Permit CITY TIGARD ELECTRICAL PERMIT
OF TIGARD #: ELC2006 -00016
DEVELOPMENT SERVICES DATE ISSUED: 1/10/2006
- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133CD-14100
SITE ADDRESS: 14028 SW BLUESTEM LN ZONING: R -25
SUBDIVISION: PEBBLECREEK NO. 2 LOT : 032 JURISDICTION: TIG
Project Description: (1) circuit for kiln. Job #1159.
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:
JAMES KOENIG CONDUIT ELECTRIC
14028 SW BLUESTEM LN DBA DUIT LEVEL TOOL CO
TIGARD, OR 97223 19461 SW 89TH AVE
TUALATIN, OR 97062
Phone: 503 - 692 -1428 Contact #: PRI 503 - 692 -1428
FAX 503 - 692 -3652
FEES
Description Date Amount Reg #: SUP 4501S
[ELPRMT] ELC Permit 1/10/2006 $46.85 LIC 109669
[TAX] 8% State Surcharge 1/10/2006 $3.75 ELE 26 -905C
Total $50.60 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: S , , c'N
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.
2006 /JAN /10 /TUE 10:09 AM Conduit Electric FAX No. 5036923652 P. 001 /001
•
Electrical Permit ApA g >�' ��` ...,, 011. 1C'r USE ON1 A.
City of Tigard • ve —/ / () . Permit No.:6 0 /0i6 �
1 3123 SW 13x11 Blvd, Tigard, OR 97223 Alan R e view
J 10 2000,. Other Permit!
Phone: 503.639A171 Fax 503.598.1960 �i %ii I' Dated •
Inspection Line: 503.639.4175 ,�,i- � . Data Ready/By Ein 53 SeeFage 2. for
Internet www.ei.tigard.or_us CITY OF T1GA U Noti6ed/Method - Supplemental Information
f i D F a c. 4 Yyi ii M���j� d 't6�tJn'i�4 t, T�. 'ic ""'i!TYyi
1�� ,�' t ry 'A'1'� ` ,,�,� ,��ti"'; J> lt'} e^ ) Rj r p Q g fi �q i ,`. .. r7� Ar c ' lLEe�.'..'7.tS_^L.G? t. a ±�,.S..wV!il:4ZZA"
+ , l" �L'. 1« �L�irt','/ NA 'R:�tyv�«���a`��.LRJ�:A�1�id��( �..uti'}3wdva
0 New construction [I Addition/alteration/replacement Please check all that apply:
[ Service o ver 225 amps; comm'l (Hazardous location
0 Demolition J] Other. OService over 320 amps —rating 0,Buildng over 10,000 sq, fl.,
�% "' #rL. „a h " ei t i i1 A , 11'. t li Y P's.
F r w i" l ' y o£ 1- and 2 -fandl dwellings
4 or more new residential
1.4 1- end 2- fiutllly dwelling ❑ CommerCial/industrial ❑ .Accessory building °System over 600 volts nominal units in one structure
°Building over three stories °Feeders, 400 amps or more
(] Multi-family 171 Master builder 0 Other ❑Occupant load over 99 persons DManufactured structures or
r ne ed e , •� , S , f "1 f y ' ` 3'.' QEgress/lightingplan RV park
. „ e ..r: ° =17 fl T,¢a;:<a:Zr���.,
px �
ealtbre facility ❑Other:
Job no.: r .i J site address: II,... lw. . . ,i . IS Submit 2 sets of plans with any of the above
City/State/DP: /State/2ZP "j ° 1 J. /. The above arc not applicable to temporary construction service.
B . 7r
e - a 3 a a'y r�:: f :us i a " ;"t ' rr-; .„v r .. . ."�".
SUite/bldg. /apt no.:. 4 Project name: Aacripbm, Qty_ sea Total Iii
Cross street/directions to job site: - New residential single- or multi-family dwelling unit .
ow. .>�:-�„ Includes attached garage.
i , ' ,n - 1,000 sq. it or less 145.15 4
Subdivision: •
Lot no.: Ea. add'l 500 sq. ft or portion 33.40
Limited energy, residential 75.00
e
III
Tax map /parcel no.: � Limited energy, iron -resi dn tial 75.00
'' + ' i ^' ' 4 ,^ rt cM41 o ,1.' "_+• t'> ;e ; t .: : ; E Each manufactured or modular IIII
atrttlt:" `� a dwellin: service and/or feeder •90.90
II , II �.. ' R ilk Services or feeders installation, alteration, and/or relocation
200 amps or less • :30
�.. t ,r 201 amps to 400 amps
111
lOb_85
' ?,' . ' ' - 7 er ,e � 'u t � i • F - s2u�' }ib ; tae; , ; ',- � g w �' • ` 401 amps to 600 amps II 160.60 II
Name: p1 3 Kee 1 1P, \\ . 601 ann to 1,000 am , s 240.60
3 Over 1,000 am or volts OM 454.65 Ell
Address:
Reconnect only _ 66.85 . 2
City/State/P: •Temporaryser*ices or feeders installation, alteration, and /or
•
( relocation
Phone: (j V 7 / y � 1 Fax: ) 200 am s or less 66.85 • I
Owner installation: This installation is being made on property that — I own which is not 201 cps to amps 10030 2
intended for sale, lease; rent, or exchange, according to ORS 447, 449, 670, and 701. 401 snaps to 60D snips 133.75 2
Owner signature: . Branch circuits - new, alteration, or extension,. per panel
,, , � ua , '1" "' i 0 , as iv ''z'' .; A Fee for branch circus with
E` 7k' . i> s+?1 +. �' Cl; ` s.. Ilti . Mb E _ s a iW ` A' ° d service or £ceder fee, each •
Business name: branch circuit 6.65
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85
- each branch circuit
Address: • Each add'l branch circuit 6.65
City /State/Z1P: miscellaneous (service or feeder not inducted)
• Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E � Signal circuit(s) or limited -
'`' a .4 _ is . !tl! - '' .d'' 7?. �'i* 1 . ,r ^:. ),,.d t 5,Z, '''. Al Xo extension. panel, alteration, or g z
,,, r, tD :�^a, o Describe: Page 2
Business name: , *oaf -
Each additional Ins , effort over allowable in any of the above •
Address: y . / _ -' • AU-C.,-,- Per inspection . 6250
II
City /State/ZIP: f , • A 0 a o , ... Investination. per hour (I hrmin) 111 -62.50
- ,,,.,., , 1:, , hour MI 73-75 IMMIIMI
Phone: (SD ) ,q, - • kt.ra! istX' ';_1u l
/ � Subtotal a
CO3 Lie.: 1 cygL Electrical Lie.: c9(.0 ii/
��f� Plan review (25% of permit fee) I
Suprv_ Electrician signature, required ll , u
State surcharge (8% o permit fee) ��rr�
_ ' Date: TOTAL PERMIT W1�iiU�
Print name: C g ,
Authorized signature: S mix permit application expires if a permit .a mot obtained wlthl? 1:0
Mays after it has been accepted as complete
Print name: pate: - * Fee methodology set by Tri- County Buildinglndustry Service Board
•r Number of inspections per permit allowed
i; lBultding \Pamrita.C Permitgpp.doc 1203 4404615TO0/02/C01440a
CITY OFTIGARD _.
BUILDING DIVISION PERMIT #: 616.200 C
1 . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 ' g a 4 pu 67i , �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ( L I°Z00 SW tC.- 1/6 - V A - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: (SJc + G - r2Cv r 6) i t
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
I ti
LZZ c F /`V4 (__._
Corrections /Comments/ Instructions:
AMIIIIIM
1 MI 11 I 1 W
1 1 a IN ii ■
•
. , 6 4 . PASS ART : ' APPROVAL n CANCEL ❑ NO ACCESS
1 T AIL l C : FOR INSPECTION U ADDITIONAL FEES ASSESSED
/ I /3 '40C Inspector: i . - : —Phone #: (503) 718 -
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