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Permit
ELECTRICAL PERMIT CITY OF TIGARD PERMIT #: ELC2005 -00355 DEVELOPMENT SERVICES DATE ISSUED: 5/27/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111 CC -23200 SITE ADDRESS: 10440 SW GREENLEAF TERR ZONING: R -12 SUBDIVISION: SUMMERFIELD NO.5 LOT : 290 JURISDICTION: TIG Project Description: (3) branch circuits for air handler & NC unit. 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: 2 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: SIPE, LOUANA WEST SIDE ELECTRIC CO INC 10440 SW GREENLEAF TER 1834 SE 8TH AVE TIGARD, OR 97224 PORTLAND, OR 97214 Phone: 503 - 598 -9245 Phone: 503 - 231 -1548 FEES Reg #: LIC 13306 Description Date Amount SUP 4654S ELE 26 -1313 5c [ELPRMT] ELC Permit 5/27/2005 $60.15 [TAX] 8% State Surcharge 5/27/2005 $4.81 REQUIRED ITEMS AND REPORTS Total $64.96 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: 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. May 24 05 05:02p West Side Electric Co. (503)736 -0677 p.2 \ •E'iesctricar Permit Appiici' iu� llltr� � � �� FOR OFFICE USE ONLY ,City of.•Tigar� C � R,et: 13125 SW hall Blvd„ Tigard, O12 97223 p� pp i)aedily- eiYea �� 0 5 - # .--74L. Permit No.: � �'�, Cis', -- Phone_ 503_639.417) Fax 503.598.1960 MAY l , ,e; Plan Review u 2 / �-� I , . ty I % Flan R y: Utter Permit: Ins cti Lin 503.639,4175 viii .)! ' lx _� Date RcadyBy: Jo g1 yet. Page 2 for Internet www.ci,tigat•d.or.us CITY Y OF TIG ■ =' Nulifie f 1� Sit pple menla! Information Ty 6 C ! (VISION PLAN REVIEW ❑ New construction 1 Addition/altcration/rcplacemcnt Please check all that apply: T 11] Demolition ❑ _Other: • _ ❑Service over 225 amps, comm'I ❑I•lazardous locution • - • © Service Ovcr 320 amps rating El Buildng over 10,000 sq. II.. CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 Or more new residential 11 I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑Molti- family ❑ Master builder _ Other: 0 Building over three stories OPeedern, 400 amps or more -- - ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND: LOCATION ❑ tigress /lighting plan RV park . C ` ^�^ ( �� ❑19ea[th - care facility ❑O[ht.r: Job no 1 G l& Job site ad I CA L . C S L . `�. , �._A - ._ t.S �. - - -- . - - : �e. _. Submit. 2 sets of plans with any of the above. . City /Statc/ZIP: C I Cyr . , { CH 2 . Z . 4 1 The above are not applicable to temporary construction service. 3 �' PEI:' SCHEDULE Suite/bldg. /apt. no Prujecl name: J r � t61, •y •"••••• _.,� .f�.�. Dcrcrltvfou `'13''I sec._ . L I'm.' f Cross street/directions to job site: ` <. 1 ' 4 r.: 1 New residential single- or multi - family dwelling unit. - • .. • Includes attached garage. __ — _ 1,000 sq. It, or less 145,15 _^ 4 Subdivision: Lot no.: - Fa, add'l 500 sq_.ft. or portion 33A0 I Limited energy, residential 75.00 2 Tax map /parcel no.: - Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular T ` — ■ t r dwelling, service and /or feeder 90.90 2 lti it `' - C -� `. " \C'Ct‘t.!'t '-' "'r 4 % t C. „„ Services or Yccders installation, alteration, nail/or relocation 200 amps or less 80.30 2 �„ PROPERTY OWNER _ E7 'TENANT 201 amps to 400 amps —_ 1 UG -85 2 ___ - -- 401 amps to 600 amps 160,60 2 Name_ t--0.,S' L ___. J, , - 601 amps to 1,000 amps __ 24(1.60 " _ 2 Address: l_' � Over I ,000 amps or volts 454,65 _ 2 4_.. � _ : -e — -. Reconnect only 66.g5 2 City /State/ZIP: Tempornly services or feeders installation, alteration, and/or Phone: (' ) cl ``:' - r Li , I Fax F ax: ( ) relocation' .......- 200 amps or less _ 66.85 I Owner installation: This installation is being made on propert 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 si _Date: Branch circuits — oeW, alteration, or extension, per panei ^ ^_ ❑APPLICANT 0 CON XACI P tSON ' A Pee for branch circuits with service or feeder fee, each 6,65 2 Business name: branch circuit Contact name: Y ---- B Fee for branch circuits — - without service or feeder fee, 1 46;85 (ii Q 2 Address: each branch circuit _ Each add'( branch circuit 7 6.65 j tl, r 2 City /State/ZIP: Miscellaneous (service or feeder not included) __ Phone: Pump or irrigation circle 53 :40 _ - _ 2 ( ) Hex; ( - _ Sign or outline lighting 53,40 2 E - mail: - _ „ Siva) circuit(s) or limited- CONTRACTOR energy panel, alteration, or • extension, Describe! Page. 2 2 Business name; WEST SIDE ELECTRIC CO. Address: 1834 SE 8TH AVE. Eaeh additional inspection over allowable in 'any of the above - Per inspection 62,50 _ Cit /State /ZIP: PORTLAND, OR 97214 -� Investigation per hour (I lm min) 62:50 _ ! �_ � Phone: (503) 231 -1548 Fax: (503) 736-06'77 _Industrial plant per hour 73.75 -� ELECTRICAL PERMIT FEES* CCB Lie.: 13306 Electrical L 26-135C Suprv. Lie.: 1 -1/ 0 51.. I S M Subtotal �"�� Suprv. Electrician Signature, ature required: 1 s�.� 1 � - __ p pm tq � � ! ■ - //c - f'v 2 , L1 plan review (25% of permit fee) Print name: � • . A.cx� - L? , A. J Date: ee / �. / ,N State surcharge (8% of permit fee), t - � .1; ' ( — �� _J_ _ ,1 ! G ., TOTAL PERMIT FEE 0_1 q 4, Authorized signature: Thi permit applies don expires it' a permit 19 not nbtulned within - ilia • "'- -•—'" days after It has been accepted no eompicie Print name: Date: - ree methadelo setb Tri- County Building industry Service 13onrd _. ._• •• Nulnhcr of iaapectioin per pornnl :.(lowed. i:\ nuildinK1 'mnits\ELC•Peneitnpp.doc 12/03 410.ne1 Sr( t0/02./COM,WEB I CITY OF TIGARD BUILDING DIVISION • PERMIT #: - ECC2005- 00355 13125 SW Hall Blvd., Tigard, OR 97223 _ DATE ISSUED: 5/27/2005 Phone: (503) 639 -4171 e ffk i iup j l l ;l '' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/20/2005 TIME: 7:11AM PAGE: 37 q . 51,, ,,, n u-'12. f-�2t] SITE ADDRESS: 10440 SW GREENLEAF TERR CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.5 LOT #: 290 TYPE OF USE: PROJECT NAME: SIPE DESCRIPTION: (3) branch circuits for air handler & NC unit. OWNER: SIPE, LOUANA, PHONE #: 503 - 598 -9245 CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503 -231 -1548 Inspection Request Scheduled For: Date: 7/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 011788 -01 503- 231 -1548 N Corrections /Comments /Instructions: AP_ ().‘/ 1-r i1/4-1 izi A z 0 ,1--, f e ___- -- 6,s c -eAIV/ C C-'I 7 cz, , c1 - 1`1 P 1--.1s L S • • • • PASS 11 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS [l FAIL Mr CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ______---- - ,/ , . - Inspector: ® Date: Phone #: (503) 718 - Ip