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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00946 �,��,�� DEVELOPMENT SERVICES DATE ISSUED: 12/9/2005 4 `� , 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S104AB 00100 SITE ADDRESS: 11980 SW 135TH AVE ZONING: R -4.5 SUBDIVISION: LOT : JURISDICTION: TIG Project Description: Change out service. 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: 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: ROBERT SUNAMOTO MCCOY ELECTRIC CO INC 11980 SW 135TH AVE PO BOX 42428 TIGARD, OR 97223 PORTLAND, OR 97242 Phone: Contact #: PRI 503 - 234 -7521 FAX 503- 234 -9473 FEES Description Date Amount Reg #: LIC 8277 [ELPRMT] ELC Permit 12/9/2005 $80.30 SUP 2175S [TAX] 8% State Surcharge 12/9/2005 $6.42 ELE 26 -82C Total $86.72 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 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: Permittee Signature: ∎ Jt \` 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. Dec. 8. 2005 5:09PM MC COY ELECTRIC No, 6734 P. 2 • lectracai rerrnnt .Application ..- t , FOR OFl l .1: l tit: O.\i.N City of Tigard Rea ... 1 0 .5 -- - „ ,, ) do Permit No 4 Li - 49A U !, ,- ••1 SW Hail Blvd., Tigard, OR 97223 Plan Review �' .Phone; 503.639.4171 Pax: 503.598.1960 ! �m - ', ,,,... , p /g Other Pemuit: inspection Line: 503.639.4175 DEC 0 8 2 0!..... j •i 'l P Rcady/By: Jurj ® See Page 2fnr interne: www,ci.tigard.or.us Notified/Method: Supplemental l»fnrmatiou - :', ❑ New construction ❑ - Ii n7 tbion/r"eplacetn nj Please check all that apply; 12 AeMOlitiOn a • ther: rt , - 0,00 ▪ Service over 225 amps eo OHazardous to ❑Service ove 32 0 amps rating ❑Buildtl8 over 1 0 sq. ft., '; `` , : CATEGORY i0;F EIONST1it iCnO .',:, oft- and 2- family dwellings 4 or more new residential '-- ffi- and 2- family dwelling ❑ Commercial/industrial El Accessory building ❑System over 600 volts nominal units in one structure ❑ Building over three stories Of ceders, 400 amps or more [] Multi - :Family ❑ lvlaster builder P Other; DOccupant load over 99 persons ❑Manufactured structures or . . , . IfE, :i4!TD; ,I:OC4vON . `,... ❑Egress/ligbtiu►g plan 1W park % Job no. As aZG3 Job site address: Il 9,9,0 yv - /5 Fr /. 171l3ealth -care facility ['Other.. Submit • 2_ sets of plans with any of the above, City/State/ZIP: 776 420 , 6 n - q Z 3 The above are not applicable to temporary construction service. Suite/bldg./apt. no.: • I Pro ect name: ';.: :. >, ., . '.'Y . ' ,;, + • S?1► lJ�r7+O 7'� Aae't olon 1 Qty- I Pea I - row ' Cross street/directions to job site: f•' A N 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 fax snap /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 . , ;I SCRl[0'1'110'6T ;;Op'' V{kiffIl`.. • `• `.: ',.` Each manufactured or modular 61. Q'U f e-it -. ✓ C e dwelling service and/or feeder 90.90 2 _Services or feeders installation, alteration, and/or relocation 200 amps or less l 80.30 90.. O 2 lP1IiE11' dER` •:: `::Sr,•'t.'.. r..: . : 20l amps to 400 amps 106.85 2 Name: 401 amps to b00 amps 160.60 2 S(4.f'YY4- -0 ;�O 41 IC al-c., ~-4-447 601 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: UV?) S:;Z(. 942 I Fax: ( ) relocation 200 amps or less 66.85 I 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, , r panel i0 ' LI AI `'. , I:'. I N A(�� I ,:;PERSOhT` >` A Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: 'li (,•„., �„� E , c , ii � C ` branch circuit n B. Fee for branch circuits l� Contact name: t (. (. &L4 s without service or feeder fee, 46.85 2 Address: C each branch circuit -- Each add'1 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- ::::.i:'..•.-', . : :oblsTR'AOTORi.'''' :', 'r ; ,;:_,;;;:. ,. energy panel, alteration, or Business name: ire extension. Describe! Page 2 2 ,Address: . i K s-- ti , _ i� Each additional Inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: Af,t.7 9 QK-- q.- . ` / Investigation per hour (1 hr min) 62.50 Phone: (5713 ) Y t t Fax: 6a3 VI /_/ ? 3 Industrial plant per hour 73.75 tJ F :-- Electrical 82.. C Suprv. Lic • o ? ( ?SS Il >E i;, '>Pl ub o f CCB Lic.: l � I,ic.• 8 ©• 30 Subtotal Suprv. Electrician signature, required: I _ e_ 7,41.4/L.— Plan review (25% of permit fee) State surcharge (8% of p ermit fee) Printname:,►Z� J ' ,o 1 Date: �Z (..) / � � TOTAL PERMIT FEE Authorized signature: This penult appllcatiun t e l m if a permit is not obtained within 180 days after![ ben accepted sa completo Print name: Date: ' • Pee methodology set by Tti County Building Industry Service Aonrd ss Number of inspections per permit allowed. i;\bui(ding\rconito∎ LC- PetmitApp.doc 12/03 440-4615T(10/02/COM/WPE CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00946 13125 SW Hall Blvd., Tigard, OR •'223 DATE ISSUED: 12/9/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 6 •-4175 1E. INSPECTION WORKSHEET FOR E: 12/12/2005 TIME: 7 :02AlvM PAGE: 68 SITE ADDRESS: 11980 SW 135TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: SUNAMOTO DESCRIPTION: Change out service. OWNER: SUNAMOTO ROBERT PHONE #: CONTRACTOR: MV9CCOY ELECTRIC CO INC PHONE #: 503-2347521 Inspection Request Scheduled For: Date: 12112/2005 Pour Time: Code # Inspection Description Confirm • Contact # Message 199 Electrical final 023236-01 503.935 -6310 Y Corrections /Comments /Instructions: C—) (■,C0 T) 6011'4 tSW. ba-93 PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL CA L FOR INSPECTIO I I ADDITIONAL FEES ASSESSED Inspector: � Date: It IP Phone #: (503) 718- ZLfq‘ •