Permit �.. 1 CITY OF H
TIG w RD ELECTRICAL PERMIT
OF PERMIT #: ELC2006 -00658
''`° COMMUNITY DEVELOPMENT DATE ISSUED: 11/14/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CC -13800
SITE ADDRESS: 10235 SW HIGHLAND DR ZONING: R -7
•
SUBDIVISION: SUMMERFIELD NO.4 LOT : 189 JURISDICTION: TIG
Project Description: 1 branch circuit to furnace for reconnection.
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 HMI 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:
FRANK TERRAGLIO BEN'S HEATING & A/C
10235 SW HIGHLAND DR PO BOX 80607
TIGARD, OR 97224 PORTLAND, OR 97280
Phone: Contact #: PRI 503 - 233 -1779
FAX 503- 651 -3345
FEES
Description Date Amount Reg #: ELE 49LHR
[ELPRMT] ELC Permit 11/14/200( $46.85 LIC 64597
[TAX] 8% State Surcharge I 1114/200( $3.75
Total $50.60 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: d.lZ
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.
r= -
NOV -14 -2006 09:00 AM BEN
S f 503 651 3345 P -02
" E I ec tricAl Permit Ann'ricat � tttit01-1.1,1 t'I:t►NIA
104 City of Tigard e , ?006 oats if s `� OG 8
0 1 3125 SW Hail Blvd,, Tigard OR _97223, Wan Review " `"
!R Phone: 503,639.4171 : - FaLxT1503:598.'i�960 =I�.ti- D • other Permit:
I l c . I , Innpactlon Line: 503,639:4't75 d 1r' --- -,: r7 A Dime Read rB
Y Y See Page 2 for
Internet: www.tl d�or.gov Tr ^ 'ti N
`W , l , Supplemental information ■ :' " +'r . ; .x "..,.' TYkE "OF WORK Cf!^ ' t ' '' it =its .•4;',:1!'`�', . A„ . ' • PLAN REVIEW
0 New construction Ri Addition /alteration/replacement Please check ail that apply:
❑ Demolition ❑ Other: CiService over 225 amps, conun'I Ell location
- ---, ❑Service over 320 amps - rating ❑l3uildnp over 10.000 sq. (l.,
CATEGORY ,OF •CO i8TRUC 'PION ;.;;;' s ,- ;�.V:,.. :4.: ... , of I- and 2-ifarnily dwellings 4 or more new residential
I- and 2- family dwelling 0 Commercial /industrial 0 Accessory building ❑System over 600 volts nominal units In one structure
❑ Multi- family [] Master builder (] Off: (Building over three stories ❑Feeders, 400 amps or more
+ -: , • ; - -- ❑Manufactured'structures or
Y .. y. ,,. -, r,. ::� s1 , ,., ❑Occupa load over 99 persons
: „ !OB ' Bt'1l`.t; Biel OjRMATIOTF 1 1NlIa ' Uie- 4'l< }; ' ❑Egress/lighting plan RV park
Job no.: Job site address: If)s2 , GJ ill ['Health f1+ClNty ❑Other:
' Submit j_ sets of plans with any cif the above.
City/State/ZIP: 77-11/4 & it 0( C r” a0- if The above aro!not applicable to temporary construction service.
Suite/bldg. /apt no.: Project name: r ,, .• • ',' . ..FEE! SCHEDULE
Dewription Qty. i Pm .. Teel }
Cross street/directions to job site: New realden l single- or multi - family dwelling unit.
-• Includes attadhed garage,
1,000 sq. ft. or: less 145.15 4
Subdivision: Lot no.: Ea. add') 500 sq. I. or portion 33.40 I
- Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non- residential 75.00 2
. • • DESCREPTION OR'
" ''': `,:' Each manufactured or modular
RC - to ee 6 s frJv dwelling service and/or feeder 40.90 2
tCJ r"c,� _- - Services or federa installation, alteration, and /or relocation
200 amps or less _ 80,30 2
amps 106, 8$ • 2
p aorER r OWNER , > • 20 amps to ago 16 i r Q'TE)HANT . ".::.:. . 401 am to 6 t 0 amps 160.60 2
Name: /pp 1 - r rr Aviv - 601 amps to I X000 amps 240.60 2
iddress: / t) y � k r Ova 1,000 wipe or volts 454.65 2
Reconnect one ! 1 66 2
City / StateZIP: - -
ff n t �(� a, ,pZ, Te mp orary services or feeders installation, alteration, and /or
Phone: b ) 7 V _ I ' Fax: ( ) reit i
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, tent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 6tI0 amps 133.75 - 2
Owner signature: Date: Branch clrcu - new, alteration, or extension, r pane .
• ' a• APPLICANT: •CONTACT „PERSON ' . • A. Fee for branch circuits wish ' •
- service or feeder fee, each
6,65 2
Business name: branch circuit
�1 (A t�)rX !B, without for v circuits `
Contact name: lt service Hou! servicic e or feeder / eder tme, a6.85 2
Address: first branch Circuit
- -. - Each add'I branch circuit _ 6.b5 2
City / State/ZIP: Mlsceltaneouit (service or feeder not Included)
Phone: ) 3 t3 • 7 pa,t; ; ( ) Pump or irrigation circle 53.40 - 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit( or limited-
' . : ':t' energy panel, alteration, or
/ . CON I RA A - , . ”
� � extension. Describe: Page 2 2
Business name; -� o_�}�
Address: P 0 f ' A. Q O6d 7 Each additional Inspection over allowable in any of the above
Per Inspection 6
City/State/ZIP: Q is or q°7 80 Investigation per hour (1 hr min) 62.50
Phone: f13) Z23,. ' 1 1 Fax: (g 6s1- 34 S Industrial pia ranter hour 73.75
. ELECTRICAL. PERMIT FEES'
CCB Lic.: 6 X4 7 Electrical Lic.: 4q 414.12 1 Suprv. Lie.: Subtotal: ({{( •
Suprv. Electrician signature, required: 1 ! Plan review (25% of permit fee): r
N....... Print name , r 1 Date: State surcharge (8% of permit fee): ; .--2
11 TOTAL PERMIT FF.E 3p. d
''•
Authorized signature: •'' This permit a,ptcaIIon expires If a permit (s not obtained within I go
days after It has been accepted as complete
Print name: ( . likto ' Date: t 4 • Pee methodology set by Tri- County Building Industry Service Board
Number of Inspections per permit allowed.
maullding\Pamkn\. LC.PermltApp.doa ovate 0461511I1/es /COAUwea
.
CITY ������8��������
��nm m OF mn�m��na�� . ,
BUILDING DIVISION PERMIT #: ELC2006-00658
1312GSVV Hall B|vd, Tigard, ORQ7223 DATE ISSUED: 11/14/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503 639-4175 -_,111- * �1. •
INSPECTION WORKSHEET FOR DATE: 12/7/2006 TIME: 7 PAGE: -;)
SITE ADDRESS: 10235 SW HR3HLAND DR CLASS OF WORK:
SUBDIVISION: SUMK8ERF|ELD LOT #: 189 TYPE OF USE:
PROJECT NAME: T[RRA£L|Q
DESCRIPTION: 1 branch circuit to furnace for reconnection
OWNER: PHONE #:
CONTRACTOR: BEN'S PHONE #: 503-2331779
Inspection Request Scheduled For: Date: '1217/2O06 Pour Time:
Code # Inspection Description Confirm # Contact # Message
146 NC or heating unit circuit 040806-01 5B-233-1779 N
Corrections/Comments/Instructions:
0 .
.
PARTIAL APPROVAL n CANCEL ' 0 NO ACCESS
FAIL I CALL FOR INSPECTION Lii ADDITIONAL FEES ASSESSED
Inspector: Date: Phone 718- (5O3)
� __'' ., � ^� "��_ �� #: ` ' ___Z-___C___,*. . _