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Permit
ELECTRICAL PERMIT CITY OF TIGARD PERMIT #: ELC2005 -00679 dk. DEVELOPMENT SERVICES DATE ISSUED: 9/14/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S126DC - 04400 SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C -P SUBDIVISION: LEHMANN ACRE TRACT LOT : 007 JURISDICTION: TIG Project Description: (5) branch circuits: 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: MARTIN, ROBERT CLARE WILLAMETTE ELECTRIC INC THELMA M PO BOX 230547 BY JO RENE M MOODHE TIGARD, OR 97281 SHERWOOD, OR 97140 Phone: Phone: 503 - 624 - 3631 FEES Reg #: LIC 75059 Description Date Amount SUP 1965S ELE 34 -283C [TAX] 8% State Surcharge 9/14/2005 $5.88 [ELPRMT] ELC Permit 9/14/2005 $73.45 REQUIRED ITEMS AND REPORTS Total $79.33 • 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: Permittee Signature: j wry 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. SE) 13 2005 3: 43PM HP LASERJET 3200 . p . 2 • -'' ' ' - EINIE . :t - ' '.. ,0: . • - - • • -• • _ . .• .. ,. Electrical Permit A t she...0A 1p FOR OFFICE USE ONLY 7 7 City of Tigard Received ") ....., / 7 ) ..) ---;_ p ,..41 p erm . N 6LCI i' ( 77 13125 Hall Blvd., Tigard, OR 97223 Da te/E3y: "1 SEP 13 2% Plan Revieim Phone: 503.639.4171 Fax: 503.598.1960 A ,( is i / . 1 ' Date/13y: Other Permit: • Inspection Line: 503.6394I 75 ,..4„Y.--- ' ' Date Ready/By: hilis. &I See Page z for Internet: www.ci.tigard.or.us CITY OF TI:: _ . Notified/Method: -.1 ) ( Supplemental J nformation 1 87 r %,-:: ,:. 2 -,- -,R. .--•...-A7 reml,..:tr. - 1 Plipppintilt:f E ,:.,04 `11<pirl,...§..li .: .\ji4)>E 11 E] New construction [Addition/alteration/replacement Please check all that apply: ['Demolition fl Other: IDService over 225 amps, cDmtn'l 01-lazardous location . .., _ ['Service over 320 amps - rating OBuildng over 10,000 sq. ft., .fy,.„..i.rtr,eyfY'jliirkllnt',Mstjr,rnl,FNnPn't,tip5:,grVgir:t:NA'ili"iNfAZ4F4Kr;,Idt of 1- and 2-family dwellings 4 or more new residential 4. 7P .... - 4 - .ii i..ii it.,o. , i , .. - e,..io.. , 1. aiioe 0 1 - and 2-family dwelling Commercial/industrial 0 Accessory building El .E Sys tem over 600 volts nominal units in one structure 1=113 DO over three stories OFeeders, 400 amps or more El MUltiTfamily .._ Master builder r,.. fl Other: Li , , ,,.., Occupant load °VET 99 persons 0 Manufactured structures or )4 illyt..700.01itg4tERli:e4r6FC-iWi.:t.,,,,-ir.V.VVNiv..4-0...1-41.;„41/..VMViil'ITY sa Ki"`al l ' I ': 0-1.1 ''c 4 iri'Vc" 1 "A r q.- RV park ifi i'le:Wii4iz. ''-.!= 0 Egressnight Plan Job no.: 4 ‘ .6 Z , Job site address: 9 V30 $48.9 c,2041 s). EjHealth-care facility pOther: Submit 2 sets of plans with any of the above. City/State/ZIP: 7 - ,,- , 2,,, / 0, 9 7 ZZ 1 The above are not applicable to temporary construction service. Suite/bldg./apt no.: 2 0c I Project name: Dr C / a f k TOgigiaagARIORROOM4AIilAr.:.:'' 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: 1 Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no . _ ,,,.., ,_ ,,,,,,,.... ,_, , . .. ,, ,,_ ,_,, ,,,,,,,,,„, , Limited energy, non-re sidenrial 75.00 2 ' " j" 11" f t), kiit ' t Aaktirgat Each inanufactured or modular V.211,1-..i....LI.J......:...cris.L............ •.....F. k,. '', 41 - "1.,LES.P.,121141,1`11 , , ' , dwelling, service and/or feeder 90.90 2 4,10,f,, c)rf;ce / e re4 * 4,441 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 7 .'. , :'■ , t ±Z,g(47,1::.!;ti*,•,,viry,j,par,ityT,ZiFflb.L'''Wralltrrilliffi'-tto ' l'Itill'■ ''It'''..1iN2, 201 amps to 400 amps 106.85 2 5 4:70 11 7.11,t pritE@ , ...:1 - !'''"4! . .M..it!'7`i'. 1 1 - A v .iirr.,urklair,: , ..0. MAY Ir..-",21t.' ..,' ,'''.- L-' ' ',. la '' 'AT.,'I. - 40 r amps ro 600 arnps 160.60 2 ' Name: 601 amps to 1,000 amps 240.60 2 Address: 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 relocation Phone: ( ) I 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 1 133.75 2 _ Owner signature: Date: Branch circuits - new, alteration, or extension, per panel r A. for branch circuits with th MiVeSSiiiiUttkAYgggre'AV;iikalgtalikillidtb:ta,retiMiitit'i:::*Ai.:,,t - uirta,. .T, k',",'.,:•..,I., Li ' service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits . Contact name: without service or feeder fee, ) ' 46.85 ye as 2 each branch circuit Address: Each add'l branch circuit i i 6.65 26 §..? 1 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2 E-mail: Signal circuit(s) or limited- 111A t.' . ., la tr.it , e :net, lit or Page 2 2 Business name: f I, il 4.14.4 14 '1_ 10 ,,, 1,... 4,........ Each additional inspection over allowable in any of the above Address: p a g ?_"Q c 4 4 _ Per inspection 62.50 _ City/State/ZIP: r e suv ri... C)."._ 9 f z lr I Investigation per hour (1 hr min) 62.50 Industrial plant per hour 73.75 Phone: ( ,R3 ) 42-4. - 1 //3" 1 Fax: (03 ) (2At - 24 3 k CCB Lie.: 7-) c q Electrical Lie.: ' 4. 75 C uprv. Lie,: /94 s- C Subtotal 73 -V - Suprv. Electrician signature, required: Plan review (25% of permit fee) ... State surcharge (8% of permit fee) / io ,fte' Print name: r, F-L.C-c.. Date: 1 -4„? •■• of \-- TOTAL PERMIT FEE 7, ..._ Authorized signature: This permit application expires Da permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by let-County Building Industry Service Board 44 Number of inspections per permit allowed. i, \BuildmePerrnitsTLC-PermitApp.dac 12103 4-40-461 5T(10/02/COMTWEB CITY OF TIGARD BUILDING DIVISION PERMIT #:SIG y0 — 675' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 eiivgvet Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: I 0 — Q I1 — ©S TIME: /44/1 PAGE: SITE ADDRESS: et 14 3 O SvJ Co 14 S4 CLASS OF WORK: SUBDIVISION: Sf e- jO LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: �y.�: PHONE #: CS73X) -' — 363 / CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: JA PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: C��-- t` V Date: \O(/ Phone #: (503) 718 - Z}-