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Permit 1. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00850 .i DEVELOPMENT M Ir y E I CES DA ISSUED: 10/31/2005 13125 ' g 5 03 - 639 -4171 PARCEL: 2S111 DC -06500 SITE ADDRESS: 09480 SW BRENTWOOD PL ZONING: R -7 SUBDIVISION: SUMMERFIELD NO.9 LOT : 499 JURISDICTION: TIG Project Description: (3) branch circuits. Job No. Forrest 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: 2 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: FORREST & CLEMENCE WINNER ELECTRIC INC 9480 SW BRENTWOOD PL 5950 SW PROSPERITY PK . TIGARD, OR 97224 TUALATIN, OR 97062 Phone: 503 - 620 -0848 Phone: 503 - 638 -5028 • FEES Reg #: LIC 14794 tion Date Amount SUP 34 Description ELE 34 [ELPRMT] ELC Permit 10/31/200' $60.15 [TAX] 8% State Surcharge 10/31/200`. $4.82 REQUIRED ITEMS AND REPORTS Total $64.97 This Permit is is 7d subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work , . .e done in -., ordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspe'ded for more than 1:14 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rule are set forth in OAR 95 i. 00 through OAR 952 - 001 -0100. You may obtain copies of thes- . -s or direct questions o OtJNC at 503 X 46 6699 or 1 800 33 Iss ed By: , � o Permittee ' ignature: i . ; ,,..f Aueli % 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: ONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELE I_.... ..i�,`,.traim ,��- . 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. u. zuf zuu4 u9 in, FAX 50� t ' CITY OF TIGARD ff3j 001 ti t t_g. ..1 r Electrical Perm► 1� 1C ,� ( - FOR OFFICE USE ON IA' City of Tigard f ti � RDatceceived B : to 2 _, O . _4, Permit Nu.: Q, n 5 13125 SW Hall Blvd., Ti ar P�9 Phone: 503.639.4171 1 A- 503'S9 -t6 `� t ,,,dr u ;'. ' r�. Plan Review l Other Permit: tP•� ; ;: � IhtcB inspection Line: 503.,i�t ^ DING D ®IV . . I i Date Ready /13y: P1 u See Ic m Pagc Internetr v.'ww.ci.tiga >. -- Notif,ed/Memod: �' S pp cntal lnfo rmaeion 1:1 :i'r. ' I .,.I , I 1!:i' ;I' ', 1'..k!'.;Q'�,,if .,Ii::ili. .y. 'i1, al` l' ' ii'.!. .... ."I:�d . l,! I,„ :�,:, ':�`�"� ,�•' :�. ':,�i. ;:�L:,I�It ,.I�I� .. I :., , . �I� .I :i',�l i .. I, . I� i , �: "� �.'• • .: ':'�,�I��I.�!,,,, . .....'PL•'AN j REY[Ek%;lill� . ❑ New construction 5 Addition /alteration /replacement Please check all that apply; ©Service over 225 amps, comm'l ❑Hazardous location ❑ Demolition ❑Other: , `. ; ;I,I........ ;i......' is r l ;!I; li!'i ; ;i.. ; ; �y l:jpjti I ; . I of 1 - and 2- family dwellings 4 or more new residential .i :l ❑ over 320 amps - rating ❑ Buildng over 10,000 sq. ft., " ` Wi " '"' ' ° '" '1GO:.d ! O� t! I ! I.: I .� I. I :•,•L ..l .�,., . .,... l ■..,. �.:.,I ; I I. I I: NBT]tttU.t X'ION ; .: , :. �.I , •.. ,. ,� :., •:: ` .= r!, �, .., , : C4 1- and 2- family dwelling ❑ Commercial /industrial El Accessory building (]System over 600 volts nominal units in one structure p Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more ;I l ii'i; ,i '� " ' i �O� "3 ����, �, I'' ' I' i "i':: I'J:f � . I ( Ii I:l : ❑Occupant load over 99 persons ❑Manufactured structures or I .'tai ; :L `.•i?Xd y`illi .i ; !;tl'.0.ft00: •a:: I g r /lighting plan RV park Job no.: Fps. m e5,f Job site address: 111-1 Q eR,,v/)00.3 .P / 'iC Sub h -care facility ❑ Other: I Submit 2 sets of plans with any of the above. City/State/ZIP: G� /l,ngJ ail- 9 '7.a 1 a ,•/ The above are not applicable to temporary construction service. Suite/bldg./apt. no.: pro ect name: �� I!ii i'!' 1 1: 1 : :: :i I• Agp, ipi [EDULEi!''''!" . i '. . ,�, 1)exrnptton I ors. I pee. , Totnl I C on- Street/directions to job Site: New residential single- or multi - family dwelling unit. - Includes attached garage_ O bu 2 ...' f J 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no,: Ea. add'1 500 sq, ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ' d!.d'i ;'IC! ;,i: ":III.,' ;i li -,.i ' Limited energy, non-residential 75.00 2 i. 4`''i i, 1.1i':, ..!1 ;lii[Iik,fl I sl!!I ',ri( L' 0,C1C1l ,T�b *, ''OR' i I t'i�i':!'. f,.I I �� � A: � � I•% :+ Iri! ' ' •.: Each manufactured or modular dwelling, service and /or feeder 90.90 2 . ^ 415 An �.) ems, "/ 5 FAA) S n _ervices or feeders installation, alteration, and /or relocation /i't✓ a- 7'0 e A i 3 .t- r I 4 j UP ley. ,e 200 amps or less $0.30 2 . '!.;! ;!y!II;r; ,m:! "1� '0pP t !i 0�y11Pt R ;i,,' �I :, �I., ;. ,,.iL.,,,: amps to amps .85 2 'ril: �• .. �.,. .i „�,�'i! a !IrII.iIi!II � '' TF;IVt�►NT. l!I:g ;i, : 1 201 400 , 106 401 Name: �, � r - � 11-1 2 �� l t� _ amps to 1, 0 amps 160.60 2 - ik� y _tA F A) d_� 601 amps to 1,000 amps 240.60 2 Address: - T 4 ,C.� ' + ( E_ Over 1,000 amps or volts 454.65 2 ` Reconnect only 66.85 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or Phone: (7-6 ' + D P ( ) relocation 200 amps or less 66.85 l Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 600 amps ' 133.75 2 Owner signature: Date: .. �. ;�: ^, l ::•; � ........ ...... ,,, �:,L•I��,i i .•:. . ; .. - ,.,I..,,.. Il'ran - new, alteration, or extension, per panCl Branch circuits nc Iterati ..:.t ' r: iii il 'ii,l�!,:��i'i;.� ; ;! ;I!:: ;.,,.1 '.... ∎:;IF ( A. with `:' : I::..I,•, 1 Vii, ;:,.i ,I ,,' .'C' �t'L�$. Plia service ecfor or branch feeder circu fee ita each Business name: I branch circuit Q., 6.65 f33t) 2 B. Fee for branch circuits !” Contact name: p~ without service or feeder fee, / t: 4G.85 ii re Address: each.branch circuit ( 2 Each add'I branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not Included) Phony. Pump or irrigation circle 53,40 ' 2 ( ) Fa x. ) Sign or outline lighting 53,40 2 E -mail: Signal circuit(s) or limited. !'a:,..r,r: i:. d∎1 b:I.I',i L...;'........ CONTgAC'1OR L .. . ,''':11,.- :.:... 1 1' ; i..`' i j∎ energ panel, alteration, or Business name: CO ,; , - V v e i l - - V _ef.kl'�, ext en si on. D escribe, Page 2 2 Address: 59 0 6 L,6 f?,z os 1e/1. t P 'Z- pd- Each additional inspection over allowable in any of the above City/State/ZIP: �' ,/ ,ta Per inspection 62.50 Ci �' /'tr 4 --4 4 - �' 6A... q -2 investigation per hour (1 hr min) 62.50 Phone: ( &5 ) 6-OZ6' Fax: (5 ) ag £ I Li/ L _ Industrial plant per hour 73.75 � iil l' i'i! h '.'.'EI;LC ;TRXCAL:.' PE 'IXT'; FEES*' , . , CCB Lic.. �. •7t ( I Electrical Lie.: 34-/6 Suprv. Lie.: r? Z 6r Subtotal 66,1667 Suprv. Electrician signature, required: t1 ) ,L, 11 - Plan review (25% of permit fee) • Print name: \ i pate _ State surcharge (8% of permit fee) Z S .,1-.k J4V i 27 - v5' � I' — TOTAL PERNIXT FEE gq, 97 Authorized signature: • Thiel permit application expires if n permit it not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board " Number of insnenrinno n,.r,,.,,,,i, ..n....,.,, - CITY OF TIGARD „ . BUILDING DIVISION PERMIT #: ELC200E00850 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/31/2005 Phone: (503) 639 -4171 :a j .. Inspection Requests (24 Hrs.): (503) 639 -4175 ...,...,W ! INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 68 DaQ. /(Av -N y A oc ( , SITE ADDRESS: 09480 SW BRENTWOOD PL CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.9 LOT #: 499 TYPE OF USE: PROJECT NAME: CLEMENT DESCRIPTION: (3) branch circuits. Job No. Forrest. OWNER: CLEMENCE, FORREST & SHIRLEY PHONE #: 503- 620.0848 CONTRACTOR: WINNER ELECTRIC INC PHONE #: 503 - 63 &5028 Inspection Request Scheduled For: Date: 11/3/2005 Pour Time: Code # Inspection Description Confirm # Contact # Messag 199 Electrical final 020180.01 583 -638 -5028 N Corrections /Comments /Instructions: gt,t( (92/ 61,14,..-4-X V/A-6- kikk, L' - , i F L S 44 14- .-/ kiekki.i 4/2, o c ab 4--Aici. 0 A( ) / ,= 2 2 aM : I , cL.C7 7 7-4- ›iels S. , -(J 2 0O o o c5 7 11- . 0 .. 5 -------- i PASS n P RTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ,/ C . F07 '.4lON ff ADDITI• AL F S ASSESSED 7 i d / 3 , Inspector: A L V Date J Phone #: (503) 718