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Permit g ITY O F TIGARD ELECTRICAL PERMIT �, i DEVELOPMENT SERVICES DATE ISSUED: 7/6/2005 �� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PERMIT #: ELC2005 00477 PARCEL: 2S110DD -05400 SITE ADDRESS: 10600 SW HIGHLAND DR ZONING: R -7 SUBDIVISION: SUMMERFIELD NO.4 LOT : 154 JURISDICTION: TIG Project Description: Installation of (3) branch circuits for a /c, furnace and GFI. Job No. 3265 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: 6014-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: DAY, DAVID A + MARTHA KAY HILLSBORO ELECTRIC 10600 SW HIGHLAND DR 21185 NW EVERGREEN PARKWAY TIGARD, OR 97224 HILLSBORO, OR 97124 Phone: 503 - 670 - 4092 Phone: 503 - 439 - 9666 FEES Reg #: ELE 34 -4399C L1C 134481 Description Date Amount SUP 4941S [ELPRMT] ELC Permit 7/6/2005 $60.15 [TAX] 8% State Surcharge 7/6/2005 $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. Speaalty 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 a - -t fort OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 -24f -6699 or 1 -80- Issues By: ii 11A Permittee Signatu4 • 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: -' z!..„;!, / ' ` (4 --R-- --- 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. • v% Frorn:HILLSBORO ELECTRIC LLC. 5036013680 07/01/2005 16:57 4974 P.002 /002 ,1 1 rtrtrt NED G - : ,;� c Electrical Perlmit p ation FOR OFFiCI USE ONLY City of Tigard I'tJL 0 5 2005 Received 7 ` �,�,/ Permit No.: ESGoaS'e DDate/13 ; d 7 ' e/ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503,63A,4171 Fax: 505,598,1960 OF FTIGAR 'k' 4 ' i , patolBv: rY Other Permit: Inspection Line: 503.639.4175 L s PI NG 0IVISIO' r n ' Date Ready /By: �� 2 See Page for Internet: www.ci.tigard,or.us BU�� Notified/Method; Supplemental rnfarnsntion • TYPE OF WORK . PLAN REVIEW ' ❑ New construction []Addition /alteration /replacement Please check all that apply: Demolition E2 Other: Service over 225 snips. comm'l ©Hazardous location ❑Service over 320 amps — rating ❑13uiicing over 10.000 sq. ft, . • CATEGORY OF CONSTRUCTION • ' • • • . . of I- and 2- family dwellings 4 or more new residential • I and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories • OFeeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons El Manufactured structures or . JOB SITE INFORMATION'AND LOCATION ; :' ❑Egress/rightingplan RV park - ❑Henl[h -care facility ❑Other: .lob no.: Job site address: I L n . , Submit 2 sets of Is with any of the above. City /State/IP:T /� aid q 177.4 The above are not applicable to temporary construction service, Suite/bldg./ape no.: " 1 Project name: DU FEE" SCHEDULE . :. '... :... p Description ! .:: j Qty. I Fre. I Tel •" Cross street/directions to job site: New residential single_ or multi - family dwelling unit. Includes attached garage. _ • _ 1,000 sq. f. or less 145.15 4 Subdivision: Lot no.: Ea. add'' 500 aq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel rig.: Limited energy, non - residential 75.00 .. ... ,., DESCRIPTION OF WORK' «::- �,; , : : : : :, : -�' :;:::; ; .,... . , . • Each manufactured or mo dular Air Q iV'16 + � . 1 dwelii service and/or feeder 40.90 '� lAl' 1 t "� Services or feeders installation, elteration,and /or relocation 200 amps or leas :: •: , 5 .... 201 amps to 400 amps_ 106.85 2 OWNER - . ,. ,: .PROPERTY � .. : :. :,�, • ❑' TENANT.;;:.... "' 401 amps to 600 maps 160.60 2 Name: ' VA ®n _ 601 amps to 1,000 amps 240,60 2 Address: ,A. J A 5 dew V Over 1,000 amps or volts 454.65 2 • Reconnect only 66.85 2 City/ State/ZIP: Temporary services or feeders Installation, alteration, and /or relocation ?� — t[� _ Phone: ( ��r Fax: ( ) 200 amps or less 66.85 t 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 ex tension, per panel : ❑ AP L : :, : ;,., , , . :.. : ❑ CONTACT PERSON;;: `;:! : A. Fee for branch circuits with ' service or feeder fee, each 6.65 • Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, O each branch circuit ` 46.85 n 'Q 2 - Address : Each add'l branch circuit 7 6.65 v . J 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 n 2 E -mail: Signal circuit(s) or limited- CONTRACTOR : .. ,. • .;,-;:.:::;•.' ° energy panel, alteration, or extension. Describe: Page 2 2 Businessname:Hillsboro. Electric L.L.C. Address: Each additional inspection over allowable In any of the above 21185 NW Eve rgreen PKWY Ste #110 Per inspection 62.50 City / State/ZIP: Hill sboro f OR . 9 7124 investigation per hour C l hr min) 62.50 Phone: (5 0 3) 439-9666 Fax: (5 0 3) 601 — 3 6 80 Industrial plant per hour 73,75 CCB Lic.:1 34481 Electrical Lie. :3 4- 4 9 9 C Suprv. Lic.: 4941S • Subtotal Sttprv. Electrician signature, required: / Plan review (25% of permit fee) Print name: 1 Date: State surcharge (8% of permit fee) , 5j l Joey Vi tacco 1 i . TOT AL PERMIT FEE 9 , �( Q Authorized signature: Thi permit aeereatien expires If n permit is not obtained within 180 - days after It has been accepted as complete • Print name; Date: . Fee methodology art by Tri- Counry Building Industry Service Board •• Number of inspections per permit allowed. i; t[l uildi ,aApanniaa \ELC- PormiIApP.doc 12/113 .40"4r, /COMN✓EB , . . . CITY OF TIGARD Twvt\u„ -5.A.-Aklii-i--) BUILDING DIVISION PERMIT #: ELC2005-00477 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/6/2005 Phone: (503) 639-4171 amp#11141Iliti Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 7/11/2005 TIME: 7:07/0/1 PAGE: 90 SITE ADDRESS: 10600 SW HIGHLAND DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.4 LOT #: 154 TYPE OF USE: PROJECT NAME: DAY DESCRIPTION: Installation of (3) branch circuits for a/c, furnace and GFI. Job No. 3266 OWNER: DAY, DAVID A + MARTHA KAY, PHONE #: 503-6704092 CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439-9666 Inspection Request Scheduled For: Date: 7/11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final V 011065-02 503-638-2953 y M il/ 4 " IP° Corrections/Comments/Instructions: A C " A 4 , i 4 0 1 I ,i rttAr_ 1,ie.Z..■M ■lf i i1' __.itAr(i... ' _. A' — OV • g PASS El PARTIAL APPROVAL El CANCEL Li NO ACCESS n FAIL El ALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED 1,--(frac Inspector: Date: ( Phone #: (503) 718-