Permit CITY TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2005 - 00936
DEVELOPMENT SERVICES DATE ISSUED: sAl. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2 S 108AB - 01000
SITE ADDRESS: 15305 SW 153RD AVE ZONING: R -
SUBDIVISION: WONDER VIEW ESTATES LOT : 003 JURISDICTION: URB
Project Description: Temporary construction power.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
PHELPS, DAVID S AND JEANETTE STONE MILL ELECTRIC INC
PO BOX 551 121 STONE MILL RD
TUALATIN, OR 97062 KALAMA, WA 98625
Phone: 503- 590 -0116 Phone: 360- 673 -6424
FEES Reg #: LIC 160298
ELE 37 -1042C
Description Date Amount SUP 2853S
[UELPMT] ELC Permit 12/5/2005 $66.85
[UTAX] 8% State 12/5/2005 $5.35 REQUIRED ITEMS AND REPORTS
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable laws.
All work wil • - .one in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspendr d for mor- an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a set forth in O' ' 952 -"! 0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503-244-6699 or 1-800-331-'344.
Issue • By: I I OttA44.444)
Permittee Signature
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: • ' !r airula , DATE: /
LICENSE NO: A6'53
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
Clty,.pfoTagard DReceiv�
eB d /���� Perm No.. L e . 1
13125 SW Hall Blvd., Ti ard, OR 97223 Plan an'If Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �" l °1'A Date/B : Other Permit:
Inspection Line: 503.639.4175 ea. Date Ready/By: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: _f Supplemental Information
TYPE OF WORK PLAN REVIEW •
JA New construction ❑ Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location
OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential
] 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: Job site address: O `
�S 3 S' Sw � ❑Health - care facility ❑Other:
L LL. M i rJ A Submit 2 sets of plans with any of the above.
City /State /ZIP: -s c A i221, I o t The above are not applicable to temporary construction service.
P
FEE *SCHEDULE
Suite /bldg. /apt. no.: Project name: Pt,' ,
I- Description I Qty. I Fee. I Total I`
Cross street/directions to job site: 1A,,,,,,.. 9 1 tv B..L` Mewl -Al New residential single- or multi - family dwelling unit.
Includes attached garage.
Q, i Q IS 3 ' . A, z N a ce q_04. . 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
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular •
dwelling, service and/or feeder 90.90 2
/ c lM P ostUJRY S t 20 (GE- Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER . ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps 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
relocation
Phone: ( ) Fax: ( )
200 amps or less i 66.85 66. fjS 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, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add] branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax::( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: .u 111t_t_ El__ci21<- 1 ) L..
Address: 11_1 S o,J� ]nom l L l_ Q� - Each additional inspection over allowable iu any of the above
Per inspection 62.50
City /State /ZIP: F...A L Ai "/N, , , ).A 9 `st2.S Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: (360) 6,-7 3 - � L 1 �-y Fax: (36v) �i 3 - / 2:33 p p
ELECTRICAL PERMIT FEES*
CCB Lic.: /607,9 Electrical Lie.: ?7 - /J yi t Suprv. Lic.: Z S / S �' " j ; ;;I Subtotal 44 gS
Supry . EtQi�i�rl // i g nature, required: l6 t �` r i Plan review (25% of permit fee)
_ State surcharge (8% of permit fee) ?
Print name: , y� • • kr�rAV E. Date: /S /O � �� �
TOTAL PERMIT FEE 7a, 20
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: i Date: * Fee methodology set by Tri- County Building Industry Service Board
' • Number of inspections per permit allowed.
i.\ Building \Permits\ELC- PermitApp doe 12/03 440- 46I5T(10 /02/COM/WEB
r,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005. 00836
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: '11
Phone: (503) 639 -4171 A i i, l
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 1/4/2006 TIME: 6 :59AM PAGE: 55
SITE ADDRESS: 15305 SW 153RD AVE CLASS OF WORK:
SUBDIVISION: WONDER VIEW ESTATES LOT #: 003 TYPE OF USE:
PROJECT NAME: PHELPS
DESCRIPTION: Temporary construction poorer.
OWNER: PHELPS, DAVID S AND JEANETTE, PHONE #: 503-590-0116
CONTRACTOR: STONE MILL ELECTRIC INC PHONE #: 360- 673 -6124
Inspection Request p q Scheduled For: Date: 1 /412006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1'10X\ Temporary electrical service 024323-01 360-917.7110 N
Correc '•ns /Comments /Instructions:
_- ,,
Cr
41/
zin hn 6 t R14) . 5 3-? )` 49
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIl1/4 n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: J >L-.i4 lip -+-s-, Date:/ y "C Phone #: (503) 718 --7` 7�'