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Permit • CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00386 ,31d • DEVELOPMENT SERVICES DATE ISSUED: 6/8/2005 - -' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 CB -01711 SITE ADDRESS: 10125 SW HOODVIEW DR ZONING: R -3.5 SUBDIVISION: HOOD VIEW LOT : 010 JURISDICTION: TIG Project Description: AC circuit. 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: BERYL LASSEN GOT POWER 10125 SW HOODVIEW 17990 MONTICELLO DR. _TIGARD, OR 97223 _ GLADSTONE, OR 97027 Phone: 503 - 969 -9447 Phone: 503 - 722 -1295 FEES Reg #: LIC 158067 ELE 3 -589C Description Date Amount SUP 4678S [ELPRMT] ELC Permit 6/8/2005 $53.50 [TAX] 8% State Surcharge 6/8/2005 $4.28 REQUIRED ITEMS AND REPORTS Total $57.78 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 am s orth in R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at ' 503-246-6 99 or C a;�J�l/ /� �1� r 1 800- 323444// Issued k , ,..•!. Permittee Signatur - • ; ��� _L � Issued 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: %, ..:1- . ./APUPW V.r.�-�� DATE: LICENSE NO: C e 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. 06/06/200'` +1:16 FAX 5037221592 Got Power Electric [1002 Eleetr r j ermit ApplicatioL� s® OFFICE USE Ol' City of Tigard t Gtr �a ` °d L2 $ 13125 SW Hall Blvd., Tigard, 0P Plan Review Phone: 503,639.4171 Fax: 503.598,1960 ,1,`` (q r '� 7 05 A „ e.:i'i�( ;t a ; (jt Date/13v: t7 Pettit' Inspection Line: 503,639,4175 ,t oy \J � 1GA A!.�► r :I Date Ready/By: a See Page 2 for Internet: www.ci.tigard•or•u5 Notified/Method: ! Supplemental reformation ,-rV (�F .�otG�� 3:?"„ - iI' 4' - `. - 34r: :w.. y- •,`.r • i•v "',:1:f'�Lw.�d. .t�';i4Sei' :'. t:!Yx:i7i�.;� °574r� '�4�:�M. �:��d.12 °�M � .'1r,;.;.,, -: - - • t.>, 4 ,•r _ 4 ,�. 3 - °4 1.,,, •S.. = _w';lE::!.�,,,,.. ,y .i 1.., s.:ty.,- :.!� >.,.lu.,.;r:. M<_.?. a �.' ,�:.:;�.ti� �`� :it7 r, =�;:. .�' a ��` - �`t;� = "- iF�, _•ln �_ �:'.��e5•�t'��la.s ,. �_; li...._...,.... �_,,:, �t: •..C 0 New construction 16,7.d.' `dinon/alteration/replacement Please check all that apply: I ❑ Demolition Other" OService over 225 amps, comm'l 01- Ia2ardous location l ^��sl1U', - ter• ;1�. ;l,r, : . s.r -L "i: . .3` _ � 5 ❑ Service over 320 amps - rating ❑ Buildng over 10.000 sq. ft., ; . . $.,. _ „(. , , Af at aC?f �^ a2kk r : 5.0.0 ,l :r1 - t L P4 t ' v i:. -, ; - );:: =' ;t: 4 ,! , - . :s , '. of 1• and 2-family 'dwellings 4 or more new residential ;ii .t: " , , '. -. : , a rig at'r 1 ...x_, _-. - ..,.,.,. __.,,.,._4-^ ,. 3, Sit, r...,l:..k ::.:.., - r.:i;..:, /il 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building []System over 600 volts nominal units in one structure ❑ Multi- family ❑Building over three stories ❑Feeders, 400 amps or more ❑ Master builder ❑Other ❑Occupant load over 99 per sons 0., ry T� , �t�t r * ❑ Ivlanufacturcd structures Or tr , "(. 9 t t; } s 715 � , �+'fie %:6 a e 'e : , ' 1 ' ❑ s �?_wr t * �,..r,Pkl�,�"� , .:..�_ , .� :,.• r�' R�::,Y:a,,:N b / , �� „�s:7'h� ._�,R�t ,',� .. Egress/lightin plan RV park Job no.: Job site address: /12 / oZs 5W / I /61f/ Dry , ❑Health -care facility ❑Other: _ _ Submit 2 sets of plans with any of the above. . City/State/ZIP: -i 2 ,4Y_2) o, 9 '722 3 The above are not applicable to temporary construction service. Suite/bldgiapt, no,: Project narne: 4.6 e . / go. vjT • rl rr ""`' t_ "'' :, , .- �" Description QtY• I Nee. •'•, Total Cross street/directions to job site: . 5 - 4 0 /4 j .P ir,,lid , j-konfoeui New residential single - or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft, or less 145.15 4 Subdivision: J Lot no,: Ea_ add'1500 sq. ft. or portion 33.40 • 1 - Limited energy; residential 75.00 2 Tax map /parcel no.: . c residential 7 - • 2 t . .:, „ _.:r.,_; `? , y , �� ,m �.c,• , _ ^;; .. 'ta., Limited nergy, no n 1.:�'� E ' +5✓ .. °qq� jJ iA, ,;A `7� .^ 5 V '. ; . ..- L..'e.�Q r/6 r/ c � 5 't' °s i C' : : Each m anufactured or modular r .,. C..- r��`,`� "$',1�1�'�1" ": ,4:c , {R:a +nit[" _... i...._ t;'.:.•....:_ l.''=` 6. �.. �.. �. 3. � .3�-- �'a1«,::�• � /z ( } dwelling. service and /or feeder 90.90 2 Ar G c/( t 1d (7 - „.. T I4 / £ar -Q. Services or feeders installation, alteration, and/or relocatio i t/ . fV 0-(-A5/4d-X-- 200 amps or lest 80.30 2 uy � yn; �� � � ;� _: r• sy �` '+ ' :x, y = 2fl1 amps tc 400 arrtps 106 - 2 � •Firiii' �Y l�. "^ otl gy� :, r ,i• !h4 M.S4: : ?jI:rii ki .y ;.> `.w.via� > ', a .�,x:; , . ���. „, �� - -_� ;,Q;,�• �r.� ;iiti= _.�; ;?-:;r, qpl amps to 600 amps - 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: 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 Phone: ( ) 1 Fax: ( ) 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- flew, alteration, or extension, per panel 3 y y . til � ,,p,, _ ' r z A r t i gy . , i A. Fee for branch circuits with n. + k.,.a a,, l:t ;,," ,P ,.. ,._ , i '4 t ii;S ,,.��`� ✓✓ service or feeder fee, e ach • 6.65 2 Business name: 6:->E2.1-- ' Y ! i ' y-7 /G branch circuit C `� B. Fee for branch circuits Contact name: . " - a, / _ without service or feeder fcc, / 46,85 �f �� 2 each branch circuit (�,. Address: / Mr-174 /G e)/D � J � ' Each add'1 branch circuit i 6,65 4 ,65 2 _ City /State/ZIP: ( j;( 0 J ©2 �7v Z 7 Miscellaneous (service or feeder not included) ^ � y Pump or irrigation 1 in circle 53.40 2 Phone: ( ) , ./-2.9 Fax:: (5D Z t Z Sign or o lighting 53.40 2 E -mail: t • Li%ef j co- x-4Ca5't , //1 ,. Signal circuit(s) or limited - - ., . r , 4 , ..- ,•s i s , aNZ'' �u� , •;g:- """•.4'f"+`- IIR crier Pane'. alteration, or '. a to r. i � " ;Ci" 11rau= 5+ � SYp Page 2 2 tuc'K,6-I .1 �`z�i *. ' ,, •.J: -` �.s :.7ci\4 4:�, i54tt=�' =o �. � "- .:�vt_y'as�t,r;a a6:�:::� extension. Describe: Business name: � ��` � ,�� /i'L t • Each additional inspection over allowable In any of the above Address: 5:41711,6 Per inspection 62.50 City /State /ZIP: r 0 Investigation per hour (1 hr Rain) _ 62,50 i / Industrial plant per h our 73.75 Phone: ( ) a :sue 05- Fax ( `j 0 (■ D ?; r _ 1Y ma t y."': ,>=- t fit „, : r< GCB Lic.: /5 7 Electrical Lic. :3 � 5 e-- Suprv. Lic.: E/6, 785 Subtotal 5 '3, 5 Suprv, Electrician Signature, required: 1 ?�y /' "v /gee.,, I Plan review (25% of permit fat) Print name: , ' � � r • ., Dater -� S State surcharge (8% of permit fee) s � p� f ( TOTAL PERMIT FEE .� / 7 .7 2- 3 e l J ✓ • S Authorized signature: /t`?" i.,_ Thin perarit application expires if a permit is not obtained within Igo ' a �7/ / days after it has been accepted as complete Print name: /ft( c ` /,•�' Q G, Oil. e ' u 'Datc:G --G " 6 ,s • Fee methodology set by Tri•Cotmty Building Industry Service Soard -- Number or inspections per permit allowed. is\Building\Permit l5LC- PermitApp.doc 12/03 440- 06157(1c /O71COM1wm .r CITY OF TIGARD BUILDING DIVISION' PERMIT #: ELC2006- 003f36 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/8/2005 Phone: (503) 639 -4171 : Applo I i Inspection Requests (24 Hrs.): (503) 639 -4175 :..,... INSPECTION WORKSHEET FOR DATE: 6/15/2005 TIME: 7 :16AM PAGE: 106 • SITE ADDRESS: 10125 SW HOODVIEW DR CLASS OF WORK: SUBDIVISION: HOOD VIEW LOT #: 010 TYPE OF USE: PROJECT NAME: LASSEN DESCRIPTION: AC circuit. OWNER: LASSEN, BERYL PHONE #: 503- 969 -9447 CONTRACTOR: GOT POWER PHONE #: 503- 7211295 Inspection Request Scheduled For: Date: 6/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # essage flitif.( 199 Electrical final 009263-01 503- 753 -9362 Y Corrections /Comments /Instructions: / e . . X SS ❑ PARTIAL APPROVAL ❑ CANCEL [11 NO ACCESS ❑ FAIL 1 F(1j;1": ION ❑ ADDITIONAL FEE ASSESSED f /0 1, / Inspector: Da Phone #: (503) 718 �