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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2009 -00003 COMMUNITY DEVELOPMENT DATE ISSUED: 1/2/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110BC -00700 SITE ADDRESS: 12350 SW CORYLUS CT ZONING: R -1 SUBDIVISION: AMES ORCHARD LOT : 004 JURISDICTION: TIG PROJECT: FITZWATER Project Description: (1) circuit for new range. 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: SIGNAUPANEL: 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: D SCOTT FITZWATER CONDUIT ELECTRIC 12350 SW CORYLUS CT 19461 SW 89TH AVE TIGARD, OR 97224 TUALATIN, OR 97062 Phone: Contact #: PRI 503- 692 -1428 FAX 503 - 692 -3652 FEES Description Date Amount Reg #: ELE 26 -905C [ELPRMT] ELC Permit 1/2/2009 $46.85 LIC 109669 [TAX] 12% State 1/2/2009 $5.62 SUP 4501S Total $52.47 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 fe • - an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rul -. are set for i• • • • • 2- 001 -0010 through OAR 952 -001 -0100. You may obtain copie •f these rules or direct questions to OUNC at 503.246.:•99 or 1.800.'2. Issued B . : � � �� Permittee Signat ire: 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 J SIGNATURE OF SUPR. ELEC'N: 9 & ��� 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. u09 /JAN /02 /FRI 02:31 PM Conduit Electric FAX No, 5036923652 P. 001 ' I.- Electrical Permit A EN\I ED FOR OFFICE USE °Nl A' 4 a Received cx o>f�[� aIa © o Pe rmit Na.: t„.4t 0 0 -000(5 3 . Date/B e 13 1_5 SIV Hall Blvd., Tigard, OR $7qq O , 2U. 3 1 Plan Review t t Phone: 503.639.4`171 Pax: 503.59811 Date/33y. OtberPermit: TIGfil 1) Inspection Line: 503.639.4175 ®� Taw Date Ready/ By: Juri • ® See Page 2 for Internet: wwiv.tigard- Or.gOV Y t7l T 7nti5ed/ 4 thod: / IQ. Supplemental Information ,x y t n�, v.r ; i ";1 , 0 ; , ! .r g t ` Y Y � ' ::,k i;.:ii ! O r: °�Y' l u3T ;!,.4s � p , 1 •�rr�,:,.+U;;''';1 C � , iA'll ,,.� e .p , 9 t r1 .'�tt �V:dV' � + � ; elr1��' �'� vXM�t q�1 rl 5 "1. , i , '.,.. :I�tr:P��.f� ! >�t , ., `1�".:�, ., 1 "�kf µa �' �'L y. Please check all that apply ( submit 2 sets of plans w /items checked below): ❑ New construction Ei Addi on/aitcration /replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories- ❑ Demolition I Other: where the available fault eurrcnt ❑ 1vlArin and boatyards. V ;'., , ,:., ;i ^ , t `. , a,: n.oa. , i,> , •, yy . ';: - t. .n+i:rC s; V. "` i ?" exceeds 10,000 amps at 150 volts or buildings. � •' nt,. t,t , F.' , f ' ? = 'r;' '. .'1 . t a lF hCi " ' , ' N t '' '' ➢ D Floating s. ' S y u'. > ¢j f ,,(, ,t �, , a :� - , v,, '' '''''''''$' d,> . Y ,t ,' a;l ?t '{' sic ground or w:coeda id 0 Commerc a1 -use 8rr u rural Z 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ulti- fa amps for all other i stailwtions. buildings, rnil ❑ Master builder ❑ Other: pump. sta3 o VA. or l " Otli Fire l] installation n of 75 IC r ,:`;g ,.,• . ,�,� ,..�y,.���y�.1f)��.m ,.. ,�.- 7 .�.,� .,. ,,,.,,,.,,,:...:; :.••;, r , P ', r` ^. uc.; �Pmergency system. ar'gar separately derived system y a, f9 ( y v i 1 . P O 1Nr f�itlfY1 "."'ul+xPaW t , ` ,: `fi ^"�' i P. " �S l t nli[ y ,;,;4i'ty� + .rt,11 t Z Y +. t i :.c:' =; k, , tlN.:r, ❑Addiooa motor load of ©`'A" ">=" "1 - "1 - 100HP or more. occupancy. Job no.; Job site address: �� \ . ` L ❑ six or more residential units. 1: Recreational vehicle park;. City /State/ZI7? l ` • Q `I ['Health faciliti El Supply voltage for more than 4 . .r l ❑ Ha�'dous locations. 600 volts nominal - Suite/bldg./apt. no.: Project name: ❑ Service or feeder 600 amps or more, �� Ui „Elu ;r riY. r� 1 1: l oY q , '+4.; `,7.:ti;(i-'t:' .'5�.�Si'7:4:'M!li si'7'r57. )k.�"'0011.Ctit!.L,,,',�,_ .: :,",.,''`.."rT i' :c ;: r = , 1 Cross street/directions to job site: I netrription I Qey• I Per_ 1 Tom j New residential single or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no. 1,000 sq. ft- or less 145.15 4 Ea add] 500 sq. ft. or portion 33,40 1 Tax ma / arcel no : energy, P P Limited ewe residential • fy °, t ,,•-„1 '.:;�." f,;t, - nt'd:"'"'il °t ? '.s D� d9c'S' ; M` r,, kt ',t, i" 70.00 2 '+'�r a �1'm3` tl � V,� � +,'rr��:G�ei;,`��� tl B �'�F `T�YICA tr« roil �{ i �r �'�" ^� 'f' rZ' Ii�';� ��^;� . („vin? ahoy© eq. ft.) Limited energy, multi - family 75.00 2 r - e , _ \ . 1 -- - residential (with above sq. ft ) ■ Services or feeders installation alteration; and /or relocation All ..81 200 amps or less 80.30 2 , a' ` d' , `1I5S,, lt M; " i yytt iFF , t A, :ta`k:x far gA71 le a, pi ° s . a 201 snips to 400 amps 106.$5 2 ' am P.���i ,.... 4:. .�.�, ' , . 1 '�"hS"f� ��'1�'!�'ef �C' .,1�`G ^ l ,k �i aaa„ wU1 n..: . ,R'�,_lf�:� "�%4Y' + ` t. Name. 401 amps to 600 amps 160 -60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 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 599 amps 133.75 2 'Branch cireults — new, alteration, or extension, per panel Owner signature: Date; _ A, Fee for branch circuits with y� " "} 1r�,, i a ' above service or feeder fee, t ` r t Iw.� i�!� '..h? (; `N `' y d�>� j; I1t5C57�? l �. ?i', _ „a 6.65 2 each branch circuit Business name_ B. Fee for branch circuits without service or feeder fee; 46 85 `35 2 Contact name;_.._. —._— �Yrstbr�anch circPit_ . __.j__:_ ____.____ Address: Each add branch circuit .6.65 2 ' Mittellaneblis (service or feeder.uot Included) City /State/ZIP: - Each manufactured or modular 90.90 2 dwelling, service and /or feeder • Phone: ( ) Fax: : ( ) Reconnect only • 66.85 2 E-mail: Pump or irrigation circle - 53.40 2 �' ,i��iaEr�7 �r :7�1,".�5.,; '., i:.• ':7. �l'�: ;lr!'ii':'1' hi`-'N =�c +Y�V , ::�. + «.'y;drii :':IVY,b'`rrtl;:' '.b ��,r,V�,i1:5S;: ('t� iciilii� "r'` &ik� SS,iL� Sign or outline l x3.40 2 ;tr , t y fl,. : `:'�lv 1 tb 1; �M wP„ M ' i' i �1Q x{,8 0),g,';:C ; n „; ' g P 'a f �: �' 1 r. ` ., ,� "v.bn�iN.1•• • li:. • , t �, o•�r' >t, .t ('•,erA,: , r �; , x ' •�' ;�,, , uJr;.;,.u , �,,, ,.�-�,,:; ti, .a Signal circuit(s) Or limited- . Business name: Conduit Electric energy panel, alteration, or Address: 19461 SW 59 Ave extension. Describe: Page 2 • 2 • City /State/ZIP: Tualatin, OR 97062 J 1acb additional inspection over allowable in any of the above Per inspection • 62.50 Phone: (503) 692-1428 Fax: (503) 692 -3652 Investigation per hour (1 by min) 62.50 • • CCBLie.: "109669 - Electrical - Lic: •26 -905G• . Suprv_Lie::.4501S -. Jndustrialplantper ; 73..75 .... ..... ..: .. rcr y1-,�!� � 1= }� ^tiry g.�^`': ")�+ . g,,K r i'il 7 I If � I•+ r'r.a, ?.�,� -., )+� „,:4r .. ���;.5 ,6`..:.�i'� ... ..; ns, if i.:r�y�:.” iP • Suprv. Electricim signature, required: Subtotal: Date: — - -- plan review (25% of pertnit fee): �a. O� Statesurcharge _J,2 %ofpermitfee) _ -- -____- Authorized signs TOTAL PERMIT FEE: • • 3) ,4 4+ / . . ..,, . . .Ibis , perruit, application, expires if, o . permit , is , uot . obiaiaed within 180 . ,.. _ Date: . . days after it has been accepted as complete — -- —. _... - -- _.._._..... _...... — — ...__._..._...__... • __.. _._ k_. N er - ofanspectiQns allowed niit.. _,.., t•VttuudinglPetinii -1'erm L .doe 05/23/06 '4io-4615T(1vo3 /coM wsa . - CITY OF TIGARD BUILDING DIVISION • PERMIT #: ELC2009-00003 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 107009 Phone: (503) 639-4171 hogiiMI\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET WORKSHEET FOR DATE: 1/14/2009 TIME: 7 PAGE: 26 SITE ADDRESS: , 12350 SW CORYLUS CT CLASS OF WORK: SUBDIVISION: AMES ORCHARD LOT #: 004 TYPE OF USE: PROJECT NAME: FITZWATER DESCRIPTION: (1) c f new range. OWNER: FITZWATER, D SCOTT PHONE #: CONTRACTOR: CONDUIT ELECTRIC PHONE #: 503-692-1428 Inspection Request Scheduled For: Date: 1/140009 Pour Time: Code # Inspection Description Confirm # Contact # Message '199 Electrical final 079682-01 503-997-0972 Y Corre () 2,o p: 0 ri, t 4 . ( i: 001$ 30 1-• \\1\r\ '. PASS El PARTIAL APPROVAL n CANCEL n NO ACCESS El FAIL 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G-. N i- E " Date: 11'- I*, Phone #: (503) 718-1)14