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Permit CITY TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00772 11, `- D EVELOPMENT SERVICES D ATE ISSUED: 12/7/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111 BC 00500 SITE ADDRESS: 10055 SW INEZ ST SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R-3.5 BLOCK: LOT : 019 JURISDICTION: TIG Project Description: Kitchen remodel. 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: 9 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: JOHNSON, MELISSA & ED WILSONVILLE ELECTRIC INC 10055 SW IN EZ ST PO BOX 845 TIGARD, OR 97223 WILSONVILLE, OR 97070 Phone: 503 - 624 -5003 Phone: 503 - 638 -5353 Reg #: SUP 3854S LIC 75752 FEES ELE 3 -307C Description Date Amount Required Inspections [TAX] 8% State Surcharge 12/6/2004 $8.54 [ELPRMT] ELC Permit 12/6/2004 $106.70 Rough -in Elect'I Final Total $115.24 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and .11 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 . iss ance, or i ork is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oreg. tili 1 of .tio• C-nter. T• :.e rules are ()AR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these ru ° - -c questi.p o *1.1• at 0 246-0 9 or 1-800 -332 -' 44 V lss d By: ,_ 0 / VI i, Permit Signatur: 21111. Li m 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: *ON - , CTOIVN > AL ATIS//ONLY SIGNATURE OF SUPR. ELEC'N: �',—.... 4 � DATE: l W7A LICENSE NO: $ -' Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Applic t' FOR OFFICE USE ONLY City of Tigard leo v i E!ie PermitNo.: 1312SW Hall BdTigars ;aa Uyq".'' d Other Permit Phone: 503639.4171 Fax: it . 98.960 , te ' l� '' y inspection Line: 503.639.4175 ® CC ®� Ready/By: to ®' See Page 2 for Internet: www c1.4gard or us p P O `�• I Date Ready `` Notified/Method: /i4 Supplemental Information _ \ p` -x i'.. rl'" j 1A "p 51 F 'r' S lnYl : �e �p 1 f '` W! I O l i Y' � '�4 p'1!' P . �(i�l 1 A '� 1. il t { '.�J ! I k 5 E - Y >' x t' 1.:';', s ;ti r, : , : ' 1 D `, ®, k M.z. 4 ' k.°. k �� _, , ,R9 � 4o,, .2 q, na .: e i,,0 , �. A la i .,t �,' VZ W s: , � �� " . El New construction ` - • • :' •it /alteration /replacement Please check all that apply: f' ['Service over 225 amps, comm'l ❑Hazardous location ❑ Demolition Ej Other: .„, over 320 amps - rating ❑ Buildng over 10,000 sq. ft. ,�' �• ti ;i i i t ke 1 vNi nc a 5lara�. r! - rtl Ui s i,5'At�I.i - d,,,a � ' i -' " ; ! + = ,- kt' h r 1 "M"4' GATEGO tY*iUF p�„41, l' tL1G 4 r © .1Sr -,; � ' :.,, ; h n i a ,, ; , of 1 - and 2 - family dwellings 4 or more new residential "' ['System over 600 volts nominal units in one structure � % / I - and 2-family dwelling 0 Commercial/industrial 0 Accessory building ❑Building over three stories ['Feeders, 400 amps or more ❑ Multi- family ❑ Master builder ❑Occupant load over 99 persons ❑M Other: anufactu red structures or - •. - �• � .�,:..4 -.. ,�.,, ,..�. . , ,i' F ".y "y � l?P+ 1 ) tl' a " ";.# :n j�i\n t v tr ,T, x i JOW 4I E' I f+EURI IATZO,1�''_ ," Tff �1 0 T I�11' � ' ` ,'. ,', h ti� , ° ❑E /li plan RV park v�..51�' ��..�:. ���._ _. ['Other: "" s ❑Health -care facility Job no.: Job site address: /0 �' S'� �c �► J. _�/� �z. Submit 2 scts of plans with any of the above. City /State /ZIP: '7/ QQ, « 9 7 Ley The above are.not applicable to temporary construction service. y ,,.. 1 „ „ }r ' +Y?,',tii add: �ti'f<i�'1'` F__� ;';¢;..: _ WI ut:'�`;ih ri +; ° "c <;,i -..'i <�, ,i.;"� 'qAt, e .t i` � ktu,' "tom' Y.a t . „l Y". a �!�.urP P l i._�„ Suite /bldg. /apt. no Project name: ,3-0 Cµ C J Description Qty. L Fee. Total ** Cross street /directions to job site: ii9/2 ''�� 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'l 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 ` i. I ; �' tD11 gO11P`TION (;t rWO'tio -r i , "'' ; t , tr ; t"" r �_; a Each manufactured or modular dwelling, service and /or feeder 90.90 2 / / i' ) 0_6NA v D g L- Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 as••;..� ;f�..�r�:':, =�;:�n ° , °Yri .: {�.= ;,,.-�,a..�;rz,,r,tL�,n : st�� ; ;;'.t�;��;r , -.fir: 201 amps to 400 amps 106.85 2 7 ROPT2WNER iY , " ' N W e , r:. a- !`,``wl' x,. ,t) { to r f ,;. asr4... ,' 401 amps to 600 amps 160.60 2 , i4.-...,.. 1 . , :. , e. , ' yk Name: 0 0 601 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: () tg 9,4 00 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 g gyp (�* ���.�: - . x,,: �M� . � ",� ^¢ ��- . -_' -- s� . , r +�.. , {� rat, ���l :� "."`;�'t!: ,:!iuy; iw x ". „;�., A. Fee for branch circuits with . C ' Ji P .„ •ttY.. ICA1 ,> .':..e7 eYPrV a .'S k 4 © �� r I Ei G,4Adm , i�A t l .�W y� i M .. , ..� ' °'�'�� """"' '� "- service or feeder fee, each ' 6.65 2 Business name: branch circuit - - B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 ,Cl Q each branch circuit _lief/ Address: Each add'I branch circuit q 6.65 ,j e)'I t 2" City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - t �r u Y 41 f fr t ;� k 7 r� tc� �fi a hell kt `, r energy panel, alteration, or ,�!..,�'�. '�3at : ��' ,,.N�.i.n- >st'- ���Na , s ®'v�',4�_� tT3 " „ "�.�-�.!a�� . a. a,ti extension. Describe: Paget 2 Business name:14 j,[„50,,jV /I E /- -- / � P � � ergs. Each additional inspection over allowable in any of the above Address: Per inspection 62.50 City /State /ZIP: 1.4)92. S' f v,t1 a10 •Ll- 0�. 147a la Investigation per hour (I iv min) 62.50 , ) Industrial plant per hour 73.75 Phone: ) 3 .., $ -- •x: (c`)� b ",- #j �/ N;'ial' r':1iA= 'let; If .. _CAL,''<jP, 'I FLES' *i " ° °I,; I,: ,: 3 3 � .�J 3 7 ,'.iNitii;�rNrt4s �� +I< "1'� •C-,. ..._:,,�, ,. 10 ,,.�. �.,�,�_.�tid..- �.:_ia`,... , , CCB Lie.: -7 Electri' . • -30-7 pry, c.: 385'5.5 Subtotal / 4. - X 7, 0 . , Suprv. Electrician signature; ,- ignature es ,/ Plan review (25% of permit fee) � 9 ../ 1. / State surcharge (8% of permit fee) e Print name: ` P - r i �vf D- e: °� �� y TOTAL PERMIT FEE Sa 2_,L1 Authorized signature: This permit application expires if a permit is not obtained within 180 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. 1. \Boildine \ Fenno \ELC- PamitAoo.doc 12/03 440 -461 ST(10 /02 /COM /WEB CITY OF TIGARD . 24-Hour BUILDING Inspection Lit (503) 639 -4175 INSPECTION DIVISION Business Line: (503 639 -4171 MST BUP Received Date Requuste�d • — cQ 3 AM 1 PM BUP Location /D 0 S� �'" �"t Suite MEC Contact Person --- i� -1/I/L V Ph ( ) 63 iS , 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC a U 0 q- b 7 2. Footing ELC Foundation Access: tdhe.-Dom,44. -5 , i bti , Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear A f Framing t�l ®" � ca� r i C G-�C- - c v`7 l Insulation 4 k'Ofa/Gz ,• /4 �'�- /•�1 u �� `T't,�� Drywall Nailing Fi reveal I / Fire Sprinkler /S �� �� Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING a.; fr Post & Beam - Under Slab Rough -In Water Service - Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL .MECHANICAL:-•:: Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL ` 1 Service l Rough -I I fs UG /SI .. . Low Voltage fer0) /440.: F -'l - m � PART FAIL fl Reinspection fee of $ required before next inspectio . Pay at City Hall, 13125 SW Hall Blvd. . ''• Please call for reinspection RE: Unable to inspect – no access Fire Supply Line /� ADA � D �-- " ` Inspector - Ext Approach/Sidewalk — - Other: Final DO NOT REMOVE this inspection recor rom the Job site. PASS PART FAIL