)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00460
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 0129/2005
Phone: (503) 639 -4171 4, „, / / NlIypi �fl '(i� �
Inspection Requests (24 Hrs.): (503) 639 -4175 °':_..
INSPECTION WORKSHEET FOR DATE: 8/5 TIME: 7:02AM PAGE: 57
SITE ADDRESS: 14264 SW 132ND PL CLASS OF WORK:
SUBDIVISION: RAVEN RIDGE LOT #: 025 TYPE OF USE:
PROJECT NAME: CHONG
DESCRIPTION: Install (2) branch circuits, for a/c & outlet.
OWNER: CHONG, ANGELINE PHONE #: 603-464-7343
CONTRACTOR: GRF ELECTRIC PHONE #: 5
Inspection Request Scheduled For: Date: 8/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012905 -01
Corrections /Comments /Instructions: \/
�1�
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL E'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: AtIP, / ./% Date: 8 - 05 Phone #: (503) 718-