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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00537 DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 109AB -05300 SITE ADDRESS: 14297 SW 133RD AVE ZONING: R -7 SUBDIVISION: THREE MOUNTAINS ESTATES LOT : 046 JURISDICTION: TIG Project Description: (1) 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: BERG, DAVID AND KATHLEEN M ELECTRO WIRE INC 14297 SW 133RD AVE 18857 SE SUNNYSIDE RD TIGARD, OR 97224 BORING, OR 97009 -9271 Phone: 503 - 793 -2362 Phone: 503 - 658 -8136 FEES Reg #: ELE 26 -667C Description Date Amount LIP 67879 SUP 2717S [ELPRMT] ELC Permit 7/28/2005 $46.85 [TAX] 8% State Surcharge 7/28/2005 $3.75 REQUIRED ITEMS AND REPORTS Total $50.60 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 B y : ) ./ site Permittee Signature: -L 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. • FROM,,: FAX NO. :5036431410 Jul. 26 2005 03:07PM P2 Electrical Permit Application volt olt OFru I 1 61.. t i∎1 1 City of Tigard R 1�,U\ u v ED ''^ v� . ') li Pcrmn No : 1,4 l� /� •' Datc /B 13125 SW Hail Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 j'L 26 200c 'rt^ > DatelBy.. ' Other Permit: Inspection Line! 503.639.4175 i L 1 . 1 I Date Rsady /By, 1 IN Page 3 far : • • Internet: www.el.tigard.or.us Notified/Method: ° ?t1 snpplementalInformation .- Tee-'norl l ;:�,6 , .t , :r; ? rcyt{ 's:s.'.10,• 1 .:;t> :,jx i ;;, •,r. µ : ,: r ;. .,,t r &�"3s:u%.„f'; : "r {n : w � i s n rMP k zu +r F-` � • ap . �\ Y" A} .. a,ev A, `t:,,, 1 ,y 4,/, ' ?' h +,'. .ky , m ir; g yl' .,.�' v { ..)� ! a �.n R < �1�f�, "'�. a » „F > i�;;�t,e �1 .,^e:•G, "@:�� rA • nrvwF���ia�.kL��airt6S�` �.�"'#'hJl�r�t'I;��ax {der ".'. ��f*R���> El New construction (at Addiliony iltcration/rcplacement Please check all that apply; El Demolition Other: Se vice over amps, coming ❑ Hazardous location .,;., >,�kr�:e < „ y�;i�``v w�ri?�,:��41',� ?,� Y,:, ( � . )^ �s >; r ` ; ,�',t:” °' .;�.v.'; Cl Service over 3 amps - ['Bulking over 10,000 sq. - ��tt �,n�, ±?�� y� p 1�, 20 rating �•, °:e.�fi'ii.�... °(;:a.,0.2„ , ft.,;a{a�n. .4.,'hZ VI' . 1.� ,Z1i, =;�a� " v "�S a! ?( ?ui "§ :. `. .. , t� �'�,, . z aa.,,; $. >, a3 cr of 1- and 2 -&mily dwellings 4 or more new residential jA I - 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 ❑ Multi -family ❑Master builder ❑ Other: ; jG'` � ;i� i rkr ?,? fr" r > y¢� y w t +: ,t�`,� w �,w t::,,.w, t ,• � Occupant load over 99 persons ❑ Manufactured structures or A.���e,:�.�r�.l.: �. �,. ..w:,J.� � •, k.. mama.. n C. •.,U ., mama. ��' •1i,'' {��, 1 ` 0'n A� ��:.F.!1''; �;,,1�' 1 ,■, Fl " sl �� �1�'.1A 'H \B` 0 8 gressnighting plan {. \V park. Job no.: Job site address: �.� 9 5 � 3 vie 01ealth -care facility ❑Other: Submit sets of plans with any of the above. City/State/ZIP: ., B / The above arc not 1 - - Q i�f� applicable to temporary construction service. r Project n �t f , the '-1 w,r� e .+ r:,rlrAyym �I �'t1 , Suite/bldg. /apt. no.. j arse: " r �_�- 5 's 'art'r� *fit ,:•,Aar'.. M:..• '�t,l —�4 - .d Datripeim Qty. Fc . Total , ' Cross street/directions to job site: New residential single- or multi- family dwelling init.' Includes attached garage. 1,000 sq. it or less 145:15 4 Subdivision: I Lot no.: Ea. add'1500 sq. ft or portion 33.40 1 Tax map /parcel no.: . Limited energy, residential 75.00 2 u °. i.r �; {(�� s f <,:.� Y vy: Limited energy, non- residential 75.00 2 . f ;gk; •.:t�1t;.:, i, > N §r '. ,� i , P ", _. •`i 4.i; r;+' : f F9' _ ^;ajs5 ' tfA . , ✓ < : \.. , 1 �. a , ,. :`YH..>. �.t... , �v.r.� �.�t: °.f;« ' >: "'.>���'v�.�:,:,,�k�t, � "a� %'"" Each manufactured or modular dwelling. service and/or fader .90 :90 : ' . • . - 2 Services or feeders installation, alteration, and/or relocation , 200 amps or less 80.30 . 2 ? �,'� %C`� •_ -.o:,. yes .v��u ;a.:. 4 �'M��' .1iH�'1. ').a d t �'. { "Y;v;�; �:.,, ...�'' �.d; "...•�ir�, � ':'wSri 201 an I0 4 t)tl flm tJ °' { `' , ; "• a 3, '� .r ;. A ; " `e :£rrfr:? , "i ;.s e c cps p5 106.85 2 .,;:;; ». >:A, "`: y;a. 1,F:, y i > -..,,. 1.,.� Y.,-,v.,0,,•1,-:,',,,%.r. g'.. :.: 6a SB .+''riil ?> , : , `: ,,y r1 :l.A . 401 snips to 600 amps 160.60 2 . Name: • 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 Phone: ( ) I Fax: ( ) relocation 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 clrcuita - new, *iteration: or extension, per panel h cr1;!ii,..S, `• , : ,� � � � '��� 1ic } uhf` u � " "� `�/ �>.'�'. � A. Fee for blanch circuits .`r .. �.. F ,, 1 mama Y, e > , � , �� � .. o � o! \ �J.. \ , I� �, ©��.�a.ef- :�'n; A is ' ��`"�Yjy �t9 wft�! . . ...,.. ,.n:.. ..,..:... - . mama. � 1 + Business name: h s � e b or ceder each 6.65 2 circuit • H. Fee for branch circuits • Contact name: without service or feeder foe, I 46,85 .�P 2 Address: each branch circuit Each add'I branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53,40 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- ; . \�;:�'�:.k ��.4diF.11- '� \.? M.M �� }:� "i� ,4I `i'l„i'NNi'�r�\`i' ,5.11 '�:'S.,•..: u � :1 ?,,.,a•.t,., . \�, �,;,�' >� ;�;C�,�C��t,. , � . A� bpd) { t ,a..1�,�.it 1 a; ",., ri:.,t,,:q eration , ar • ".'. ' . 1 4 � . -1 ... �+ll� 'c. {, +;'�S �.,��i'cn;; ...,.. ,l•.�2;. .v't;. °r.�Yh'!; i.7 ;i.,1`�,'ir energy ponsl. N. extension. Descri alt be: Page-2 . 2 Business name: � 1 — eV �Q.__. . Address: f $ S 6 ' .S � J , 0 Each additional inspection over allowable in an of the above �" "Lr Per inspection 62,50 • City /State/ZIP: 97 • Investigation per hour (1 br min) 62.50 Phone: (Lt,,, r- S ! 4:, Fax: (C ) 5 1 g — T O 1 Industrial plant per hour 73,75 CC13 : mica ; } :. EE a t`e`as "i• a ¢` ( p' S 7 El ec trical Lic.:�� � -(0 6 S uprv. I .i i .:� ' Subtotal .�/ • • .ii Supry - Electrician signature, required` J' / .„a�-- Plan review (25% of permit fee) . + h u State e srcar Print name: 4 V , ! _, ea _ 1 Date: � � ,e, � Se (8% of permit fee) •U � TOTAL PERMIT FEE 5 0 i (p D Authorized signature: 'This nem& apptleat:e>o expires if a permit h ■et obtained wi nun tan days attar it'dwa bomanieptad as carmptste Print name: Date: • Fee n ctbodology set by Tri- County Building Industry Service Board "• Namber of imspcctions per pewee t allowed ' i:\Building\Perrnit J-C- PoeknitApp.doe 12/01 440 61 iT(10/O /COMM'rB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006 -00537 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/2005 Phone: (503) 639 -4171 ,,,,_ j yp g'II I Inspection Requests (24 Hrs.): (503) 639 -4175 _lig- 1.L. • INSPECTION WORKSHEET FOR DATE: 8/11/2005 TIME: 7 :09AM PAGE: 83 SITE ADDRESS: 14297 SW 133RD AVE CLASS OF WORK: SUBDIVISION: THREE MOUNTAINS ESTATES LOT #: 046 TYPE OF.USE: PROJECT NAME: BERG DESCRIPTION: (1) circuit for A/C unit. OWNER: BERG, DAVID AND KATHLEEN M, PHONE #: 503.793 -2362 CONTRACTOR: ELECTRO WIRE INC PHONE #: 503..658.8136 Inspection Request Scheduled For: Date: 8/11/200x Pour Time: Code # Inspection Description Confirm # Contact # Message 145 A/C or heating unit circuit 013292 -01 603 - 5799706 N Corrections /Comments /Instructions: ,, ,/ C &,Zc c = 0 .016, OIsZ S"a o/ 2GP©2 i �a '/ S la. °S 4l G IS K R C P /& So .-4-►M P - A /c_ u a i i M- k CQ '1 / it Z .Sr . ( s Z: 7----- S 0 /1-1-1. P F r , s (.: Agismaithr --...-■■. a Ir PASS P. RTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL "ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r , f,_ / Inspecto • _ ,i ' / Date: "— Phone #: (503) 718- •