Loading...
Permit C ITY CIE TI GARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00035 . _�i� DEVELOPMENT SERVICES DATE ISSUED: 1/25/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103DD 00420 SITE ADDRESS: 10825 SW FAIRHAVEN WY SUBDIVISION: FAIRHAVEN COURT ZONING: R BLOCK: LOT : 013 JURISDICTION: TIG Project Description: Service and (6) 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: 1 W /SERVICE OR FEEDER: 6 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: SAMPLE, SUE &AL VARNES SAM HARDING INC 10825 SW FAIRHAVEN WAY 23833 NE GLISAN TIGARD, OR 97223 WOOD VILLAGE, OR 97060 -2942 Phone: 503 - 620 -5231 Phone: 780 -3159 Reg #: LIC 00087048 SUP 3376S FEES ELE 26 -549C Description Date Amount Required Inspections [TAX] 8% State Surcharge 1/25/2005 $9.62 [ELPRMT] ELC Permit 1/25/2005 $120.20 Rough -in Elect'l Service Total $129.82 Elect'I Final 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 1 80 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 N otification 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: 13Cizk42.1 � 4( 1 �, 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 01/21/2005 09:59 FAX 5035981960 CITY OF TIGARD Z001 RECEIVED Eiictr Permit Application FOR OFFICE USE ONLY Ci of Tigard JAN (� x 3. JAN z'' o 005 �S PermitNo,S -6,0035 SW Hall Blvd.. Tigard, OR 97223 w q h , �� 'F � Ph one: 503.639.4171 Fax: 503.598.1tiTY OF TIGARD 111. ,' Datc/ey: Other Permit: ' Inspection Line: 503.639.4175 l! ' ,,,, Date Ready/By; Jvne G ®See Papa z nu' Internet: www.ci.tigard.or,us BUILDING DIVISIO Norified/Mehod; Supplemental Information ... r vp lr i OP WORK REY .. , 'd':' Pte. 1t{r:`........ ❑ New construction. Addition /alteration/replacement Please check all that apply: OService over 225 amps, comm'l ❑. Hazardous location ❑ Demolition ❑ Other: ❑Service over 320 amps– ratting ❑ Buildng over 10,000 sq. ft., : • • .. •• • CATEGORY pF CONSTRUCT10N , ° ?• • of 1 -and 2 - family dwellings 4 or more new residential tit 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ MuIti- family ❑ Master builder ❑ Other ['Occupant load over 99 persons ['Manufactured structures or . :JOB:SITE INFORMATION 'AND LOCATION • , , . ❑Egress /lighting plan RV park • ❑Health -care facility ['Other. d d Job no.: Job site address: a g° �� l Submit 2 sets of plans with any of the above. City /State /ZIP: The above arc not applicable to temporary construction service. FEE :SCHEDULE Suite/bldg, /apt. no.: Project name: _s _ S . `' uescrlpdon 1 Qty. l Fee. J. Total I -- Cross street/directions to job site: St'o G4 ` S7 4. / /© 747 New residential singic- 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.: Limited energy, non - residential 75.00 2 - SCItI T'[ON OF "VYO1tK . - i'! ' Each manufacture d or modular f/ dwelling, service and/or feeder 90.90 2 �( T Se = ' ( _ ■ :ad Services or feeders installation, alteration, and /or relocation 200 amps or less — / 80.30 g 2 - PROPERTY OWNER .'..,. •.. ' .... 1:1• TENANT a to " • •... . 201 mpg 400 amps 106 85 2 401 amps to 600 amps 160.60 2 Name: S', • / j/, t .b 601 amps to 1,000 amps 240,60 2 `' _ • Over 1,000 amps or volts 454.65 2 Address: . « Reconnect only 66,85 2 City /State /ZIP: 7 tgl. CI Temporary services or feeders installation, alteration, and /or relocation Phone: ( g) L. _ .. 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 amps 133.75 2 Owner signature: Date: Branch circuits -- new, alteration, or extension, per panel ❑ APPLICANT. ❑ . GONTACT...IPEXL50N : branch circuits with fee, each So 6.65 A Fee for service or feeder e Business name. 4 /. ,/ :• d !Yi A branch circuit .�Q 2 ._ s. B. Nee for branch circuits Contact name: without service or feeder fee, 46 85 / each branch circuit P ^ Address. i2 3 '3'3 /V 5 . f5i9 i1/ Each add'l branch circuit 6.65 2 =" �, City/State/ZIP: ' d90 d i 4 o , .0 Miscellaneous (service or feeder not included) — Pump or irrigation circle 53.40 2 Phone:) i7lS.Z.. � 9 "7 Fax= = � ) �.7 Sign or outline lighting 53.40 2 E -mail: ja i ; --. Signal circuit(s) or limited - ..,. • .CONTRA.CTOR. -:: :. . or r :' '' • energy panel, alteration, o extension. Describe: Page 2 2 Business name: r r ,, ' v i Each additional inspection over allowable In any of the above ,C,' �O r v Per inspection 62.50 ...to • t / � / /\ 1/ Investigation per hour (1 h min) 62.50 0— IV t Industrial plant per hour 73.75 f1 Phone: ( ) ` / ' , . , ! ' ELEC • FERMIT F1S' :.::r ` • • .. CCB Lie.: moo / � Electrical Lie.: 5q9 - Suprv. Lie.: 6 ' Subtotal i j Ra Suprv, Electrician signature, required: ./ il. / Plan review (25% of permit fee) It State surcharge (8% of permit fee) ?. . 2 k. Print name: c' Date: ,+ ye _ f� /� . iN'� ! — i °Or • 9' p itt Authorized signature: / TOTAL PERMIT FEE d"' � � Thi perm app exp i ra permit is not obtai�w t hin 180 • - ""- days after It has been accepted as complete Print nairic e .�.� ;� ' / kis d� .. Date: - ,...61 v Fee methodology set by Tri-County Building Industry Service Board _�� "` Number of inspections per permit allowed, ■ !Valli ldin5Wcm \ELC- Permit App.tloc 12/05 440.46157(10/02 /COM/w P,B -j, . c.k•T 9 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00035 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/25/2005 Phone: (503) 639 -4171 :'nlhlll'I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 51512005 TIME: 7:16AM PAGE: 99 SITE ADDRESS: 10825 SW FAIRHAVEN WY CLASS OF WORK: SUBDIVISION: FAIRHAVEN COURT LOT #: 013 TYPE OF USE: PROJECT NAME: SAMPLE DESCRIPTION: Service and (6) branch circuits. • OWNER: SAMPLE. SUE & AL VARNES, PHONE #: 503-620-5231 CONTRACTOR: SAM HARDING INC PHONE #: 780-3159 Inspection Request Scheduled For: Date: 5/512005 Pour Time: p q Code # Inspection Description Confirm # Contact # Message 4-41 199 Electrical final 005967 -01 503 - 780.3159 Y Corrections/Comments/Instructions: • (Z PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEE 'SSESSED Inspector: illi Date: Phone #: (503) 718-