Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00149
DEVELOPMENT SERVICES DATE ISSUED: 2/23/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DB - 03700
SITE ADDRESS: 12996 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT : 075 JURISDICTION: TIG
Project Description: (2) branch circuits, A/C reconnect, gfi within 25'. Job #50967.
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: 1 • 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:
SHANKAR BALA SUNSET HEATING & COOLING
12996 SW HAZELCREST WAY 0607 SE IDAHO
TIGARD, OR 97224 PORTLAND, OR 97239
Phone: 503 - 808 -0380 Contact #: FAX 503 - 234 -0439
PRI 503 - 234 -0611
FEES
Description Date Amount Reg #: ELE Cl 17
[ELPRMT] ELC Permit 2/23/2006 $53.50 LIC 161085
[TAX] 8% State Surcharge 2/23/2006 $4.28 SUP 4638S
Total $57.78 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: :72� Permittee Signature: ca' , c>
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.
Feb 21 06 02:46p p.
Electr Permit Application i, l Hz (t i s l( is t si ON.I.\ . '
Ci of Tigard . t Permit N- 6 0:647.00 /�f
131 Hall Blvd., Tigard, OR 97 ` p� w " • J D ' ` !`t 7 d y %
Phone: 503.639.4171 Fax: 503.598.I960 7 '� +l,r; l,t I i • Date/By: Other Pe `--
Inspection Line: 503.639.4175 - -a.141 'I i Date Ready/By: Ju is: 21 See Page 2 for
Internet: www.ci.tigard.or.us FEB 21 2001 Notified/Method: -T i 1" Supplemental Information
ton: . t = . b t y �,r s i ^a i x @ 4 ` i k 1 . .. � ° { t > , } �'.S` N t "t� ? . d ; - .S; �, his . i,, a ` r ' .:1.T t . s l �'� `tik'.a" i , w.
s�� .<. �;!.� n �, •�,. x :�x : "� ..., - ? _...,,F i'�. :. "� �r :'] x .. � ,cai.;'S'.�Z..:: :u ,� :. 7[ ..,C+ +'.�.2 t`,r ...�. ,...... ?.. �_�.. � ..L- ..,;,...,: has; rw2+.., •ra3�^t:....�".^.c- ....:`.s�,� �. v^'t1
❑ New construction ►�1� ' i t . Jr.. IL -nt Please check all that apply:
s :� r �T
❑ Demolition ILA i'�! 1N DP 1STO1� ['Service over 225 amps, comm'I ['Hazardous location
r i mi a w o +� * ba s ;rr�� � ,,;- ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
1
A`. s s `rl ,, ,. R r r r ( t o n 'i c ,r t yt" �Z- t
- s,tw .;, teu:t i s i t t. : ., - : ... ` e ,4, : - ..s, ^ .. : ;',`, taco ;;x ■Vry V,,, , ': of I- and 2-family dwellings 4 or more new residential
R t ..rs: a._ . ).
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Mulu- family ❑Master budder ❑ Other ['Building over three stories ❑Feeders, 400 amps or more
-family , # r ti z r 4 mot: w � , Occupant load over 99 persons ['Manufactured structures or
to
*, • � 4., :se ;. ,s ...Vtit: �,c; „.~.a .. '. l., t t u" * " t ;' ❑Egress /lightingplan RV park
• Other:
Job no.: ,; t ❑Health -care facility ❑
t` C Job site address: 12 0 t IL:' f. -1 Li t t: I c.1 —t" � f o i 'j y
-�� t �.' r? � � f t � J Submit 2 sets of plans with any of the above.
City/State /ZIP: _11 e ' 'D (Al 2:2_1 The above arc not applicable to temporary construction service.
Suite/bld ./a t. n . . - .- . .. , � K� .•,<,,.;:<: •,
g P o. l Project name: T; I s . ) t t ' ' s . ., )t3 : =: .- ..; : :, , _ Total -� f �• .v Description i Qty. I Fec. ( Tot
.,,, ?.
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: 1 Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
s';', ^i� .y,�,,rs,`,,;h, 7 _ ' 42 A5 ,. rKe ^w Limited energy, non- residential 75.00 2
�?„ ,t: Me • a$; :;�1 •, ysi 1':?; t F,' .1/4 zR+ ` tiat.?d14 '� ',!i�&;_,, r. a-3•e. ; iv.•' � �'u.
...., ra.. t J , tiw�'�,::K,.rv'sv:l�`v3!yv :; ..w.;�.cvx1' 31+.a�"^x.�U ers, rh.: :k.' ^` :E,?�� •. ",..:; sx�`: i" a^?* dctA�n. ''P?,''�Y;1u+k'a:;';��.;c:«`..a Each manufactured or modular
- t dwelling, service and/or feeder 90.90 2
...'(` .•t'f C - (), i : L.(. i',•i
( . , ' ', -•,,+ A (..' "j i,V'1 I r ' Services or feeders installation, alteration, and/or relocation
L 200 amps or less 80.30 2 '
,,, "-' ,...4fit;' 's'ift y ,,, . - ..,,w
` > e4 . 4 , . y 0.1, -"»l .?3" (.'a`»"stda = : '.',�-`?. „au. .,q f. a c ey ^ , .tt ;
..,.f..'t:",?: -�Y .a: -: }+� �, . w.w. .a.. . ".'`�,a� a^.u...'m... ��sn , Y .,..t" a,y� iu;,ea's.,, 261 amps to 400 amps 106.85 0
>... . .. r n. y .. ... ;� ' .. .. _ ..z .,. n=ew k�;:,.. Sa ^" , .a,:, <.z�
'' "' "' 401 amps to 600 amps 160.60 2
Name: �! °4.•, f -� _(:-..-)1\ ) ( . .. 1 1 1 '� ; Y , ' -' 601 amps to 1,000 amps 240.60 2
Address: _ ' L i. ` (y; ) ? 11L� 't. (/ 1. , Over 1,000 amps or volts 454.65 2
I if, r" ( "'` Reconnect only 66.85 2
City /State /ZIP: -11C1 ) S'. 072-4 Temporary services or feeders installation, alteration, and /or
Phone: (C 5) •a i j ''.5.:71...A- ; ` Fax: relocation
X o > ; y t.; ( ) 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
1 w»'"' g? : . s zit `�rt;3a ,_ ; { ;'� ,, ° Y; A. Fee for branch circuits with
i�K e, ,,,,r. t im ]; '; ' .... - " , i '; ; ;,V.K., , ; Y; ,,c . 3ti! , K ,,e,,,,F,_ ,,,,,,, , ,%,, Y i ∎.
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, I 46.85 1 (' Z
Address: first branch circuit
Each add'l branch circuit c 6.65 .l k ,:.:< 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
t E.K,C .4:.41514011-1i ,.dry , 4'1: t'�; +- �t•.:i, a..wn +�^ ri.. �.'Y r�+°sh
'al l . }.,,,wCa .' .. . .* Ft; ...y ':' Ar• tiw;.. :t` ,' —y * n, energy pan alteration, or
extension. Describe: Page 2 2
Business name: Sunset Heating and Cooling
Address: 0607 SE Idaho Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Portland, OR 97239 Investigation per hour (1 hr rain) 62.50
Phone: (503) 234 -0611 Fax: (503) 234 - 0439 Industrial plant per hour y 73. y 75
a ^ut< ;. $.:,3: `r; itYri. 1 :Fxi$ '. 't`,, it:ii a ,dt r` ,i :;'n`E.y
CCB Lie.: 161085 Electrical Lie.: CI 17 Suprv. Lie.: 4638S Subtotal F-, . "
Suprv. Electrician signature, required: g._.____, Plan review (25% of permit fee)
tt( O�
Print name: � J v -- State surcharge (8% of permit fee) L.) <,) `�
l d.. G SS Date:. ; . - t t ;_: /
� J TOTAL PERMIT FEE j f. t �
Authorized signature: This permit application expires if a permit is not obtained within 180 ft
days after it bas been accepted as complete
Print name: f/�/ / Date: ,.) t ' a , ; . ^; Fee methodolo
� LI . �1 G; 1A(2-5
b�'Q�'v , ,� - t. Lt,c� g y act by ' Tri-County Building industry Service Board
•• Number of inspections per permit allowed.
is'.BuildingWe miis\ELC- PcrmitApp.doc I2/03 4404615T(10 /02/COM/WEB
CITY OF TIGARD Ez_
BUILDING DIVISION " PERMIT #:, - �
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 / � � r'�°Ilu�y�piB1�'
Inspection Requests (24 Hrs.): (503) 639 -4175 I
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: a 9 / � � / j CLASS OF WORK:
SUBDIVISION: ?" 0 LOT #: �/ TYPE OF USE:
PROJECT NAME: o
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- 2_1-0( Pour Time: fv. - /rl
Code # Inspection De ription Confirm # Contact # Message
Corrections /Comments /Instructions:
I
b 4.
1
a(
g rf
� "
r 7
( \kr t i I ii
X E....p„ss n PARTIAL APP • V • . n CANCEL ❑ NO ACCESS
n FAIL I ALL F• •- " PECTION El ADDITIO • L FEE ASSESSED
• ) p
Inspector: 1 Date ' I Phone #: (503) 718 y/(�_,