Permit pr
'"CITY OF TIGARD'
ELECTRICAL PERMIT
PERMIT #: ELC2005 -00378
DEVELOPMENT SERVICES DATE ISSUED: 6/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103CA -00601
SITE ADDRESS: 13465 SW HOWARD DR ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 2 branch circuits. AC and furnace.
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:
STOCKAMP, MIKE HILLSBORO ELECTRIC
13465 SW HOWARD 21185 NW EVERGREEN PARKWAY
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 709 -7033 Phone: 503 - 439 -9666
FEES Reg #: ELE 34 -4399C
LIC 134481
Description Date Amount SUP 4941S
[ELPRMT] ELC Permit 6/3/2005 $53.50
[TAX] 8% State Surcharge 6/3/2005 $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 are set forth in OA 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 -8 - 332 -2344.
Issued By: _ �i Permittee Signature: 'j�/fr
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.
, From :HILLSBORO ELECTRIC LLC. 5036013680 06/02/2005 17:17 #743 P.002
y
Electrical Permit Ap i it10 NE FOR Cll +'!IeI USE ONLY
City of Tigard Deceived / Permit No.: C..)(55 t/ d ?
13125 SW Hall Blvd., Tigard, OR 97223 qA�, Q Plan Rovie
Phone: 503.639.4171 Fax: 503.598,1960 014 o J i0,:,o • �f 'Ai"' { 't Date /By: Other Permit' '
Inspection Lino: 503.639,4175 -
_ ,f. 4 ,',r „a R
•I : Date Ready /By, 10 See Page 2 In
GI
Internet: www.ci.tigard.or.us �Y °F No tificd/Method: Supplomentnl Information
T1 fs� WORK 01%/ISO PLAN REVIEW - • ..
❑ New construction • ddition /alteration/replacement Please check all that apply:
❑ Demolition Other: ❑Service over 225 amps, comml ❑Hazardous location
❑Service over 320 amps - rating OBuildng over 10,000 sq. ft., •
• CATEGORY OF CONSTRUCTION ... of i- and 2- family dwellings 4 or more new residential
• 7 and 2- family dwelling 0 Commercial /industrial 0 Accessory building ❑System over 600 volts nominal units in one structure
Building over three stories OFeeders, 400 amps or more
Multi- family El Master builder Other:
❑Occupant load over 99 persons ❑Manufactured structures or
• f OB SITE 1N.FOItMATION• AND, LOCATION ❑Egress / lighting plan
RV park
Job no.: -5Z2., Job site address: `3kk,„6 tom? 6 [Health-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: _- . /() 7, The above are not applicable to temporary construction service.
-
:' :PEE** SCHEDULE
Suite/bldg. /apt. no.: Project name: _
Description r Qty. [ PCC, I Total I ',
Cross street/directions to,job site: New residential single- or multi t`amily dwelling unit.
- Includes attached garage.
• ! 1,000 sq. ft. or less 145.15 4 -
Subdivision: — 7 Lot no.: — Ea. add'I 500 sq, ft. or •ortion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: 2
Limited energy, non - residential 75
.,..:..,. , .., :i..:.. DESCRiPT10N OF WORK' ^:.” :`:; .. ,...., ._ modular
Each manufactured or
' • l
l dwelling!, service and/or feeder , 90,90 , _ 2
•�
mok Ala. -_ Services or feeders Installation, alteration, and/or relocation
200 amps or less �- 90.30 • 2
....�. ••. 201 amps to 400 amps 106.85 2
.:: PROPERTY OWN�Ii. ,. �:: :'•:' . " Q TENANT:,'_ ;. , °, .,,`.;:.•....:.
" 401 amps to 600 amps 160.60 2
Name: ,f.i.\� 601 amps to 1,000 amps 240,60 2
Address: 1'"j,-`� � ,43 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: t:? / p' 7 �1 — 4Z Temporary services or feeders Installation, alteration, and /or
relocation
Phone: ( ) I Fax: ) 200 amps or less 66.85 I I
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 am .3 100.30 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, er panel
0' •APPLICANT;':.:: • ii:._ *.0 C ON.TACi - PERSON::: 'r
A Fee for branch circuits with
•-- • service or feeder fee, each 6.65 2
Business name: branch circuit .
B. Fee for branch circuits
Contact name: without service or feeder fee, ;( C ` 2
each branch circuit 46,85 uI • 4✓
Address. Each add'I branch circuit i 6.65 J t , � A , t p- 2
City /State/ZIP: Miscellaneous (service or feeder not included)
- Pump or irrigation circle 53.40 2
Phone: ( ) l=ax: ) Sign or outline l ighting 53.40 2
• E -mail: . Signal circuit(s) or limited-
.: ..:•::......::. . •:.. •..:,• . CONTRACTOR . ^::;= ;•::.'::: .:'.' `.:.i: ' T... ::: ,: '..; ::'.::.:�:. e nergy panel, alteration, or
extension. Describe: Page 2 2
Business name: Hillsboro Electric Z.L.C.
Address: Each additional Inspection over allowable in an1of the above
21185 NW Evergreen PKWY Ste #110 - Per inspection 62.50
City/State/ZIP: Hillsboro, OR. 9 71 24 lnvestilation par hour ( I hrmi.+) 62.50
Phone: ( 50 3) 439-9666 Fax: (5031601-3680 Industrial plant per hour 73.75
•• • .ELECTRICAL PERMIT FEES' • ,
CCB Lic.:1 3 4 4 81 Electrical Lic.:3 4 - 4 9 9 C Suprv. Lie.: 4941 S Subtotal 53. r�O —
Stiprv. Electrician signature, required: r� Plan review (25% of permit fee) ---
State surcharge (8% of pennit'fee) 1--( 2Z
Print name: Joey V 1taCCO Dam' - 4 TOTAL PERMIT FEE 5-7- - 7-$
Authorized signature: This permit application cspiten ira permit in not obtpined within iSD
-- days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- Counry Building Industry Service Board
— ** Number or inspections per permit allowed.
i:\ DuiIdi \PCrinile\E LC-PermiIApp.dec I 2 440 -46I 5' IWt1Z/COM(W6B
CITY OF TIGARD ,. )
BUILDING DIVISION - PERMIT #: ELC200S -00378
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/3/2005
Phone: (503) 639 -4171 : r��/0101iI�l;l�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 78
SITE ADDRESS: 13465 SW HOWARD DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STOCKAMP
DESCRIPTION: 2 branch circuits. AC and furnace.
OWNER: STOCKAMP, MIKE, PHONE #: 503 - 707033
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503- 439 -9666
Inspection Request Scheduled For: Date: 7/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 010680 -02 603-538-2953 Y
Corrections/Comments/Instructions:
iZ 0 R r - T - 0/46W 6.70.0c
. l d. 0 c 6 y 1- s 0 E
CC?- - N n4.-0
CA i
K DASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ✓ - ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: —� Date: h one #: (503) 718 -