Permit ` �4 CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00648
DEVELOPMENT SERVICES DATE ISSUED: 9/6/2005
Ali
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CD -14400
SITE ADDRESS: 07937 SW CAROL ANN CT ZONING: R -12
SUBDIVISION: REBECCA MEADOWS LOT : 001 JURISDICTION: TIG
Project Description: Installation of A/C unit.
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:
JOSH FEGLES HILLSBORO ELECTRIC
7937 SW CAROL ANN CT 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: 503 - 522 -8571 Phone: 503 - 439 -9666
FEES Reg #: ELE 34 -4399C
. Description Date Amount LIP 134481
SUP 4941S
[ELPRMT] ELC Permit 9/6/2005 $46.85
[TAX] 8% State Surcharge 9/6/2005 $3.75 REQUIRED ITEMS AND REPORTS
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 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: fL,G27- Permittee Signature: sue, cs 1 P
OWNER INSTALLATION ONLY 1 �}
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.
09- 02 -'05 16:03 FROM- Portland Bolt 503 -227 -4634 T -535 P002/002 F -469
Ac; A e trical Permit Application FOR OFFICE 'USE ONLY
City of Tigard ,/ R e c eived t /
. �- D ata /t3v; ( V P ermit No.: ed • t r
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone; 503.639 4171 Fax: 503.598.1960 ! ?. Other Permit;
1nspecrion Line: 503.639,4175 b 0 2 2005 a ' Date Ready /By: min El See Page 2 riff
Internet: www.ci,tigard.or.us Notified /Method: ( SupplementalInfarmation
. Ci" -Yet F FLAN REVIEW
❑ - [�tAfddi`ti "N iDl''teW on/reaplac n1cm Please check all that apply:
Ncw construction
❑ Demolition ❑ Other: ['Service over 225 amps, comm'I ❑Hazardous location
CATGCORI' OF CONSTRUCTION • ❑Service over 320 amps - rating ❑Bulldog over 10,000 sq. fl.,
•
of I - and 2- fatnify dwellings 4 or more new residential
I and 2 family dwelling ❑ Commercial /industrial ❑ AcceSSOry building ❑System over 600 volts nominal } - units in one structure
Q mufti-family ❑Muster builder III Other: ['Building over three stories UFeeders, 400 amps or more
JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑ lured structures or
❑Egress /fighting plan park
Oileotth -care facility ❑Other:
Job no.: M " fob site address: ,�i�wy l l l ` Submit 2 sets of plans with any of the above.
City/State/li': i A 4 44 C '' 1 .4._. The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name:, Le e )FC)r; SCHEDULE ., ` . .: .
ZYeyrription Qty_ I Par. ( TOtet
,
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
' 1,000 sq. ft. or less I 145.15 4 •
Subdivision: . Lot no.: Ea. add'1 500 sq, ft. or portion 33.40 I
. Limited energy, residential 75.00 2
Tax map /parcel no.:
:..'..• DCSCI t1'TION OF WORK .. ;.:•• ; :;;,:,:; 7 :..; • `',' ::,.
75.00 2
Limited enerbry, non-residential S 2
Each manufactured or modular
.. ` 1 dwelling, service and/or feeder 90.90 2
1 " U , . Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
PROPERTY OWNER „ ` a.3 - ; , .. , . 201 amps to 400 amps 106.85 2
�—` 401 amps to 600 amps 160,60 2
Name: lc 6 01 amps to 1,000 amps 240.60 2
Address: aw(ei",C dove, 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 : 5���1 1 Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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: __ Branch circuits new, alteration, Or extension, per panel
API'LICA'1VT'." ` : ::•: .::::.:.•.. ;,.; : ;: ^ > ; , .(:J CONTACC N T PERSO'. ;'.::.':iiis ; °',., A. Fee for branch circuits with
service or feeder fee, each 6,65
Business name: branch circuit
Contact name: B. Fee for branch circuits
• without service or feeder fee 46.85 2
each branch circuit
Address: Each add'l branch 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 . > • :. ;•:::.• ' T. • :. energy panel, alteration, or
extension. Describe: Page 2 2
Business name :Hillsboro Electric L.L_C.
Address: 21185 NW Evergreen PKWY Ste #110
Each additional inspection over allowable in any of the above
Per inspection 62.50 •
City/State/ZIP: Hillsboro , OR . 97124 Investigation per hour (I hr min) 62,50
Phone; (503) 439-9666 Fad: ( 503 )6 01 - 3 6 $ 0 _ Industrial plant per hour 73.75
• ELECTRICAL, PERMIT FEES*
CCB Lic.:1 3 4 4 81 Electrical Lic.:3 4-499 Suprv, Lie.: 4 941 S Subtotal Li
Sttprv, Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of ()emit fee) ''
Print name: Jo Vitacco Date: G
TOTAL PERMIT FEE -- 54r
Authorized signatur- v
Print name: (,U C This permit application expires if permit it net pertained within ISO
, Date: F ( l 1 - days after it lute been accepted as tungllete
• Fee methodolog
y set by TO-Count Building Industry Service Board
" Number of inspections per permit allowed.
i:l Building \rrnnas \ELC -Permit. 0e I] /(B 440 44;1:M11 p? /COM/WEH
CITY OF TIGARD
BUILDING DIVISION } PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ELC201� OOCiB
Phone: (503) 639 -4171 �'��4po���gl��i��� 9/612005
Inspection Requests (24 Hrs.): (503) 639 -4175 =�
i INSPECTION WORKSHEET FOR DATE:
9/26/2005 TIME: 7 :12AM PAGE:
I
SITE ADDRESS: 07937 SW CAROL ANN CT CLASS OF WORK:
SUBDIVISION: REBECCA MEADOWS LOT #: 001 TYPE OF USE:
PROJECT NAME: FEGLES
DESCRIPTION: Installation of NC unit.
OWNER: PHONE #:
FEGLES, JOSH 503 - 522 -8571
CONTRACTOR: HILLSBORO ELECTRIC PHONE # : 503 -4 39 -9666
Inspection Request Scheduled For: Date: W2 &2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 016507-01 503. 538.2953 Y
Atm
Corrections/Comments/Instructions:
l►1
PASS PARTIAL APPROVAL I I CANCEL n NO ACCESS
n FAIL / 'ALL FOR INSPECTION [I] ADDITIONAL FEES ASSESSED
Inspect r 72O Date: '' Phone #: (503) 718 -
all I