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Permit A., CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00421 DEVELOPMENT SERVICES DATE ISSUED: 7/13/2004 ° - ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 115AD -03700 SITE ADDRESS: 10878 SW DOVER CT SUBDIVISION: DOVER LANDING ZONING. R - BLOCK: LOT : 018 JURISDICTION: TIG Project Description: Add /alter (5) branch circuits for kitchen remodel. 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: 4 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: WHITE, DAVID RAND RENEE J WEBER ELECTRIC INC 10878 SW DOVER CT PO BOX 231154 TIGARD, OR 97224 TIGARD, OR 97281 Phone: 503 - 624 -2720 Phone: 503 - 620 -1906 Reg #: LIC 44087 SUP 4028S FEES ELE 34 -442c Description Date Amount Required Inspections [TAX] 8% State Surcharge 7/13/2004 $5.88 [ELPRMT] ELC Permit 7/13/2004 $73.45 Rough -in Elect'I Final Total $79.33 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Speaalty 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 suspen e hi ore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those r s are set forth in • ° ' 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain copies of these rules or direct questions to OUNC at (503) 46 -6699 or 1 -800- 332 -23 I sued By: ■ .1 liall 4 ;V 1 Permit Signature: 0 S 0 . _ , /.,, 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: 'yd gg s Call 639 - 4175 by 7:00pm for an inspection the next business day • Electrical Permit Application FOR OFFICE'USE ON , Received J ' ' City of Tigard Date/By /��7 Permit � tNo (,� ,6 • –�D9 a- 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review / / Br Vri Phone: 503 639.4171 Fax: 503 598.1960 Ni Vil � 41\ Date/B Other Permit Inspectton Line 503 639 4175 .`. ; . Date Ready/By Jut ^ El See Page 2 for Internet: www ci.tigard.or.us Notified/Method f Supplemental intormation `:a,. -��` 1i` '.;tg �^zt n .;`:3�'r� ,� :� : �. t:1; °` ' :r�," �i .., ;A;�:;:` ' i ;'� i. •fr:V OF R?ORK. ��� . •K— L,N - .. . • ❑ New construction ddition/alteration/replacement Please check all that apply EService over 225 amps, comm'I Hazardous location ❑ Demolition 111 Other gi _ -j ., -, A7, .4,7,-,,,-...,,-.--,- „ , -,:.z,, , ., ,_ „ to - �" []Service over 320 amps - rating ❑ Buildng over 10,000 sq ft , ;, �' - : ,, fw 5'CATEGO OF PONSTR C4- ,: <, � 7,; , ; ""; of 1- and 2- family dwellings 4 or more new residential a� ±« --- 4 -.�.'w ,amx�=9� ras,,.: � _sue ��u�.€ ?� �¢'��;. ;�. _ u;,�- .Y,twe�z°�.,' "� =� '� 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 ['Feeders, 400 amps or more {R �, „� £ y t ",F Other: _ . ['Occupant load over 99 persons EManufactured structures or ` : ( "':i. s t„, ''4'. "SiTE -, ; FOI IY I TIQ `� .x I QGATION. R' : F '::, ; ,,, RV park ' t JOB: N v.',,, v> �" ❑ Egress /lighting plan �;e. u=, a.a, �,„�...�a��v' o� �.�;�. za•.��:....� .:.a�;. ;..»�E,:ae� � =:st�a ��- =.��r.. r�.., >_ .. x�..��:: »i�c �t��.�s *• Job no.: Job site address: /Q�' 7g <1,i l.)r ❑Health -care facility E] Other: , Subrrut 2 sets of plans with any of the above. City/State /ZIP: / [ �,,,,, z ,...op.._ 9 2 22 1 The above are not applicable to temporary construction service J '°" _ "`, : :14iJJft .,g//i"EE"E *C,HEDULE,. m Suite/bldg. /apt. no.: Project name: - :S ' ' ** Description Qty Fee. Total 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 Limited energy, residential 75.00 2 Tax map /parcel no.: _ z -r Limited energy, non- residential 75.00 2 R l ` 4—' " , _ ;. �AErSCRIPTI01\ Each manufactured or modular Q/ � dwelling, service and /or feeder 90 90 2 /96t,) /' V(SECJL C'! \r Services or feeders installation, alteration, and /or relocation /‹ -1-C—ktAl ( 0 200 amps or less 80 30 2 i.,, -, ° ri °� '" •: =r� 201 amps to 400 amps 106 85 i® I'R P U - f' ia �'-. , ETE r ?4 -z =r f ' ����' ;� - • , ,,i• ;� :�.r.�r. �.:_..� �_,� ��� n .. _ , . ,�., .: .. k,:.: .� 16060 2 401 amps to 60 0 amps Name: A� Ib st R ite kJ/417-e- 601 amps to 1,000 amps 240 60 2 Address: L 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: )/� �[ Fax: ( ) relocation 3 Y��'T — 7 �� 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 R ' '' ' 7 –d i' A V i I IG Tii 1 R - ;; y i _ w~;�' : ' 'i A Fee for branch circuits with ,, ' - � - ; ` ' *' 7- , „32: ;„ ,.,u... .`�;,' t ; , •: _ ° ;. ":. ®. CO2iiii.PACT )?EI2501V, , , �' "" service or feeder fee, each Business name: branch circuit 6 65 2 B Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46 85 L�� g5 2 Address: ' Each add'1 branch circuit 4 6 65 24, , (p C7 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53 40 2 Sign or outline lighting 53 40 2 E - mail: Signal circuit(s) or limited - .< ia" ';,`m :n w Vii:,: yGOIV• ia '.,1 U ; : , ", ;3..,1 energy panel, alteration, or f� �. /C(.e extension. Describe Page 2 2 Business name: � C rc L .L.-� � Address: �Ej 2 Per additional inspection over allowable in any of the above Per inspection 62 50 City /State /ZIP: ` e j / c o 2 � 7 1- // 5� / Investigation per hour (1 hr nun) 62 50 Phone: ( 5 o 3 G zco 1 C ,9 (p Fax: (S© 6 20 6' cr Industrial plant per hour 73 75 Y N:'•,AreELE'CTRI CALiYPEI2MIT; F`E F 17; - '; = "- ' `,- -' ° CCB Lie.` / n /� lo `p 7 Electrical Lie.: 3i - q 11- Z(''�Suprv. Lie.: 4 S Subtotal ' 3 q S p Ce to t ( lffrl signature, required: � i Su rv. lec 1 st ature, re uired: `7-7/7 �� Plan revi (25% of permit fee) Print name: na � - Date: 7 -4 State surcharge (8% of permit fee) �, g 2x TOTAL PERMIT FEE 79 , 33 Authorized signature: 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 Tn- County Building Industry Service Board ** Number of inspections per pemut allowed I \Building\Pernuts\ELC- PermttApp doc 12203 440- 4615T(IO/02 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: :.;, 01*. , IAL W Q RK;iQNIG =Y Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: RCIAL`WORK'NGY: .a '- .x,. ?-; Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations \Building \Permits\ELC- PernutApp doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business -Liner (503) 639 -4171 MST / BUP Received �y Date Re nested / /D AM PM BUP Location /D 7 �S 4�-�J - Suite MEC Contact Person moc_ ) Ph ( ) 1 9 7 3 R PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC WOO ( - 7 1 — O e �a 1 Footing r)1/ 0\140\C f ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall n �(( \ A 0 t 0 Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service ?I/2/2Y Sanitary Sewer Rain Drains Catch Basin / Manhole • Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line , C g /ji6q Smoke Dampers j Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab • Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE " ri Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA G4^ 4Q Est Approach /Sidewalk Date Inspector Other: Final DO NOT REMOVE this inspection recor from the jo site. PASS PART FAIL •