Permit CITY.OF TIGARD ELECTRICAL PERMIT
AP&
PERMIT #: ELC2005 -00274
i
DEVELOPMENT SERVICES DATE ISSUED: 4/22/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 CB - 01723
SITE ADDRESS: 10350 SW KABLE ST ZONING: R - 3.5
SUBDIVISION: HOOD VIEW NO.2 LOT : 022 JURISDICTION: TIG
Project Description: Hook up heat pump & add plug.
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+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ARNOLD, ROBERT J + VIRGINIA L TR HILLSBORO ELECTRIC
10350 SW KABLE ST 21185 NW EVERGREEN PARKWAY
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: Phone: 503 - 439 -9666
FEES Reg #: ELE 34 -4399C
LIC 134481 '
Description Date Amount
SUP 4941S
[ELPRMT] ELC Permit 4/22/2005 $53.50
[TAX] 8% State Surcharge 4/22/2005 $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 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.
Issued By: ' j j.� � j Permittee Signature: Slit- K,}\D Q
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 :HILLSB0R0 ELECTRIC LLC. 5036013680 04/21/2005 15:38 #460 P.002
Electrical Permit A e® FOR OFFIC:1 .iSi ONLY .
D ate Resdy /B
City of Tigard G Date /Bv. Received 7 ; -- -6 c,'° Permit No.: C- it , , 00) ly
13125 SW Halt Blvd., Tigard, 97223 1OQJ Plan Review
Phone: 503.639,4171 Fax: 503.598.1 RO tit . ifrRi' Dato/6v: Other Permit;
Inspection Line: 503,639.4175 \en -,, - N ,_ ; y: See Page 2 for
Internet: www.ci.tigard,or.us ‘_\I OF - A` , �S1� Notified /Method: .. to See
Infnrmut
G en
WORK ::. ; . PLAN REVIEW
❑ New construction Addition /alteration/replacement Please check all that apply:
['Service over 725 snips. comml Hazardous location
❑ Demolition ❑Other: °Service over 320 amps ,- rating ❑Buildno over 10,000 sq. ft.,
. CATEGORi' OF CONSTRUCTION- • ' . of I- and 2- family dwellings 4 or more new residential
711- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
]Building over three stories 0 Feeders, 400 amps or more
❑ Multi - family 0 Master builder 0 Other:
❑Occupunt load over 99 persons ❑Manufactured structures or
' - JOs SITE INFORMATION ANA LOCATION : .: l :' . '. ' • ❑EgressRi ghting plan RV park
❑Health -cafe facility QOther:
Job no.: 31 Job site address: O� Syv �,
�e>• Submit 2 sets of plans with any of the above.
City/State/ZIP: I l \j 'j V 1 61 ".. �] The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: p ,, �,,j ,
FEE *: SCHEDULE ,.:,
Description J City. I Rpp, I Total I .•
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: 1 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
' DESCRIPTION OF WORK:_,: '.::.:!. :••••••;:i- : :' " .: 4. or Each manufactured onodular
i,� (/� p /� ddwelling, servica and /or feeder 90,90 2
f 1��� 1' �f. (�1 � 1 f +� ✓ Services' or feeders instanation, alteration, and /or relocation
200 amps or less 80.30 2
.PROPERTY OWNER':' ; '' . ; .,.. ,., •. , d .; c ... LQT 1VANT -:!i:: : '
201 amps to 400 amps 106,85 2
40 1 amps to 600 amps 160.60 2
Name: k fO'V' A 4 ` 601 amps to 1,000 amps 240.60 2
Address: ,� r t l I� v✓�v Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City / State/ZIP: Temporary services ornstallatiun, alteration. and /or
Phone: ) l'K- V ()7... 1 Fax: ( ) relocation
200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 i 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
' .. ❑ •APPL CANT •:0• CONTACT PERSON;;;
A. Fee for branch circuits >, +;/h •
'service or feeder fee, each 6,65 2
Business name: , branch circuit
- _ ' B. Fee for branch circuits
Contact name: w, huui service or feeder fee, 46,85 j ' Sc 2
each branch circuit
Address: Each add'I branch circuit I , 6.65 (,Q • tr) 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) - 2
Sign or outline lighting 53.40 .
E -mail: Signal circuit(s) or limited-
_�: _
•
• . . .
; ::. .!.:•.:!:.:, '::: ever anal, alteration, or
: : ..
� ..... .. : •. ... CONTRACTOR :�� ::_ ,, , •
... . . energy P
extension. Describe: Page 2 2
Busincssname: Hillsboro 1ectric Li . L. C.
Address: 21185 NW Evergreen PKWY 1 1 Q Per inspection additional inspection over allowable in any of t abovr.
@ Per nspection 6. 5 3
Ciry/State /ZIP: Hillsboro, OR. 97124 Investigation per hour (1 hr min) 62.50
ax:
Phone: (5 0 3) 439-9666 1 F 05 0 3) 6 01 - 3 6 8 0 Industrial plant per hour 73.75
'ELECTRICAL PERMIT FEES: •: • . •
CCB Lit:. :1 3 4 4 81 I Electrical Lic„3 4 — 4 9 9 0 Suprv. Lie.: 4 9 41 S Subtotal .F) •5U
Suprv. Electrician signature, required:
4 1_44. Plan review (25% of permit fee) -
t~ y +�/ / State surcharge (8% of pen-nit fee) L., .
Print name: Joey Vitacco / Date: k b TOTAL PERMIT FEE C
Authorized signature: This permit application expires aril permit is not oltku w 1-1
days after It has been uccepted as complete
Print name: . Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
I:\ Building \Panics \ELC•PennitAlnldoc 12 /5 3 440-161R( 10/02/CDtvl/wEB
CITY OF TIGARD °'
.BUILDING DIVISION PERMIT #: EL /005-00274 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/22/2005
Phone: (503) 639 -4171 �I 1 1 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/12/2005 TIME: 7:08AM PAGE: 91
SITE ADDRESS: 10350 SW KABLE ST CLASS OF WORK:
SUBDIVISION: HOOD VIEW NO.2 LOT #: 022 TYPE OF USE:
PROJECT NAME: ARNOLD
DESCRIPTION: Hook up heat pump & add plug.
OWNER: ARNOLD, ROBERT J + VIRGINIA L TR, PHONE #:
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439-9666
Inspection Request Scheduled For: Date: 5/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 006665 -02 503 - 538.2953 N
Corrections /Comments/ Instructions:
Y PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( Date:' 1 --. hone #: (503) 718-