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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00297 DEVELOPMENT SERVICES DATE ISSUED: 5/3/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136DD-00900 SITE ADDRESS: 06830 SW ATLANTA ST ZONING: MUE SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 002 JURISDICTION: TIG Project Description: Temp power pole. 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: VINCENT, BRADFORD DAVID JEROME ELECTRIC 6830 SW HAINES RD PO BOX 751 TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: Phone: 503 - 648 -5144 FEES Reg #: LIC 36051 Description Date Amount SUP 2877S ELE 34 -119C [ELPRMT] ELC Permit 5/3/2005 $66.85 [TAX] 8% State Surcharge 5/3 /2005 $5.34 REQUIRED ITEMS AND REPORTS Total $72.19 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: x. 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. ~ 04/30/2004 08:31 FAX 5035981960 r€ITY OF TIGARD 1 On r E• Electrical Permit A o p ri FOR Or rick USEON Vl City of Tigard 7-CS 0 a°`°' "ed f- Pe rna tNo.: G g t•4 Q Dets/B : J 0 C _ , 0,4 ` -60, 13125 SW hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax 503596.1960 -s t 't' - , : t a : n • l t �, Dete)By, Other Permit' Inspection Line: 503.639.4175 , 3 • ' - J . Dote Reedy/ay: I luriz E1 See Page 2 for • Internet www.ci.tigard.or.us (_, : ' t > , - e .:, N otified/Method: l IN-- r( St pplementat Inrormotion i�,,�,,,�� "11 £ - J J fry - 7 .- . 1 , _- q . = t _ • - 'f!r'i L e s ; '/ .., t, / .v , . � cs.: b , C16'10 a '," ... _ • : q r ?1i m-Of r y�,�a ' °� '• 9 �"' , �,�• �.��''�� , I a I ... i , I r : � - i:,. ��lL y„�: +:r.�J.:L:,.'.�)'• _:.I f'j�h3w', . ��!;,{l"erl 9•C 1n;.a�a- .J1;1 @ �j r yi �,,• t ''�; ���4 a41c..�... • .Ih... �'.7S• , c::I:",:�ir:. ' j •.. " - ❑ New construction 0 Addition/alteration/replacem ent Please all that apply; El Demolition - 6 er: OServa over 225 amps, comm'l [Hazardous location ' alit ^ l � :� , , rte _ u .... . 1 M , p ... Ac over 320 amps - rating [Bunting over 10,000 sq. ft., b 1 tr !;� ' P .t u i1' 91. C 61 J�q n h i f � � , �t `.° tom? i�G tG tf . A , '- 1L•9 ,•r�.��� ,9 l'ri � 1 � S ; of t - d 2-family dwellings more new residcn � � ? � ; e1f"d'�.:�di „ � '• 0 Ser n Y 6s 4 or m r tial O 1 - and 2 - family dwelling ❑ Commercial/industrial ❑'Accessory building ❑Sys over 600 volts nominal units in One structure ❑ Multi-family 0 Master builder et ❑Build' 6 over three stories [JFeeders, 400 amps or more u , y - u ,. 00ceu ant load over 99 persons ❑Manufactured structures or ' f t1'�I „ g r :: ! w • 7t1 u l. ;.0 ^'`r+•,ltr-t ')! r ! RV t ^ y _M ti,' - 7 ❑ $r S ' W 4.4 �. : .1 W _ i RV ark ipt tt r�5�1 r � @t�� l M � � r .r , i I! E ee Righting plan P • Job no.: S (D Job site address; T�k• �/"� • ❑Health -care facility C��fi t■� "�a " Submit 3, sets of plans with any of the above. /r a City /State/ZIP; O ,3, 5 ji i ��� M The above are not applicable to temporary construction service. Suite /bldg. /apt. Project name: Ie ,�,'tdill.'' ARM' !av`' i'A,•- .iixI ,',,';,,,`....Y ..,..:" . -.: - ^.ssaiptlee Qtr. IMEMMIEMIlill Cross street/directions to job site: •-,.• . , , * . . � New residential single -or multi - family dwelling unit. �, i Includes attached garage. " Y 1,000 eq.f. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 eq. ft. or portion 33.40 „, - Tax map /parcel no : Limited energy, residential 75.00 y Tt: � `I ",� t1i1 A l i } el no 1 ' I . Ii ' 9� "• D' fI 0` } 0'1 f�0 d+V i I r ' i1 `., gyp,. s,r Limited energy, non - residential 75.00 • �, „w.:.t , !r ' a...,,.,� „� .`I. . n,�crnu::it „...),.i., ....•r r�kcn �_.:, Each manufactured or modular ... �' `� , - ,,, 1 A dwellin:, service and/or feeder 90.90 r Services Or feeders installation, alteration and/or relocation ��IIII��� !!��LL 200 amps or less 80.30 � U �i . �i ' ' lb P i ;"' , �" , 6 � ? �' ,�+ a p '• . - c:ea�z ; ,I^ r "; ' "i 201 amps to 400 amps 106.85 �af U l7FJt, . ;4.wik�`w ~,, f,_..,a4 t i =n Name g , � 401 amps to 600 amps 160.60 A A 4.. �► . 601 amps to 1,000 amps 240.60 Address: ' 4 A • - 1,000 amps or volts 454.65 [tc � I�g Reconnect only 66.85 © City/State/ZIP: 5:2,0..9--- Temporary services or feeders installation, alteration, and/or Phone: ( ) t1!'/ -- li Fax: ( ) + Lc . e ^ \\ - relocation l 200 amps 66.85 Frcou Owner installation: This installation is being made On property that T own which is not 201 amps to to 400 400 amps IIII 100.30 Ell intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 600 amps 133.75 2 Owner Si: attire: Date: Brach circuits - ne w, alteration, or extension, per panel p, n r`Fi fltr�lT;_ ,.2t r 2 s xl> ` :�_,.u . 24 •• 'xl' (g c :,sl i l t f v ` l A N L 1 - r � ': } r �lVll +� A. with �` �' l� A Fee for branch circuits wi service or feeder fee, each Business name: breach circuit 6.65 2 Corttaat name: B. Fes for branch circuits without service or feeder fee, 46.85 2 Address: each brea circuit s• . Each add'1 branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not Included) Phone: ( ) Fax : ( ) ' Pump or irrigation circle 53.40 2 Sign or outline fighting 53.40 fl Email: _ Signal circuits) or limited - z ''1" r:.:', ' s, n ed u y t �{ cog a IN E: :. j.I s.J'� l"¢s.'C�1 � .�' v � `�'�1'�:1n ��r.?..1�oc i� �i'��l�t.'�!7'LE!����!�a� �d. r. 44.n��:: 2rbi lid:'•' ens rSY panel, alteration, or extension. Descnbe: Page 2 Business name: e r o - _ - Address: P 0 B 0 X 751 Each additional Inspection over allowable in any of the above Per inspection 62.50 r llw-a "t ;' City/ State/ZIP,: ' 'Raj : 1 sb;o;r o$ ' ' Investigation per ( �� r 4 .ti;: . 0•R��s e:stf anon hour thrtnin) 62.so , 1 1r( 'Phalle _., s .... , . ..,," r ,z . ; ..,: 5. ) , . -. ' a Industrial, plantpm - hour - .. _ -� (50'J64 5 1 4 4" P X 3 =6 . r . 8- . ,97.2 3''_:; '-"' 58119 ,3 4 -119 Ip - 1�'e' �(• • :I/ .� -,�: 6,.1 CCB I.iolt Electrical Lic. C Suprv. LIG.: 2 8 7 7 s _Subiotal • Suprv. EIectrician signature, required ` �� Plan review (25% of permit fee) Print name: David A Jerome Date: State surcharge ($% of permit f8e TOTAL. PERNIII' F'EE MEM Authorized signature: This permit apptieatioo expires if a permit Is not obtained within 80 clays after it has been accepted as complete Print name: Date: • Fee methodology set by Tri.County Building industry Service Board • • Number of inspections per permit allowed, $ 15ulineerrnits\Et.GYenitApp.doe 11103 440.461S111Wtoico w89 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006.00297 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 5/3/2005 Phone: (503) 639 -4171 ar °llu�i�ll�j1hl� Inspection Requests (24 Hrs.): (503) 639 -4175 W ':_.. INSPECTION WORKSHEET FOR DATE: 6/4/2006 TIME: 7:15AM PAGE: 64 SITE ADDRESS: 06830 SW ATLANTA ST CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 002 TYPE OF USE: PROJECT NAME: VINCENT DESCRIPTION: Temp power pole. OWNER: VINCENT, BRADFORD, PHONE #: CONTRACTOR: JEROME ELECTRIC, DAVID PHONE #: 503.648 -5144 Inspection Request Scheduled For: Date: 6/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 006050.01 603 -648 -5144 N Corrections /Comments /Instructions: • 7 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 7 Date: S` Phone #: (503) 718-