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Permit
} CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00462 COMMUNITY DEVELOPMENT DATE ISSUED: 7/6/2007 TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S111 CC - 19900 SITE ADDRESS: 10265 SW GREENLEAF TERR ZONING: R - 12 1 SUBDIVISION: SUMMERFIELD NO.5 LOT: 25$ \ JURISDICTION: TIG PROJECT: BOTTOMS Project Description: Service panel change. 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: 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: BOTTOMS, SARAH C TRUSTEE WILLAMETTE ELECTRIC INC 10265 SW GREENLEAF TERR PO BOX 230547 TIGARD, OR 97224 TIGARD, OR 97281 Phone: Contact #: PRI 503 - 624 - 3631 FAX 503 - 624 -2938 FEES Description Date Amount Reg #: ELE 34 -283C [ELPRMT] ELC Permit 7/6/2007 $80.30 LIC 75059 [TAX] 8% State Surcharge 7/6/2007 $6.40 SUP 4226S Total $86.70 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 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: f2 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. JUL 05 2007 1:54PM WILLRMETTE ELECTRIC INC. 5555555555 p. 2 • � ix y ;4,°� r : �ti, fi n �� r a ''s � , ` / ' s li ma r ti;_a, ,t ,7 sq , ,_ 1 � � .. .,. P•1.; "� ,R, }y l4 a,Ik� ."" ilt� , M: ::. „. ii hM1 . l '. „j; in s;ll lt°tf if "If1SIU: 1�� j BT � c ., JUL 0 LOO/ : 5 t �., ',,. „;:di i ?h•1., i ; g.9iu (}I:. T'I ?.G4 '' >" • ,( , iA 1)atci (7 r , { '. •r P • rnw -hone. O,3.;t }'i'1 171 i aa. .. I� o . , . ; :;);.. ` � IT d,. R�:,d rl;y J 1O CITY ., G O F r 03 4 � \ 1 7" :1 , tt'i,d: — _I ; _ ' u(r�lernc�iF »S ln(or a;xti� n sp i1 l 1 inc.: .1ig .ca3`i 4 r75 UL � -- -- -- ' — _ — -- — ' , t( B l r - •. - -.' • - •' - ^ J lease check all that apply: A ddition /alteration /replacement 225 . J larardous IocaCOn New c.)rsiF,l;;(tC,] �� I..JScrvice over 225 amps, comet l C� i�t - — _ . - - - -- i...1Service over 320 amps •' • rating r over I0,00(s l it.. ;`..-)n: lt1 ion 4 or more nrw restdcniiel �, — .�-� 1 of 1- and 2- family dwellings ------ --- - -- ��'T &�'��''�!=;�Ii<: " �IV�'�'•$!C`>F��I�i: ^ ^__ [.rits in one structure .._ -- — []System ovel 600 volts nominal __ _ - [� unitS in one amp e mole (� 1 and G tan'tily dwelling 0 Commercial /industrial ❑Accessory bulldirb Building over three stories [f Other: ❑Ocpant load over 99 persons ❑Ivlanufactured structures or ❑ Multi-family ❑ Master builder _ cu RV park o <` ❑ Egress/lighting plan '.�9 �'� '- :- ...,.,.��... � �Health-calEfacility Job no.: e? 3 , Job site address: 0,405 6,,I /r # .i k ! ; Submit 2 sets of plans with any of the above. The above are not applicable to temporary construction service. City /state/ "LIP: . .... �� G -:S ;;m �" e� .. `i .« Total name: s D cscrtptl°n Q t y Suite /bldg. /apt. no. • Project ���`� � � New residential singles or multi- family dwelling unit. • Cross street/directions to job site: Includes attached garage. 1,000 sq. ft. or less _ 145.15 —© );a. add'1 500 sq. ft- or portion _Q 33.40 Subdivision: Lot no.: Limited energy, residential 111111 7 5. 00 _© U Limited energy, non - residential 75.00 Tax map /parcel no.' ::_ ;:,> ' dular - ',.�e�. . I ' a ii4.- cia'71 k=ii `�' Each manu or m o :. .: " , „ t;': . ! _: , ..: t:::. ,1= `, ... =`> ''` : „, .r. ' ' ■ 90.90 —. Ill .' "- ,`! dwelling, service and /or feeder - y ..9 1� I Services or feeders installation, alteration, and/or relocat� 2 __— Or/ 200 amps or less 80.30 2 _ • :', 201 amps to 400 amps 106.85 .o:.: - '-:,r, �"`. ::3;; y'. = - :;,:: _.�u_s, :y':,,i ";� ,� i s 160.60 — Ell #) "r Y.t ] ;l ' r_ . 401 amps l0 600 alnp ;,' , :�`;,,'_ ; ......a=:'., . -�'......'::� 240 63 _ a r 601 amps to 1,000 amps � _ El Name: .4 ( Over 1,000 amps or volts 1 A�Idress' Reconnect only _ 66 -85 2 Temporary services or feeders installation, alteration, and /or City /State /ZIP: relocation Phone: ( 1 Fax: ( ) 200 amps or less 66 -85 _ = 11 ® =© Date: Owner installation: This installation is being made on property that 1 own which is not 401 amps to 6oD amps intended for sale, lease, rent, or exchange, according to ORS 447, 449, , 670, and 701. 401 Branch m ps si amp w, alteration, or extension, per panel - Owner signature: yr -rr w '4 0- ?:f A. Fee for . branch cncuits with ■ x. tr t:_ r�ac �' _ ' "lf °: § >:'��:�T r, service or feeder fee, each 6.65 �� ��, .� WtII._ _ branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 ■ first branch circuit Each add'] branch circuit 6.65 2 • Address: Miscellaneous (service or feeder not included) Phone: City/State/ZIP: ( /7.IP: ) Fax:: ( ) Pump or irrigation circle IIII 53.40 _ © Sign or outline lighting 11111 53.40 _ Signal circuit(s) or limited- E-mail: -: ••,;� J L s 'F ="'�`' energy panel, alteration, or 2 ' — ' • - i '' "`' extension. Describe: Business name: La wi i a „diiit Each additional inspection over allowable in any of the above 0ay � 62.50 _- � f; '� � � Per inspection • Address: , ! 3 62 50 _ Investigation per hour (1 hr min) - tnduauial plant per hour MI 73.75 Phone; (h`'`am' ) � L ` y ..... y t =;'c NI Fax: (3-4_;..i J ) t'*Mt�_' � _ Subtotal __ Electrical Lic.: 3'i z6 , . Suprv. Lie.: -- .x- ,...... -... .. -. Plan review (25 °/a of permit fee) 5uply. Electrician signature, required ._.:' "' State surcharge (8% of permit fee) 4 1p____- i ;; Date: � ✓ � — TOTAL PERMIT ____ AI _Print name: �-tl ,.: • <.._' '',, _ _ _ _--- — — - -- " – - mi.; p2rrtail ;anpiicaivae eairires it a pencil is ,let Cb(ainCtl wilbin 1SO I AUtI]DI /ad signature. daps, Alter it lilts been Accepted a;. 4ornlr +e °e vice titian.) — ..._.”— '---- -" - - sel l] T,i -Count Building lnAusU %See vi -- — _ - —_ Date: p0: methodology Y Y Print name: _ Number or i uspecuonn lei penult allowed. --- ___.. --- g I n'r(IO,o2 /C iM wi ?a i it] uilding�Pu rn i„•bLC- Pcn (1,.‘c (2,,(r; / C/ (' /i CD-5 1 11 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00462 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/612007 Phone: (503) 639 -4171 ' °' p �lR5i� I Inspection Requests (24 Hrs.): (503) 639 -4175 : - ' _ INSPECTION WORKSHEET FOR DATE: 8/312007 TIME: 7:03AM PAGE: 53 SITE ADDRESS: 10266 SW GREENLEAF TERR CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.5 LOT #: 268 TYPE OF USE: PROJECT NAME: BOTTOMS DESCRIPTION: Service panel change. OWNER: BOTTOMS, SARAH C TRUSTEE, PHONE #: CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503- 6243631 Inspection Request Scheduled For: Date: 8/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Messese 1 9 9 Electrical final 053341 -01 503- 624 -3631 bA-IL) Corrections /Comments /Instructions: /4fr( k1 Z L/tiltom' 3.c"z ° •.tb CZ(S l') (-k 1e G, o 2 o 6 RoApm/ itrn M--... lb PASS IR 'A IAL APPROVAL ❑ CANCEL I I NO ACCESS n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ANO_ Date: 8 A 47 Phone #: (503) 718- 7----6.7