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Permit
T CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00875 �� DEVELOPMENT SERVICES DATE ISSUED: 11/8/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 102AA - 02100 SITE ADDRESS: 09065 SW CENTER ST ZONING: C - SUBDIVISION: KINGSTON LOT : 015 JURISDICTION: TIG Project Description: Reconnect only 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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: JAMES ANDREWS OWNER 9065 SW CENTER ST TIGARD, OR 97223 Phone: 503- 620 -2086 Phone: FEES Reg #: Description Date Amount [ELPRMT] ELC Permit 11/8/2005 $66.85 [TAX] 8% State Surcharge 11/8/2005 $5.35 REQUIRED ITEMS AND REPORTS Total $72.20 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended f• • - = 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules a - -t forth in OAR 6 .2 -00 II 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 -24• -6699 o 1- 800 -332 •4. Issue By: / • ` Permittee OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Date / Received l d �_'!!�!%1 Permit No.: Aio g7:' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 4444 Date/B : Other Permit: Inspection Line: 503.639.4175 �. I.J.. Date Ready/By: liffal ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information ,," O • :y. qua : � >.� :; > ?y; = ? �"$;:`.. .. :�� .� , .�- .- ._� -,_.. .��, _�. .43:s,,, -� .s�� °..:�... .,,. r•,.3- ;'.tp;ta ,. ,.= "'�- �::��.,._�.r�>"'rr.`� 5 r`.. - .,:�n� '' Q ��• a�C� . >-,..� ❑ New construction [ ilettiatoicialteriaeftgeplacement � Please check all that apply: ❑ Demolition % Other: P6WE 2. Tt. X 6�R (p MO 4i 4 ['Service over 225 amps, comm'I ['Hazardous location _.,. w .> ;;,, , :,. :. - _ — rating ❑B dngo sq. ft., \ \� > J Service over 320 amps raf uil over 10,000 F a , T ! GO)!i'SE? UE NCO RUC " q -, 4,,, „,,,, of 1- and 2- family dwellings 4 or more new residential ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi- family ❑Master builder ❑Other: ❑Building over three stories OFeeders, 400 amps or more f ami l , �P , ['Occupant load over 99 persons ['Manufactured structures or � V <r >: ':SLA IN I. FO1 TION 4D:`�` C?N ,'ce ; ; -• ., RV park - , ac������::��z -� �•: :�wa��;�x,w���- »_.. .. ..,;.- ;�:;.��: ������•.•��=- �:,.i.�?:���„ �_�. ;° ❑Egress /lighting plan P Job no.: Job site address: 'A g065 SW Center St ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City /State /ZIP: Ti gard, OR 97223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: ,: < gia -':.. !: F: ' Description 1 Qty. Fee. 1 Total I ;. Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: 2 .51 O2 AA �9 Zl 00 Limited energy, non - residential 75.00 2 residential 75.00 2 � Limited energy, n M ,:we. „i!,--§,,,, r ., sa �"�'., ? 'C ^ °,�•, : . ,, - eS:C' s;%�- ° �`- ��,.° `ti > , ev;•• i 1?j S O` !O OE: , '� r,. Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 , o-,.,,•;.,_ , mr -61,.. 201 amps to 40 x r ���� ;y� ,` p 0 amps 106.85 2 a ., - .. , °i '\ „ <' ; .;.. . . y ' ''' i;' 'W 401 amps to 600 amps 160.60 2 Name: James D' Andrews 601 amps to 1,000 amps 240.60 2 Address: PO Box 23784 G ALL. F i ¢ST Over 1,000 amps or volts 454.65 C 2 Reconnect only / 66.85 t 4 , p 2 City/State /ZIP: Ti gard , ; OR 97281 Temporary services or feeders installation, alteration, and /or (503) 620 -2086 1503 )684 -3636 relocation Phone: Fax: 200 amps or less 66.85 1 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: Branch circuits — new, alteration, or extension, per panel ”; `''_ a A. Fee for branch circuits with i A l ' "IC • 7 v ! r,-W ••: , ='CC ' ` I - I= C „a i ,, : ER I , : service or feeder fee, each 6.65 2 Business name: 5 As p1?Opeart bld Kelp_ branch circuit Contact name: B. Fee for branch circuits without service or feeder fee, 46.85 2 Address: each branch circuit Each add'I 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- f ' "�, a .r . "" 4° �.� r= �` E ;�.'.: panel, alteration .....� . _ ,. � -.:, � ` :_. =RACT(3�t:;:: a, ; _. � �:�::,�U::. =,��:���i- energy P D , or extension. Describe: Page 2 2 Business name: 14 I A Address: / Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 x V 11- Wiz.:• CCB Lic.: Electrical Lic.: Suprv. Lie.: Subtotal I/ i _ Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: J AIM D. A"to12..l W 5 Date: i1, t. 0 5 State surcharge (8% of permit fee) . 3 7 TOTAL PERMIT FEE 7g ,2 Authorized signature [mod/ 0. This permit application expires if a permit is 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 inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB . CITY ������N�������� ' ��mm m ��m wn�m�mom�� / ' BUILDING DIVISION PERN1|T#: ELC2006~00878 18125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 11/8/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 .�3N INSPECTION WORKSHEET FOR DATE: 11/14/2006 TIME: 7:12AM PAGE: 68 — SITE ADDRESS: O90G5SW CENTER ST CLASS OF WORK: SUBDIVISION: KINGSTON LOT #: 015 TYPE OF USE: PROJECT NAME: ANDREWS . DESCRIPTION: Reconnect only OWNER: ANDREWS, JAMES \/ /~` ~� /} }./l\ #: PHONE G503-620503-620-2086 G���0G CONTRACTOR: OWNER k�/� 8�h - ~ PH #: vn� � ' ` Inspection Request Scheduled For: Date: 11/14/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 E]extricalneipum 021128-01 603-620'2086 Y ' • Corrections/Comments/Instructions: L. t . . ` ASS ' PARTIAL APPROVAL 0CANCEL n NO ACCESS PAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: �^ �O�1e�/�'��^�,/'� Phona#� /5O3)718' ` . � ° ' ., `' ' CITY OF TIGARD . BUILDING DIVISION _PERMIT #: ELC2005~00875 .. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2005 Phone: (503) 639 -4171 �oau Inspection Requests (24 Hrs.): (503) 639 -4175 . ' 1 __ INSPECTION WORKSHEET FOR DATE: 11/0/2005 TIME: 7:09AM PAGE: EA SITE ADDRESS: 08065 SW CENTER ST CLASS OF WORK: SUBDIVISION: KINGSTON LOT #: 015 TYPE OF USE: PROJECT NAME: ANDREWS DESCRIPTION: Reconnect only OWNER: ANDREWS, JAMES PHONE #: 503 - 620 -2086 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/0/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical finial 020703 -01 503. 620.2086 Y C # _L_- Pei bt2 Corrections /Comments / Instructions: . 6 cab f E - 1 7 = S L-7 4 f- e ; •1- A l i 4--C_ 7 vL in0s Pc i -- po _. f : ©o .— --- g>65 1 7k 6 1 ----. -- N-(- 31, Th 1 - E s 01.1 - _ p\/,6 1/4-7 , pi enzfre:____ ��n� (ice l� t/� b d'�J tit -no G-, 2d L . ) t. b -aW Iii PARTIAL APPROVAL CANCEL n NO ACCESS 4 FAIL gJ C - FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspecto : _ — Date: 9.a Phone #: (503) 718 -