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Permit
C ITY OF TIGARD ELECTRICAL PERMIT W • g' PERMIT #: ELC2004 -00462 DEVELOPMENT I r SERVICES DATE ISSUED: 7/26/2004 13125 (503) 639 -4171 PARCEL: 2S 104AB -05700 SITE ADDRESS: 12288 SW 131ST AVE SUBDIVISION: MORNING HILL NO.4 ZONING: R BLOCK: LOT : 086 JURISDICTION: TIG Project Description: Electrical to accessary structure. 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: 1 W /SERVICE OR FEEDER: 1 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: OYLER, ALLEN + GERALEE OWNER 12288 SW 131ST AVE TIGARD, OR 97223 Phone: Phone: Reg #: FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/26/2004 $86.95 [TAX] 8% State Surcharge 7/26/2004 $6.96 Rough -in Elect'I Service Total $93.91 Elect'I Final 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 0 C at (503) 246 -6699 or 1- 800 -3 44. Issued By: a Permit Signature: 4 .4"./ - r OWNER INSTALLATION ONLY The installation is being made on property I ow which is • .• -nde• '•r sale, lease, or rent. A ige - OWNER'S SIGNATURE: 01 DATE: CONT' ; FOR INSTALLATION ONLY • SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day ' Permit AppIlC.at10I1 y FOR OFFICE USE ONLY , f�' � � il V E © t Rec e ived // ' / I (1 &0 City of Tigard Date/By: v y Permit No. v 0 � 13125 SW Hall Blvd., Tigard, OR 97223 y /// 1 2 6 2004 Plan B Phone: 503.639.4171 Fax: 503.598.1960 � ° ateBy: y: Other Permit Inspection Line: 503.639.4175 /uata,NlN''�' a "& j � �� Date Ready/By: Jury. 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: �! Supplemental Information MTV /1r- TIP A in r. 3.'!¢;�'# ...h ; � .a"¢ ' :r=', flLr 7•':�dt,':1 d'.,.8� > »Atb}VU? 4w?�, " t'C' '�S^t.' : .';"� FJ �.� »;= .'�: :�.. ".`- S ix' ::.44 ..:`4;:. -'.ri:. `:': �.".�.'� ' ', , _ , `' t , � ` , i Tyl "OFD. ORKs= .r * . . t � V :, ,,, "% .t . e . . t r „Ikm. ,,,,, „ � r .:, 1 . -4. l 1),rs;x: ' t.~...=i €':'.l't day z.L*n.��a..z.. w ;Ift v . ;4-.. - ell. 5tt'i' N .. . . " ".. ,� � � � �° ,.:�;. PLA �, VIEW.., ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: El Demolition ❑ Other: Service over 225 amps, comm'l ❑Hazardous location "ro rte,, t * ,,,, x Oth er trE _, a „ ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., &%171 :,i W- ... - GORY O CO S RU TI Al . . _.: of 1 -and 2- family dwellings 4 or more new residential XI and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure ❑Building over three stories ❑Feeders, 400 amps or more 10 Multi - family ❑ Master builder El Other: $, . ❑Occupant load over 99 persons ❑Manufactured structures or M� > I . y . 3OB SITE aIkV1+OR1l 'PION ANU„ f,, 0 Y w : - ital ❑Egress /lighting plan RV park Job no.: Job site address: �y 5� ❑Health -care facility ❑Other: ���4I 52,4} J/ � �yG Submit 2 sets of plans with any of the above. City /State /ZIP: The above are not applicable to temporary construction service. ;s vii Suite/bldg. /apt. no.: Project name: ' ` ': r:`. ' >'T'N'"�FEE*:=' °'SCHEDU.LE::'t ... Description Qty. Fee. Total 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. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 y,� r _ Limited energy, non-residential 75.00 2 IM"r . _ 6 . i t DESCRIPTION� � O RJ t r i s . k - im f4 __. ffi - : ,44 4, > Each manufactured or modular / / �'ieel dwelling, service and /or feeder 90.90 _ 2 C� �'g Services or feeders installation, alteration, and /or relocation 200 amps or less / 80.30 W. 30 2 at t ROPERTfizta �ri - , s w r;;fi �° 201 amps to 400 amps 106.85 2 ' 401 amps to 600 amps 160.60 2 Name: je` / � /f 7 601 amps to 1,000 amps 240.60 2 Address: d li �-� 5 !� 3 ` 3- A�� Over 1,000 amps or volts 454.65 2 /` ` Reconnect only 66.85 2 City /State /ZIP: ,S., (� /f2� Temporary services or feeders installation, alteration, and /or relocation Phone: 3) Fax: ( ) 9 ®• / �`� 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 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 — new, alteration, or extension, per panel lip ' ;' e1P ,q0.4 ,.;, � § ? _ , r „ ° .M F •1 ,:=P%eQATAPAMONtry st4 A. Fee for branch circuits with service or feeder fee, each Business name: branch circuit 6.65 ‘,,,6-- 2 B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 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- .. ," -" �?4?tt^`'.s�`�y,a ..t;:iLt- a",�.. - z+;„.... - r *'a;.:.. ea`Er:,...... - r, gS z =' .r .�,., .004RACTO S v*; Yk �:� rW : ,:, Ma ... energy panel, alteration, o r ' ' - . ��+.i��.,.ar.�xn�� sre5�- .,.,�. ..Ha .,���.. -�,,.a �. �, N...�z,.u"".a.�:�< �,�"*� ,.s`«�'�a- A. *.._ extension. Describe: Page 2 2 Business name: (0/4..7iVe.,,r-' Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 _',;>§LECTR_ ICaAT„.;PIL;IVI,TTR:EES *h'a.,. `' . . U CD CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal ,c1.6* . Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State' surcharge (8% of permit fee) 62 q(j / J TOTAL PERMIT FEE q 3, q Authorized signature: / / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: AJ/k // Date:7 /z /4 * Fee methodology set by Tri -County Building Industry Service Board Al k..4{.., 6 ** Number of inspections per permit allowed. i.\ Building \Permits\ELC- PemtitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard, Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RTlijtNTI rr:s QRK ONNY� : rM Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: : CUM _ iWOU O1�i11,I.','`. fix-' ` r a; a Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems • ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* 7 Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is \ Building Wemtits\ELC- PermitApp.doc 04/03 CITY OP TIGARD BUILDING DIVISION .0 `'" PERMIT #: ELC2004 -00462 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2004 Phone: (503) 639 -4171 i o7191li;•jil Inspection Requests (24 Hrs.): (503) 639 -4175 °`:_.. INSPECTION WORKSHEET FOR DATE: 4/14/2006 TIME: 7 :10AM PAGE: 73 SITE ADDRESS: 12288 SW 131ST AVE CLASS OF WORK: SUBDIVISION: MORNING HILL NO. 4 LOT #: 006 TYPE OF USE: PROJECT NAME: OYLER /` DESCRIPTION: Electrical to accessary structure. OWNER: OYLER, ALLEN + GERALEE, � PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 4/14/2005 Pour Time: CI, Z Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004451 -01 503. 690.1710 Y 03 ���cl � Corrections/Comments/Instructions: (Co • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ s.ALL FOR INSPECTION ❑ ADDITIO AL FEE,S ASSESS Inspector: 1 // v - p Date: P one #: (503) 718