Permit ci CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00119
1,11�.� DEVELOPMENT SERVICES DATE ISSUED: 3/23/04
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 BC 02100
SITE ADDRESS: 08260 SW HUNZIKER ST
ZONING: I -
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: New wiring
Job No 30363 -3
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: 3 W /SERVICE OR FEEDER: 55 PER INSPECTION:
201 - 400 amp: 1 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:
JOHN ANNAND GREENWAY ELECTRIC COMPANY
8260 SW HUNZIKER STREET 15145 SW GULL DR
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 503 579 - 8054
Reg #: LIC 153421
ELE 34 -617C .
FEES SUP 5025S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/23/04 $713.50
[ELPLCK] ELC Pln Rev 3/23/04 $178.38 Elect'l Service
[TAX] 8% State Surcharge 3/23/04 $57.08 Rough -in
Elect'I Final
Total $948.96
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 . - e e • - . accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for • - .re than 180 da . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
h OAR 952-001-0016 ro:ghO�AR • 100. You may obtain copies of these rules or direct questions to OU �t�03) 246-6699 or
1- 800 - 332 -2344.
Issued By: _ `t/ , % &G Permit Signature: ■ . difLA :
OWNER INSTALLATION ONLY F The installation is being made on property I own which is not intended for sale, lea , , or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �. DATE:
LICENSE NO: ✓0r9.5-5
Call 639 -4175 by 7:00pm for an inspection the next business day
•
Electrical PertnitApplication :. . ,,I 1 ,.,v;
Date received: m0 Permit no ap -q�,
4 114 4
ICi of Ti raj � � v � � , j . 5, � R - Date received:
no.: Expire date: 1
City of Tigard Address: 13125 SW Hall Blvd, /ga 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 MAR 16 2004 Case file no.: Payment type:
Land use approval: CITY OF TIGARD
a. ■ •.
'I1I tII PI I2, ,
' & 2 family dwelling or accessory a ommercial/industrial CI Multi- family 0 Tenant improvement
0 New construction Addition/alteration/replacement 0 Other: 0 Partial
Job address: 8260 SW Hunziker St Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: I Subdivision: 4 jj ` iC® 6
Project name: Annand Remodel I Description and location of work on premises: New Electrical Wiring
Estimated date of completion/inspection: 4/15/2004
( 0\ I It \( I,O'It \t'I/ I( . \-I IO\ I I I ti( III DI I 1
lob no: 30363 -3 Fee M ax
B
i •
usiness name: Greenway Electric Company Qty. (m.) Total aO
Address: r -a Oft " per
1 5145 SW Gull Dr. sivreillagarlalmcbriesiataebedgarage. ^
City: Beaverton [State: OR I ZIP: 97007 Sor.>cehx deb
.� Phone: 503 - 5798054 I Fax: 579$056 I E - mail: Pm. rooney4(aZverizon 1000 sq. ft or less 4
CCB no.: 153421 Elec. bus. lice no: 34 617C Each additional 500 sq. ft portion thereof
City/metro lice no.: Limited energy, residential 2
Limited energy, non - residential 2
4. . .. I.. 3 -10-0y Each manufactured home or modular dwelling
S , : lur of supervising electri `/. (required) Date Service and/or feeder 2
4 Sup. elect name (print): James V R.. License no: 5025$ SenicasorfreNara— l�all>atloa,
aNdstlonorrdoardos:
11(011- R IN O1,5 \.I 12 200 or less
k/016 2
Name (print): 201 amps to 400 amps / f . 05, 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: [ZIP: Over 1000 amps or volts 2
Phone: I Fax: [E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
frateibtdon
which is not intended for sale, lease, rent, or exchange according to ,dteratioa,orretocatfoa:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 2
•
111111111111111111, s nick ckcuks - new, altenAios,
Name: or esrtenslo■ per pose/: �C� �
' A. Fee for branch circuits with purchase of i! sue'
Address: service or feeder fee, each branch circuit _ 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
1'l..\.\ 12 'I X I.I. \S dI',Ic;i c elar�rI ;III iii 1 t I ', misc. service orfieedernot r.
( included):
'' Service over 225 amps-commercial ❑ Health -care facility Each pump or irrigation circle 2
• Service over 320 amps -rating of 1$2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings Cl Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
0 Building over three stories 17 Feeders, 400 sego or Mir *Description:
0 Occupant load over 99 persons O Manufactured structures or RV park Each additional laspecilos over the allowable In any of the above:
❑ Egress/lighting plan a Other, Per inspection I I I I
Submit eats of pleas with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions permit application Permit fee $ 7/0,6D
accept credit cards, please call jurisdiction for more information. N ot i ce: This t
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at A‘' %) $ / 7 e . 3 e
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ 57 • G O q
Expires
accepted as complete. TOTAL $ 9 . 7 �O
Name of cardholder as shown on credit card
$
�
•
Cardholder signature Amount 4444615 (dowco>v)
'frit-
1.
CITY OF TIGARD ---�• ,
BUILDING DIVISION PERMIT #: "), (lc?
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 i ,�r / 11
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'
INSPECTION WORKSHEET FOR DATE: — . TIME: PAGE:
SITE ADDRESS: O z_ 6 (:. CLASS OF WORK:
SUBDIVISION: • LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: / PHONE #: CJ l 4 - r g
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
s _____c c rkel..?
Corrections /Comments /Instructions:
L J
p1/4/
D-
,,,
lA PASS I I PARTIAL APPROVAL _ CANCEL 0 NO ACCESS
- ' IL ) ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ CJ
Inspector: � Date:. ? ` (Phone #: (503) 718-