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Permit 4, CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00375 11it‘ DEVELOPMENT SERVICES DATE ISSUED: 7/5/00 '`'-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115AD -04200 SITE ADDRESS: 10823 SW DOVER CT SUBDIVISION: DOVER LANDING ZONING: R -2 BLOCK: LOT : 025 JURISDICTION: TIG Project Description: One branch circuit for 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: RON /LINDA FINTZY 10823 SW DOVER COURT TIGARD, OR 97224 Phone: Phone: Reg #: FEES Required Inspections Type By Date Amount Receipt Elect'l Final PRMT DST 7/5/00 $37.50 0003462 5PCT DST 7/5/00 $4.00 0003462 Total $41.50 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE"/ - .. ISSUED BY: (AAA.) ?f- 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 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Plan Check # '1�125'SW HALL BLVD. Electrical Permit Application Recd By TIGARD OR 97223 Date Rec °'/— d ,- �O ,( fr DatetoPE Phone (503) 639 -4171, x304 / 1 , Date to DST � / Inspection (503) 639 -4175 Print of Type Permit# Gd-- — °° 37,5 Fax. (503) 598 -1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development , Number of Inspections per permit allowed Name (or name of business) PeOiI 6 [n'1 Service included: Items Cost Sum Address / 69 Er aZ 3 sw L tC .-T 4a. Residential - per unit City/State /Zip 7 o e 9 7.Z. ?4 1000 sq ft or less $ 117 75 4 t Each additional 500 sq ft or portion thereof $ 26.75 1 Commercial ❑ Residential4 Limited Energy $ 60 00 Each Manufd Home or Modular 2a. Contractor installai'`lon only: Dwelling Service or Feeder $ 72 75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data bas ). /� Installation, alteration, or relocation Electrical Contractor C ' tr _ tf- L C'G- tv. 200 amps or less $ 64 25 2 Address — 2,26, OS -St:{,..) ■ • • / 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 • City f !- %:r r0") 1 State G` Zip c i 700 7 601 amps to 1000 amps $ 192 50 2 Phone No (�0 ^ /� T 79 Over 1000 amps or volts $ 363 75 2 Job No. / 3000 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 3 /-- 1/7G Exp.Date 10 /0i /t O 4c. Temporary Services or Feeders OR State CCB Reg. No. SS /, / ir Exp.Date 5 G /o / Installation, alteration, or relocation COT Business Tax or Metro NI ). 25 [ Exp Date 200 amps or less $ 53 50 2 ..2:.‘ 201 amps to 400 amps $ 80 25 2 Signature of Supr. Elec'n A. A / 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, • License No , . Exp.Date % 0/ ' O/ / see "b" above. 0 / Phone No. ..5.-... L 3 7 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installzitions: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5 35 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit ( $ 37.50 ,3 -7 s Each additional branch circuit $ 5.35 The installation is being mad.8 on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42 75 Signal circuit(s) or a limited energy 3. Plan Review section (if required):* panel, alteration or extension $ 60 00 Minor Labels bels (10) $ 100 00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50 00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59 00 Classified area or stru :cure containing special occupancy as described in NEC Chapter 5 5. Fees: 5a. Enter total of above fees $ * Submit 2 sets of plans with : pplication where any of the above apply. 8% Surcharge ( 08 X total fees) $ ` 3, l Z Not required for temporary c - )nstruction services. Subtotal $ • 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec 3) $ PERMITS BECOME VOID IF W(?RK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS El Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ %Qr 3V i Adsts \tones \electric doc 11 /UY /6UU5 14:57 FAX 5U3596190U Lllx ur v vi CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE DRYER ELECTRIC INC 9409 NE COLFAX ST PORTLAND, OR 97220 Electrical Signature Form Permit #: MST2005 -00356 Date Issued: 11/9/2005 Parcel: 25115AD -0420 0 Site Address: 10823 SW DOVER CT Subdivision: DOVER LANDING Block: Lot: 025 Jurisdiction: TIG Zoning: R -2 Remarks: Addition. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: LINDA & ARR FINTZY DRYER ELECTRIC INC 10823 SW DOVER CT 9409 NE COLFAX ST TIGARD, OR 97224 PORTLAND, OR 97220 Phone #: 503 -684 -6129 Phone #: 503-771-5667 Reg #: ELE 26 -11420 LIC 153466 SUP 2876S AN INK SIGNATURE IS REQUIRED ON THIS FORM X f Signature of Supervising Electrician If you have any questions, please call 503.718.2433. RECEIVED 11- 09-2005 16:03 FROM- 5035981960 TO- PAGE 001 CITY OF TIGARD BUILDING I' DIVISION MST 24 - Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP 1 (334 '7g Date Requested '! V--7007 AM PM BLD Location / �� !l fly Suite MEC Ra ig - zad Contact Person ,(.ee- Ph (r� 2 5 PLM Contractor ` ,71,4? 1"0/1) / Ph S B .. Tenant/Owner ELC f�ef� d Retaining Wall ELR Footing Access: Foundation ? ej p$ FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear = ___ / ®- Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL CI-IAN� AL Post & Beam Rough In Gas Line Smoke Dampers Crezil■ PART FAIL TRI Service Rough In UG /Slab Low Voltage Fire Alarm * e • PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date nspector Ext Other Final PASS PART FAIL D E IT i Ef`i 4 VIE this inspection record from the job see.