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Permit A CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00108 al► DEVELOPMENT SERVICES DATE ISSUED: 3/8/04 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103CA 01100 SITE ADDRESS: 13260 SW HOWARD DR SUBDIVISION: WOODCREST ZONING: R-4.5 BLOCK: LOT : 010 JURISDICTION: TIG Project Description: Install sub panel and (8) branch circuits for kitchen remodel and AC. 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: 8 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: JORDAN, MICHAEL P + JENNIFER A HOTWIRE ELECTRIC INC. 13260 SW HOWARD DR PO BOX 2142 TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: 503 - 590 - 7817 Phone: 503 - 848 - 6823 Reg #: LIC 146276 ELE 34 -549C FEES SUP 4487S Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/8/04 $133.50 [TAX] 8% State Surcharge 3/8/04 $10.68 Rough - Elect'I Service Total $144.18 Elect'I Final 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. A " Jam, Issued By: c� / % i Permit Signature: "Aj1� 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: - 2N L DATE: d t! / F/6 L I LICENSE NO: 7 i-a7 Call 639 -4175 by 7:00pm for an inspection the next business day I Electric Permit Application FOR OFF USE ONLY . . City of Tigard DateB V Pemut No.: 13125 SW Hall Blvd., Tigard, OR 97223 P lan Revi /.__,... O' `00/45 Phone: 503.639.4171 Fax: 503.598.1960 ����� ,'1 l Date/B : Other Permit: Inspection Line: 503.639.4175 gJjp. A I . Date Ready/By: MI El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information -, ' =�rr,•�, tom,- 'u+„... = : �"� ' � eyc "K- � -:�;,se� . saa �.3:: "+ar�ti." - �ic:,a,x:�'a °�v'�,: x': fia' "��= ��..m .. _n ^;.' -�.z r..rs >e,re r.. °; .:� . . Tr' z fi %'reg10F,t }= WORTZ ' s ',r OIVKWi , �. 1 ,:.n-; ,.a . ">� I PLAN REVIEW; ,4.: . . :z.�'# . - w., ��� �. ; 4 .. 'ae ah'ua,,, ., . ' a ��.i; �z � _. ;.t .aa, i, ' �., 9. ?.ms ..07, , „�. .: _., w z.. ❑ New construction 4:J Addition/alteration /replacement Please check all that appl EService over 225 amps, comm'l P Hazardous location ❑ Demolition ❑ Other: ' .. t "x '' . , „ irk ;: t z , -, :,M _: _ > ;r E . *' " , ', at. , . rating EService over 320 amps ratin Buildng over 10,000 sq. ft. , ' t` ,r � Cl ir dO R OF O � N STT RU C i I W Isl N ,q A of 1 and 2 family dwellings 4 or more new residential [, 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑Buildin over three stories ['Feeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other: ['Occupant load over 99 persons EManufactured structures or g.1 ,;- , tl TOBSPTEIYkORMA7`IONAND LAT Nkr E ess /li htin 1° an RV park �. �,.e;� ❑ gr g gP Job no.: Job site address: / / EHealth-care facility ❑Other: / �G S �"IQ W �4 f Submit 2 sets of plans with any of the above. City /State /ZIP: r ` _( The above are not applicable to temporary construction service. µ Suite/bldg. /apt. no.: Project name: FEE *1'SGH Description Qty. Fee. Total 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: Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 ir g,k , ' E s , :t ESCRIPTIOP OF W ORK t fi 4 r ya m, r � p ?(., ; E ac h manufactured or mod l uar / dwelling, service and /or feeder 90.90 2 I t l GtiY r. f t' /� er -70J�, L / ,S u,y 1 0 4 ,,,L/ /' r �t L Services or feeders installation, alteration, and /or relocation 200 amps or less ( 80.30 !co. 3() 2 ...., nF„ - , _� - -.; 3.. x :,.,, >,.:,. -.t. --` . ,— 201 amps to 400 amps 106.85 2 Mar PRO ERT OWNER 4, ,. ) . ® TENANT , 401 amps to 600 amps 160.60 2 Name: ') . r n ; r To f d 601 amps to 1,000 amps 240.60 2 Address: e mti 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: ( 5-,,..?) S _ g - 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– new, alteration, or extension, per panel Mgr rv«,> " "= @° APPLICANT =: n r; t',k ;; t GUN : § 49N 4 `: A. Fee for branch circuits with . .- si' e�.,.H:- red,c:hu.az'.- .`rs�a�N te.:- 5 9:z.A,. -!_�, 1w.u. sa 1-' serv or feeder fee, each Business name: branch circuit _ 6.65 - 2 la w i I B. Fee for branch circuits Contact name: /9 f , ` 1S ncv4 without service or feeder fee, 46.85 2 each branch circuit Address: e b / L , . Each add'! branch circuit 6.65 2 City /State /ZIP: lF / Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( Yo 3) c 3 Fax: ( 6- o 3) & g� 3 !} - � J �s Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- t , . , ' • m � -^ �- ,,�'���,. _ � � r�� :. ': NGQN ,TRAC.,TOR,''��!��`.s�a =..,z,t» .����z »,�c�, "�,a energy panel, alteration, or 3 ��ts? extension. Describe: Page 2 2 Business name: { -o 1 i 1 •. ' / 5 . - / c t.' Address: n 0 d X L� Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: N, N 4, r a D 6, Investigation per hour (1 hr min) 62.50 Industrial plant per hour 73.75 Phone: ( a 3) g t/ - 6g Fax: (3 3) O t / S' – 6 t -3 ;t , . ,. � .. ,= � �r„�i,,;,_ ��� Amt- PER1VI EES�;�,?s} >.��wRSx CCB Lic.: Electrical Lic.: 3'» pi Y G Suprv. Lic.: ii t'/ 7..S Subtotal /3 3 , 50 Suprv. Electrician signature, required: %� 9 Plan review (25% of permit fee) ��p Print name: /n e � r5 n !t ` ' / Date: State surcharge (8% of permit fee) /� / � TOTAL PERMIT FEE 7 VIA t / g Authorized signature: This permit application expires if a permit is not obtainedyvittti -n -130_ days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. is \Buitding\Permits\ELC- PermitApp doe 12/03 440- 4615T(10/02 /COM/WEB • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: fro t7"`- 111 Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* TI Other: CO' MMERC gyp ITNE II: t1 i Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems • ❑ Boiler Controls I Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ H VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n M edical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ O ther Total number of commercial systems: • *No licenses are required. Licenses are required for all other installations i :\Building\Permiu\ELC- PeimitApp doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST 4 BUP Received CI: 2 2 Date Requested 1 Z-.63 Cri AM PM BUP Location / 3 2 &O6 4 Z7i4J icu - 2 Suite MEC Contact Person Ph ( SU3j S 2lr 9 Fl 7 PLM Contractor Ph ( ) SWR /� 411, BUILDING Tena wne IL. L ' S I '. A I ,- / .� (�C)` Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear lnt Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 4,0) Ck 4 1N 2wxa y I )0o n Other: Final r" T14 PASS PART FAIL PLUMBING • Post & Beam Under Slab Rough -In t1 Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final FAIL MECHANICAL Post & Rough-In Line Gas Line Srr oke Dampers PART FAIL 7' ELECTRICAL ' Servic- eugh -1 UG /Slab Low Voltage Fire Alarm ` i�.� ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. tii PART FAIL S ❑ Please call for reinspection RE: • Unable to inspect — no access Fire Supply Line ADA t Approach/Sidewalk Date �`©� Inspectors/ //�.JI _ �--• Ext Other: Final DO NOT REMOVE this inspection record fr m the job = ite. PASS PART FAIL