Permit /r o ..0- f � h ,a 11.
C ITY OF TIGARD V A • p �y H K PERMIT #: ELC2006 -00533
DEVELOPMENT SERVICES DATE ISSUED: 9/21/2006
��'l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 C D - 02716
SITE ADDRESS: 13680 SW ASH AVE ZONING: R - 4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 028 JURISDICTION: TIG
Project Description: Panel change. Job No. 12414 10/31/06, ADDING ADDITIONAL SUB PANEL.
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: 2 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:
BILL OSTROSKA COHO ELECTRIC INC
13680 SWASH AVE PO BOX 40
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503 - 780 -1487 Contact #: PRI 503 - 582 -9774
FAX 503 - 582 -9840
FEES
Description Date Amount Reg #: ELE 3 - 575C
[ ELPRMT] ELC Permit 9/21/2006 $80.30 LIC 157169
[TAX] 8% State Surcharge 9/21/2006 $6.43 SUP 1781S
[ELPRMT] ELC Permit 10/31/2001 $80.30
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $173.46
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 • h in • • R 952-001-0010 through OAR 952 - 001 -0100. You may obtain copies of these ules or direct questions to OUNC at
503 - 246 -6: • 9 or 1- 800 - 332 - '+""'
Issued :y: ���( � %Z -/�' Permittee Sign �re: . . J - / (
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.
' CITY OF TIG w RD ELECTRICAL PERMIT
VHK PERMIT #: ELC2006 -00533
ell DEVELOP M R 503 - 639 -4171 DATE ISSUED: 9/21/2006
- - 13125 SW Hall PARCEL: 2 S 102 C D -02716
SITE ADDRESS: 13680 SW ASH AVE ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 028 JURISDICTION: TIG
Project Description: Panel change. Job No. 12414
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:
BILL OSTROSKA • COHO ELECTRIC INC
13680 SWASH AVE PO BOX 40
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503 - 780 -1487 Contact #: PRI 503 - 582 -9774
FAX 503 - 582 -9840
FEES
Description Date Amount Reg #: ELE 3 - 575C
[ELPRMT] ELC Permit 9/21/2006 $80.30 LIC 157169
[TAX] 8% State Surcharge 9/21/2006 $6.43 SUP 1781S
Total $86.73 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 areset- forth 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of th--e -r leu s or direct questions to OUNC at
/
503 -24 6699 or 1 800 2-
Issu d By: , tijz A Permittee Signa tore_ ) r%� /�"' " rd--- �
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. ELECN. ��✓.Ar' S ' DATE:
LICENSE NO: 7 /
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 ': .11-' ELEC tR I C FAX NO. : 5035829840 Sep. 21 2006 01: 55PM P2
Electrical Permit Application
City of Tigard Received /} 2/ Ol0 I �enaikN oa •
_ DateBy: 7 El _da t. 6,... a)53 5
13125 SW Hall Blvd., Tigard, OF. 97223 Plan Review
phone: 503,639.4171 Fax: 503:598.1960 NE A ii ,, y. +r"' .,.... :. � , k ' � Data/By: Other Permit:
Inspection Line: 503.639.4175n��p r s Yf L „ Dat Ready/By: - i�rie: — See 1pai e. for --
Internet: www.cLtigard.or.ua 1 � — O 10 Notified /Method . f /G Suppleinentat Information
F,frYPE OF --pYaC J( PLAN REVIEW
0 New construction .is dtlitio`n/ v atiLnircphtccment T � Please check all that apply:
[] Demolition e tQii t e r N O' ❑ Servica over 225 amps, coming ❑Hazardous location
-- ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OP CONSTRUCTION of 1 - and 2 family dwellings 4 or more now residential
I s 1- and 2- family dwelling I=1 Commercial/industrial Q Accessory building ['System over 600 volts nominal units in one structure
Multi- family • [] Master builder ❑Other: ['Building over throe stories ❑Feeders, 400 amps or more
- -• •• �--- • QOccupant load over 99 persona []Manufactured structures or
JOB SITE INFORMATION AND LOCATION RV ark
❑ I?greas/light pl an P
job no.: \ ay l y Job site address: `:'I y 0 (*.i.3 44 stn nnit tlt -core fat itity ❑ ab o v e.
_ . V'— Submit 1. sets of plans with any of the above.
City/Stale/71P' 7'' The above are not applicable to temporary construction service.
• Suite /bldg. /apt, no,: Project name: 1 \ ('� FEE* SC DU
Project -- _ , _
�� • -'mot ••
Description ~� -_ TT Qty. " Fee. ... ^ L . T Total ^ I ••
_
Cross street/directions to job site: New residential single- or multi -family dwelling. unit.
..-_ ............:.....-.,-._....,,•--•-•.,._ •......,,._......_:._— ......_ -- - ..._ __.... _ ..__ .._.._........._,.._.....:..... Includes attached garage. _
•
. . • . . . .1,000 sq, ft, or less .. .1.45.15. , , ' .
Subdivision: Lot no.: Ba, add'! 500 sq. R, or portion 33,40 1
Tax map /parcel no.: Limited energy, residential 15.00 � -W y 2
Limited energy, non - residential . 75.00 - 2
DESCRIPTION OP WORK S - nanufactured or modular
((''�� 1 dwelling, service and /or feeder 90.90 2 •
_..,...w._.--�.! ` .11. Services or feeders Installation, alteration, and /or relocatton
....,_.,.w 200 amps or less _-..........., _...... 1_.... 80.30 , ac 2
li - --- � PROPERTY OWNER ❑ T ENANT 201 amps to 400 amps 106.85 2
- - 401 am,. to 600 amps 160.60 2
Name: ceD + 5 601 amps to 1,000 amps 240.60 __ 2
Address: \,'- 6,::: � C _ t [1J- h Over LOGO amps or volts 454.65 2
�-•-�- 1 �� t Reconnect only 66.85 2
City /State/ZIP: \ 7t l (*),R �1 �4�� _ Temporary - services or feeders installation, alteration, and /or
Phone: ( ��) Fax: ( ) relocation
— r �1 _ 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; _T _ ,. _ ,..,• -____ ._ Date: Branch circuits.- new, alteration, or extension, per panel
_.._.- _ _... ❑ APPLICANT - , - I ❑ CONTACT PLrRtSON . A. Fee for branch circuits with
aervice or fonder fee, each 6.65 2
Business name: branch circuit
B. Pee for branch circuits
Contact name: • without service or feeder fee,
each branch circuit 46.85 2
Address: _ • Each ndd'l, circuit 6.65 2
. City /State/ZIP: ' Miscellaneous (service or feeder not Included) , `_
-
- Pump or irrigation circle 53.40 2
Phone: ( ) • Fax: : ( ) _ Sign or outline lighting 53,40 2
E -mail: Signal circuit(s) or limited- -
CONTRACTOR e nergy panel, alteration, or ' •
Busines Hattie !! -- ' extension. Describe: Page 2 2
C.a t� t.‘ .ta _
Address: f-7 L � y r Each additional Inspection over allowable in any of the above
�� °° I II/ �t --- •• -•�- Per Inspection 62.50_
City /State /Z,IP: t ..) , \ ,,-, J \ Le c . i {S c°- g ' 1 Investigation. per hour (1 hr min) _ 62.50 - � T _ � _
Phone: ( ) Indust plant per hour 73.75
- c �'�l Fax: ) 5 - °� t � ELRC'fl XCAL PZRM FE • I
CCB Lie.: Electrical Lie Su ry Lie
. (t0 ,,y p `��J _ �� Subtotal
Suprv, Llectrician signature, rctpnredla I lls" ���li,i s, ' :t1r�t „.. Plan review (25% of permit fee)
Pr State surcharge (8% of permit fee) 6 •Lk •
Print name:
VT-r....-%, • ' .� , s ate: 4\�av_Qb
t - — ' --'_• TOTAL PERMIT FEE �(p ;1...3 '
Authorized signature: ' -` I i %! ' This permit yppttctttton expires if n permit to not obtained within 180
- • � ' . �
days after it hat hunt accepted as u Se
Print name: Date: _ _ �01,,, • Fee methodology set M
t by - County Building Industry stry Suwicc Board
— ° ° - -- ” Number of inspections per permit allowed.
islDuilding \Pem,itun2l.C.PermItnpp.doc 12/0 . 410- 4615T(10 /02/COM /WM
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00533
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2006
Phone: (503) 639 -4171 a lop ( (i� l
Inspection Requests (24 Hrs.): (503) 639 - 4175±1
INSPECTION WORKSHEET FOR DATE: 10/30/2006 TIME: 7:05AM PAGE: 77
SITE ADDRESS: 13680 SW ASH AVE CLASS OF WORK:
SUBDIVISION: FREVVINGS ORCHARD TRACTS LOT #: 028 TYPE OF USE:
PROJECT NAME: OSTROSKA
DESCRIPTION: Panel change. Job No. 12414
OWNER: OSTROSKA, BILL PHONE #: 503 - 700 -1487
CONTRACTOR: COHO ELECTRIC INC 1\ L PHONE #: 503 -582 -9774
Inspection Request Scheduled For: Date: 10/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 038846-01 503-780-1487 Y
Corrections /Comments /Instructions:
F kbb1 `rI mAL-
S�'J (' y
The electrical instaJlatinn riwfAnts_notad
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918- 271 -0030
f @ 77 X z
PASS PARTIAL APPROVAL n CANCEL I NO ACCESS
I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Z - m vv 1.t� Date: 1OI 30I0k6 Phone #: (503) 718 - 24440