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Permit C ITY OF TIGARD ELECTRICAL PERMIT ti- PERMIT #: ELC2004 -00641 ,, { * � [DEVELOPMENT SERVICES DATE ISSUED: 10/5/2004 n'I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S102CD -02708 SITE ADDRESS: 13560 SW ASH AVE SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R-4.5 BLOCK: LOT : 026 JURISDICTION: TIG Project Description: Installation of (1) branch circuit for fireplace insert. 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: THOMAS, ROY F SOHLER ELECTRICAL CONSTRUCTION 13560 SWASH 41131 SW BURGARSKY RD TIGARD, OR 97223 GASTON, OR 97119 Phone: 503 - 639 -5519 Phone: 971- 832 -0807 Reg #: LIC 158285 ELE 34 -667C FEES SUP 594S Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/5/2004 $46.85 [TAX] 8% State Surcharge 10/5/2004 $3.75 Rough - . Elect'l Final 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 a re 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: �/� Permit Signature: / /-�/)L/e.� — T /pry/ 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 639 -4175 by 7:00pm for an inspection the next business day -. r . ECEII VE % ..c. e a xa :tu Jr CCI mis..() p mjcai ion, FOR OFFICE E SE ONLY • City of Tigard CI TY r 2004 ! t9/�1/0 il 44)' Permit N 200`/- .& sj 13125 SW Hall Blvd., Tigard, OR 97223 Q Plan Review Phone: 503.639.4171 Fax: 503.598.1960 L F TOGA ! • • • l • i • Date/By: Other Permit Inspection fine. 503.639-4175 C®IN ' "' V /.•a..41.,. -IL' Internet www.ci.tigard.or is - 1 � - No ed#Merbod: � 1 ® Sn ppt Page for emeDtp information _' r. - -, _ - - = - ma� cc -- tt++�jO - ` - ' ' .�-. • : e -• ' v �� - 0.* W)WC: _ - f it • 4. - -' -- _ . 0 -New construction 1 Addition /alteration/replacement J Please check all that apply: ❑ Demolition Other: ❑Service over 225 amps. comm'1 ❑Hazardous location 5 ❑Service over 320 amps - rating ❑ Buildng over 10.000 sq. _y 1=f4 -- : ; . •. �6,•12Y`.OF G' ONS RICJION . .. of 1- and 2- family dwellings • •. - ' �` ° -. �• :: - T � ":` ,�:.:` • '' •' .`' 4 or more new rrsidenti: V 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories ©Peeticts. 400 amps or trtt ❑ Multi - family ❑ Master builder ❑ Other ` ,ataf3" ❑occupant load over 99 persons ❑Manufactured structures 4 r " - `S1TE' _ .0 Ali O''7; .. ,. - ❑E plan RV park Job no.. Job site address n ''^ ❑Health -care facility ❑Other. � �, 5 t. / 't a /T t '-L, Submit 2 sets of plans with any of the above. City/State/ZIP: r �t(� r Y 6 q 7 , !7 3 The above are not applicable to temporary construction service. Pmjcet/name: .�- . n: _ a- . ... t ; . } ..� Bx; S( IEDULE :- ' ' . : Suite/bldg./apt no.. e e I , (1 , , 5 Description .,.1Z-T Description ' ,:• f Qty. I Foy I Tour • Cross street/directions to job site: (" New residential mingle - multi- family dwelling unit. Includes attached garage. I,000 sq. ft or less 145.15 Subdivision: I Lot no.: Ea add'! 500 sq_ ft. or portion 33.40 Tax map/parcel no.: • Limited energy, residential 75.00 - - Limited energy, non - residential 75.00 • .. : -, - . i . _ ' ESG - 07. 01+3 =0 Fo :- _', . . _ _ .`'- : Each manufactured err modular dwelling, service and/or feeder 90.90 b w i rt r7 ,--4.,„ /c-, C Q .art sr . ✓ 7 Services or feeders installation., alteration, and/or relocation 200 amps or less 80.30 ,.ex ix1,4i4i iw., ' _`; [4:c _ ,: ij -rE r .. • _ r 201 amps to 400 amps 106.85 401 amps to 600 amps 160.60 Name: 7Z 7 d- c - , s ... 601 amps to hoot amps 240.60 Address: 1 3 - /- n S ✓ ff:}- 1- 04-1--4,.< Over 1,000 amps or volts 454.65 City/State/ZIP: f 1 J -7 7 Reconnect only 66.85 1 .f7 - 1 a i r r IC ' / 2 2 1 Temporary services or feeders installation, alteration, and/or Phone: ( ) C _ C •. Fax: ( ) relocation / / 200 amps or less 66.85 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps I mps 33.75 Owner signature: Date: Branch circuits- new, alteration, or extensio per panel ' - , ~' ;;,. '. 4iY d tP t, � • -: -, A. Fee for bran =: c SP �A1Y rte.. . - _ . . branch circuits with /-- ` / p service or feeder fee, each rte S D G e c.Tr r c_!t 1 I. i Ti branch circuit 6.65 Business to Contact tram= B. Fee for branch circuits Tn < ' e 1 1 ee.re withain service or feeder fee, . pig I i � I each branch circuit ( 46.85 1-1 1 ? 1 S t� e,�,- .t! S k R d Farh add'! branch circuit 6.65 , 2 CIry /State/ZIP: /'_ „ . f_ (� C� ^� / � Miscellaneous (service err (coder not included) Phone. 47 �T Zf 1 Pump or irrigation circle 53.40 2 ( 1) r93 . - O Fi o - 7 I Fax: : (563) ? 8 .5 IT Sign or outline lighting 53.40 2 E _ . Signal cireuit(s) or limited- .. , ' _ . •.J _ . ..►:0 B _ , n • : GIfoi2• ._ . . _ ' : _ _ _ - .-.... . , . :- aier&y panel, alteration. or / I / C. extension. Dese: Page 2 2 am Business n e: So L kvi' EJ2[ i-r- r. e, N S 7� Address: Each additional inspection over allowable in any of the above City/State/ZIP: Per inspection 62.50 Investigation per hour (1 hr min) 6250 Phone: (4) 11).E 5 _ u 8 0 7 I Fax: ( ) 1 Or I � /� Industrial plant per hour 73.75 CCB Lit:.: 1 S 6,20 s I Electri. - c.: ? It_ a7 S . Lie.: - - r crR7caic : F. ,o Subtotal :.: pp Y - � btotal G% & / 8 Suprv. Electrician signature, .. . • v... Plan review 25% of ( permit fee) r Print name: I l i Al , f V Y f D i �/ y q Slate surcharge (8% of permit fee) 3t'77 1 / l TOTAL PERMIT FEE , -) 60 , ,Authorized signature: A/(4 `4 t 1r" l r F` 4<■■ - This permit application expires if a permit is not obtained within IEa days after it has been accepted as complete Print name: tt Date: ��-� ♦M r S 4 tl �. Di b /4//6 `.i • Fee methodology set by Tri Comnty Building Industry Service Board ttea.7diagiFemdst9 C p,,mitAtmdoe 12/03 ae".4 II crr,n.n,.l•n..n..co �� Number of inspections per pert allowed. Z' d • B S86 -EOS JaiLoS 9 oC dtPz :fro - IO b0 400 CITY OF TIGARD 24 -Hour BUILDING Inspection L" e: (503) 639 -4175 INSPECTION DIVISION Business L' e: (503) 639 -4171 MST ff I BUP Received /O`� Date :e•uested / C� /•• AM PM BUP Location .4 if_ .A__.- / Suite 40 ;/5 V-- 00657 Contact Person AL. -.. %� ' Ph ( .57)3) 0 S 12°- '7 Contractor Ph ( ) SWR r`/ BUILDING Tenant/Owner 5 c -0 — ©�� 006 1` Footing ELC Foundation Ftg Drain Access: Crawl Drain Y1LD 6F.M - ELR Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Framing Sheath/Shear /� ,� ` / � ` //2/0 ) / 5 L/ /Y� -- /_/ // Insulation Drywall Nailing �/ Firewall F'—" ch *Ji M /v6 / � L,4- c 8- 7 Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING. , - „ -«- Post & Beam Under Slab 1 Rough -In 9 , Water Service Sanitary Sewer Milliffill..... Rain Drains Catch Basin / Manhole %' Storm Drain t Shower Pan Other: Final — PASS PAR T FAIL . C ANIC Beam R moke Dampers i RT FAIL PAL Service Rough -In UG /Slab Low Voltage �� .. Liam 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE ❑ Please call for reinspection RE: E Unable to inspect — no access Fire Supply Line ADA . C (247 Approach/Sidewalk Date / Inspector Ext Other: Final DO NOT REMOVE this inspection rec d from the job site. PASS PART FAIL