Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00349
�. DEVELOPMENT SERVICES DATE ISSUED: 6/22/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CC -02300
SITE ADDRESS: 08045 SW CHURCHILL CT ZONING: R -12
SUBDIVISION: BOND PARK NO. 3 LOT : 051 JURISDICTION: TIG
Project Description: (1) branch circuit for heat pump. Job # J29100.
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:
ALEX DAVIS WEST SIDE ELECTRIC CO INC
8045 SW CHURCHILL CT 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: 503 - 639 -7383 Contact #: FAX 503 - 736 -0677
PRI 503 -231 -1548
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 6/22/2006 $46.85 LIC 13306
[TAX] 8% State Surcharge 6/22/2006 $3.75 SUP 4654S
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: :1_4_ Permittee Signature:
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.
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]Electrical Permit A :) ; -..i WE
FOR OFFICE USE ONLY
City of -Tigard JUN 2 2 7n ° Received _ _
' 25 SW Hall Blvd Tigard, OR 97223
Date/B v I �,„,„,-, L� ' Let/L.7 7
1,' /y� °I
P;.one: 503.639.4171 Fax: 503.598. e/ OF TIGARD' pale Review
ins 75
inspection Line: 503.639.41 ���� Oa1dBy: Ottter Permit:
Internet: wi tigard.9,41 BUILDING DIVISION _-&- 01.1' Date Ready/By: Juris I E1 See Page 2 for
Ncli fted/Method: Supplemental Informati
TYPE OF WORK PLAN REVIEW
❑
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New construction Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service , commI
Service over 225 amps, p ❑Hazardous location
CATEGORY OF CONSTRUCTIDN ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. fl., 1
of 1- and 2-family dwellings 4 or more new residential
I- and 2- family 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 p Master builder El Other:
JOB SITE INFORMATION AND LOCATION •
El Occupant load over 99 persons ❑Manufactured structures or
r ❑ Egress /lighting plan RV park
Job no.: -- 2, I i9( r Job site address: -J oL/ S c-c-{,., L c'1c.1 �G1 t r (I ( 01-care facility ❑Other:
►
Submit 2 sets of plans with any of the above.
City /State/ZIP:
{ g 1 ZZ `�1 J
The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: i Project name: 9 00 / .5 L { f FEE* SCHEDULE
/� - f � r/ f� l llD.10. I Qty. I Fee. I Total I
Cross street/directions to job site: 1 a New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'1500 sq. •tl, or portion 33.40 I
Tax map parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK Limited energy, non - residential 75.00 2
Each manufactured or modular '
1.... 1 , vs-e._ � dwelling, service and/or feeder 90.90 2
1 Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 : 2
PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: j �f } 401 amps to 600 amps 160.60 2
�C r / R ✓ t $ 601 amps to 1,000 amps 240.60 2
Address: 5 t".1.4 , Over 1,000 amps or volts 454.65 2
City ? Sta[e /Z1P: Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and /or
Phone: (iry5) 631_ 13 p 3 I Fax: ( ) relocation
or . Owner installation: This installation is being made on properly that I own which is not 20 amps to 40 s b0.S0 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 100.7 2
401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with ' -
Business name: service or feeder fee, each
branch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee, I (� /
Address: each branch circuit 46.85 ..1172 f 2
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Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: { ) J Fax: : ( ) Pump or irrigation circle 53.40 2
E-mail: I Sign or outline lighting 53.40 2
Signal circuits) or limited -
CONTRACTOR energy panel, alteration, or
Business name: West Side Electric Co., Inc. extension. Describe: Page 2 2
Address: 1834 SE 8Tn AVE. Each additional inspection over allowable in any of the above
City /StateiZlP: PORTLAN10, OR 97214 Per inspection 62.50
Investigation per hour (I br mi n) 62.50
Phone: (503) 231 - 1548 I Fax: (503) 736 - 0677 Industrial plant per hour i3.79
CCB Lie.: 13306 1 ElectricaL Li
Lic.: 26 -135C . Suprv. c.:,654S ELECTRICAL PERMIT FEES*
Subtotal
Suprv. Electrician signature, require± /' ✓ r 6� Plan review (25 °/ of permit fee)
Print name: R v
/ � � Date: f !n State surcharge (8 of permit fee) '1 C Authrizd siature: l �� f [1 °/n TOTAL PERMIT FEE v
This permit application expires if a permit is not obtained within 160
Print name: I Date: days after it has been accepted as complete
* Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
Building ■re:muylELC- PermitApp.doc I2Je3 440- 4615T(IO/02 /COM/WEB
Zed L966 NVdWOO 012110D-3 3 aIS 1S3M d9£40 90 ZZ unr
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00349
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6122/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 J.
INSPECTION WORKSHEET FOR DATE: 60312006 TIME: 7:16AM PAGE: 30 -
SITE ADDRESS: 08045 SW CHURCHILL CF CLASS OF WORK:
SUBDIVISION: BOND PARK NO. 3 LOT #: 051 TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: (1) branch circuit for heat pump. Job # J29100.
OWNER: DAVIS, ALEX PHONE #: 503-639-7383
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503-231-1548
Inspection Request Scheduled For: Date: 6f23/2006 Pour Time:
Code # Inspection Description. Confirm # . Contact # Message
199 Electrical final 032266-01 503-231-1548
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Corrections/Comments/Instructions:
U (7 / 4-1,-At 9-PIP 1/4) .ef-itl 1 n4
e 4 76 fz'
Abv z_5" - j (
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PASS PARTIAL APPROVAL I I CANCEL fl NO ACCESS
L FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: e %L
Date: ‘'ZS ' O Phone #: (503) 718- 2-6111/