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Permit
C _ CITY OF TIGARD ELECTRICAL PERMIT r -e + "^ "' PERMIT #: ELC2005 -00199 DEVELOPMENT SERVICES DATE ISSUED: 4/1/2005 `�hi 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 110 D D -12900 SITE ADDRESS: 10955 SW HIGHLAND DR ZONING: R -7 SUBDIVISION: SUMMERFIELD NO.14 LOT : 699 JURISDICTION: TIG Project Description: Alteration of existing 120v service #TG21a1 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: KANAS, GUST /ANTOINETTE M TRS DRYER ELECTRIC INC 10955 SW HIGHLAND DR 9409 NE COLFAX ST TIGARD, OR 97224 PORTLAND, OR 97220 Phone: 503 - 639 -1900 Phone: 503 - 771 -5667 FEES Reg #: ELE 26 -1142C Description Date Amount LIC 153466 SUP 2876S [ELPRMT] ELC Permit 4/1/2005 $80.30 [TAX] 8% State Surcharge 4/1/2005 $6.42 REQUIRED ITEMS AND REPORTS Total $86,72 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. 03 - 30 -2005 13:37 FROM- T -933 P.011/043 F -594 . /O1 /2005 15:12 FAX 5035981960 CITY OF T1GAtu) ..t.. Electrical �t'ermdt A.pi1 ca tion t r: tJsl': OM, 'V I City of Tigard n c 1 elve d 0`�' ! P°111°-: tie-Ai/OS c /V 115 SW Harl Hlvd., T1gan1, OR 97223 •.se:Review - pne: 503. 639 -4 Fax: $03.598.1960 k'''' it: "1.1' ±1 f' Danar ; Other Perc spection Lunt: 51)3.639.4175 - fi!ti -" i_, ,, oak Ready/13y. roc Sec Page12 for :!1ternet wwa:. t. Netift edrMathod: _ � 1 p�� Su ppternGnc�t1 int ,,.x:.!-,,,--: . I I , 7 I ! I - r I r r Nr Y c J ..c 1 I ;fie 't5��t' h t x [ A I k d�. - • I , _ ;.' _. � . • .__..I •n I . � . ' _ .... I ,.:'} .. „ %. ';'••••:.::.•.' . .�u I ..:6e1:!SjrS;,,,,F., �O.��lti,$i_hCSt..a'LYW,•L._ t : ?. , �.. • —i New tops tru %tlan ❑ Add >t[on /alteratron/rtaplacetnent Please Ohecic E1) as apply: ❑Service ove. 225 atop_, convn'1 ©liazrrdou;, lulucency. DCIIlDl1111n [,, �j other f I i ❑service ovt: 327 amps -ninng ©8uildng oi 10,00.7 sq• f:., I p + .; ; f � , .'r^ ..,1:..r.'.':: I r t 1 1r� t r y 1 .41 , : l t l. i ti 4 G ': r eil 1 Of' 1- and 2.falr&ly dwellings 4 or more ;new residential • °System over 600 volts nominal baits in uric .structure 1- and 2 -f auily dwelling Q CarzuutareiaiG#rAdulStti;d 0 Arceessgry building (JEuilding o, or three stories ❑Feeders, 4:00 amps or more l�Iulti 7,.. _ • ❑ lvluste,. builder d Q� r ,r :,i•1 ❑Occupant load. co Cr 99.persons . OMsnufac !red structures or 7 .1 -1 I ti l ..,...,...3::,(.,....,..:77,;.....,::.,..,,,,,, 1 I I II t 1 ❑ EgressAigh izi P.414 �jR RV. pak :_ ._ .. ` t cur fa• tt b DD.: Job site : ■ dress: 55u br a i t • 2 sets. o} p • w i t h any • of the above. y �� name: ^ — nor t o temporary eonst7111etion service. , i !State /2"T ? _• above are 1 - • st y - �t �s - - • di[C/bitl$. /tiltt 'AO.: I' '�JdCt name: _ ---- •_ r [5ttcriptien - _ _ Qty. f Faa. I r Tour 1 .toss st['eet' irf ctiatls to job bite: T Kew residential single- or mold-family dwelling, unit includes a[eaclit.d };,stage. r ___ 1,0000 s . ft. or lets 145.15 4 ^^ Lot no.: add'! 500 ;;q. ft. or portion 33 -40 1 ubdi _ . ._ Limited energy, residential 75.001 2 lax map /parcel no _� Limited energy, tton_residentinl 75,00 • ' r I ai T,i' '.. 1 I , II.I i ry - _ `_i. Escl1t snufaai.r 4 ?1'tnodulnr :If ,. I I . * �.�' Services or :ceder 90.90,_ 2 � � dwelling, s f o a? s installation, Alt ration, and/6r retocatlon I t �� ...... . t� M ., ..............,.,.,....._ - 0 400 amps 106 8 , a Wit 2 00ampso 201 amps t S , ! , • ! ........ _. : _ . r I ,.; .., r u, ;`I,. 401 amps to 5(10 tulip 160.60 I, 2 1me_ �.c___ _ _. 4r 3 .. At i /3 rT J „ 601 amps to 1,000 amps M 240.60' 1 2 �.•� •►�� ''\\ // Y� /1 (?vet 1,000 sarr�ps __ va_Lf 454.651 2 reSS: , _l�.L_5 O� ea /7 �" `� ��� Reconnect only 66.85 z I "ity /StatefZD': 2 a 7,2-,2-V _ Teutporary survicai or feeders installation, atteretion, and/or C relocation 'nl t i. ( Q ) �-- / ,!),0 Fax ( ) 200 amps or less _ ; 66,85; - I 3wlter /1t3ta5tloa; This installation is being made an property that I own which is not 201 amps t� 400 amps 100.30? I 2 :.tended fort all;, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps [O 600 arcs ,s3 153,7511 z )wnvr sippetanrt _ o r e a panel — _.•,.... r . _t,•. :.... -."""^ a e q Feeforhr i h.viIceits Dt _ ,. l t , I v� 1 . .._. ._.._� _... or f eeder fee each n 6.65 p r .. n D e.Yre rr t ' i - ' � 2 _ broach circuit {usixtess Hart :_ . Fee for brand:. eircults 0f1tazt n8mt;: without service o: ,ceder fee, 46.85' 2 each branet. ci re? it _ .ddress: Beach add'lbrane5 :,rc 1it • 6.651 2 'iry/State/ZI?: T �` Miseellaneaur: (ter‘ ice or feeder plot included) Pump or inigaticn cac[c 55.401 T z 'hone: ( ) Fax:: ( ) sign or Quaint lia.kIr 53.40: [ 2 ,....,:p7,1:::: II z-s- v,,.' ; r - i 7 ` , ` i�{;. Signal panel „ dlturuli n, or L I G r _.,. ......... --._ :....- _ eneer oxtension, Descr:bra: Page � I • '3usinessn nLe: �►.`.. r '' _ . .. L [ k- each additional lnrprction over eilowI hIe in Hotly ol'the above :�ddrass: / if!” � � Par inspection _� -T i 62 -50 • • 1:4/State/21?: Ar f' investigation per hour (1 hr 1 I 62.5Q I i - j �� / ] t /� Industrial •larntI 1 /3,75 hoe: ) - � ► �v "�1 V�_ �:c a... �..._ a Ili' ;E r =lac SE .iralr :N ?i lia•••: � . : *.Fe • . .,, ' i :1 e • 'CB Lip.: Electrical Lic.:, b I LLP I Suprv. Lic.: . / /..� r, Subtotal ��� law '.iprv. Electrician sign re., required: P ler, rev (25% of permit fee) -. -- S:ate 3iirchar (8% of permit fee) e $ , _ pint name: or - N .r - . Date; ^ TOTAL PERlvft'1' FEE • <I I/ .. r • . •t.ut .gi attire: This permit alrp;icu+faa expires ti a permit i3 sot obtllne• with 1:0 I dpys zt:c; It bus bceu acacp as complete ';'iut t_Date: _ - Fee = the ecety eel 1yTi- Couneyj1u }leing(rd'.+= : Service 3oard • Number of t1'rp4etlt per permit e(17we4. ' ,.I;dinaWcrmialE :GPa•.uIiApp.doc 12/03 44C..' etrrt.o -a 'CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00199 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/2005 Phone: (503) 639 -4171 :mill V\ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/8/2005 TIME: 7:10AM PAGE: 48 SITE ADDRESS: 10955 SW HIGHLAND DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.14 LOT #: 699 TYPE OF USE: PROJECT NAME: COMCAST DESCRIPTION: Alteration of existing 120v service #TG21a1 OWNER: KANAS, GUST /ANTOINETTE M TRS, PHONE #: 503- 639-1900 CONTRACTOR: DRYER ELECTRIC INC PHONE #: 503- 771 -5667 Inspection Request Scheduled For: Date: 4/8 /2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004118 -08 503 -516 -3125 N Corrections /Comments /Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS No IL Z-CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: tO A Date: V - 4 - 0 , 1 Phone #: (503) 718-