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Permit _ CITY OF TIGARD ELECTRICAL PERMIT PERMIT #. ELC2004 -00459 I . DEVELOPMENT SERVICES DATE ISSUED: 7/23/2004 mat?"' iii 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 i PARCEL. 23104CA -12000 SITE ADDRESS• 13260 SW ESSEX DR SUBDIVISION. HILLSHIRE ZONING: R -7 BLOCK. LOT 120 JURISDICTION TIG Project Description: 1 branch circuit to hot tub 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 CALIEBE, RALF B + lR INETTE P NORTH BY NORTHWEST 13260 SW ESSEX DR 326 S 15TH ST TIGARD, OR 97223 ST HELENS, OR 97051 Phone: Phone: 503 - 348 - 0505 Reg #: MC 142140 ELE 5 -SOC FEES SUP 4512S Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/23/2004 $46 85 [TAX] 8% State Surcharge 7/23/2004 $3 75 Rough -in Elect'I Final Total $50.60 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 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) 2468699 or 1 -80 - -2344 Issued By Permit 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 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application FOR OF USE ONLY , �( Received p., City of Tigard �� 1 1/IC 0 V/ ICU J Date/B 0 it' =W t. /tV --d� 13125 S,,V Aall Blvd , Tigard, OR 97223 `L/ Plan Revie , Phone 503 639 4171 Fax 503 598 1960 Date/B Other Permit Ins ectton Line 503 639 4175 2 3 - ' . Date Read /B �II 0 See Page 21or Internet www ci tigard us JUL //.... 3 �OL Non6ed/Ivte[hod �(f�_ Supplemental Information �.a ` ' 3l5SI„,ISV TIYSEEOF OM .- s. (�reth tib i', .',,, , I C4. 1:.t ; ��:, sr:.PliAW,REYiEVY . ' - ❑ New construction RAddition /alteration/,replacement r Please check all that apply ❑ Demolition ❑ Other ❑Service over 225 amps, comm'l ❑Hazardous location „ ra „ a av _ ID Service over 320 amps - rating ❑ Btu ldng over 10,000 sq ft , a ?, ” ,"4!,7, n ' 95Y ni„ „' CATEGORY iiiiieT IoR i "% ;i 3 ? r: t 4 of 1- and 2- family dwellings 4 or mole new residential ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure [(Building over three stones [(Feeders, 400 amps or mole ❑ Multi ❑Master builder ❑ Other em i G t , rr , 4 ❑Occupant load ewe' 99 persons ❑Manufactured streames 01 3 * , 'oT ¢ 6 TOBeSI kiN60RM TION AND pre4f y 70N,,Wk-e ,£}, ' ' ' y ❑Egress /fighting plan RV park Job no Job site address I 5,,, E 5.54K De ❑Health -care facility ❑Other Submit 2 sets of plans with any of the above City /State /ZIP The above are not applicable to temporary construction sel vice Suite bldg /apt no Project name t,~g ¢ » * rc MCMPO tiIS'CfiEb'Pit ;r- CII''I Description Qty Fee Trod 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 i 1 Limited energy, restdenual 75 00 2 Tax map/parcel no _ Limited energy, non - residential 75 00 2 II' ' tie i .` FOY O PTF1 �', W ry';($ e Each manufactured or modular J�j j jr -712g dwelling, service and /or feeder 90 90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 � it PROPEILitsysiss f s 1, ,, r� ,'y4 Trio rows- 7 l ' +fact 201 amps to 400 amps 106 85 2 - i 401 amps to 600 amps 160 60 2 Name " (pI 1 C4 (kb 601 amps to 1,000 amps 24060 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 ( ) 332 __,-t t ' , Fax ( ) 200 amps or less 66 85 1 i 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 I� ' )103 2 dAP dPLICAN.T, " l x i k�a r+a"GON'f ACT,�PFRSO[Y" x `y,'�' $ S .. S...a < .� .....crvn.ft� ; T �351 a-. �roa, -Yle FJ `k.tFi A Fee for branch circuits with �iC ,� service or feeder fee, each 6 65 2 Business name A oz _ Aid c _ branch circuit B Fee for branch circuits Contact name �� � without service or feeder fee, / � �� � each branch circuit 46 85 2 w' Address l - > S 1 Each add'l branch circuit 6 65 2 City/State/ZIP 7 /fej4,5 0Q Miscellaneous (service or feeder not included) Pump or tmgation circle 53 40 2 Phone (5D3 ) 3t4 - 013 Fax ( ) Sign or outline lighting 53 40 2 E - mail Signal circuit(s) or limited - .sl,` -` `' `.,Ip'" p'lt ,, , ' ',GONTR4C7„TOgIlei; ', ` ttag A energy panel, alteration, i' or � extension Descnbe Page 2 2 Business name Naiu 7- �J,l� t q Address �? Each additional inspection over allowable in any of the above ' 6 ` 5 - / /h Per inspection 62 50 City /State/ZIP 37 tk A, e ( ye._ / %¶1 Investigation per hour (1 lu nun) 62 50 Phone 0 ) 3 - C Fax ( ) Industrial plant per hour 7375 L •n+,"-,.'' • .ELEGTRICK P ICIIRTFEES *,F+4p r ,,--, CCB Lic / l2 /9 D Electrical Lic J [- -5 p c Supry Lic ('S,25 Subtotal -J(o ,85 Supry Electncian signature, required �j `!�� Plan review (25% of permit fee) .----- / State surcharge (8% of permit fee) 3 73 Print name / O` r ocks ij Date 5 . 3_ D t_i 3 TOTAL PERMIT FEE 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 permit allowed D / O ui , \ Building \Pems\ELC- PemoiApp doe 12/03 440- 4615T(10 /02/COM/WEB Cam/ Electrical Permit Application - City of Tigard • _ Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 'RESIDE PTIQiL W tI OIV'L .,` Ir siara ,.._ 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 t�C®QMr'VIER FCL'4L�WORK ©\rI:Y 4 . } _ Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems El Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls I I Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems *No licenses are required. Licenses are required for all other installations \Budd'ngWemucs\ELC- PermaApp doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (303) 689 -4171 MST BUP Received Date Re — n t — 1 AM PM BUP Loc on 32-4, !/lip ( �4�L Suite MEC C to a Meg /1 •' ■: Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC I — 3 0 4 51 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Note g:f,— SIT Post &Beam l C A Shear Anchors �cy� Ext Sheath/Shear 1 � 1 A- t Int Sheath/Shear J Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm S)ll f- G `d 4 )bp Susp'd Ceiling I Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Serv' e '. - I NSlab Low Voltage Fire Alarm A t S PART FAIL Reinspection fee of $ required before next inspection Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE D Unable to inspect — no access Fire Supply Line ADA /O� Approach /Sidewalk Date �� Inspector A _ _ _..,/ . _ ! Ext Other Final DO NOT REMOVE this inspection record fr m the jo ' site. PASS PART FAIL