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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00321 II' DEVELOPMENT SERVICES DATE ISSUED: 5/16/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S104AB -07200 SITE ADDRESS: 13165 SW KATHERINE ST ZONING: R -4.5 SUBDIVISION: MORNING HILL NO. 4 LOT : 101 JURISDICTION: TIG Project Description: (4) branch circuits. • 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: 3 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: BERQUIST, KATHLEEN CROWN VOLTAGE 13165 SW KATHERINE ST DANIEL TUCKER TIGARD, OR 97223 12607 NE 199TH ST BATTLE GROUND, WA 98604 Phone: 503 - 579 - 2920 Phone: 360- 666 -0995 FEES Reg #: LIC 153934 ELE 37 -984C Description Date Amount SUP 4494S [ELPRMT] ELC Permit 5/16/2005 $66.80 [TAX] 8% State Surcharge 5/16/2005 $5.34 REQUIRED ITEMS AND REPORTS Total $72.14 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: r�, Permittee Signature: j e 1 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 of the project. -- - - -- _ - Approved plans are required on the job site at the time of each inspection. Mal 13 05 03:25p CROWN VOLTAGE, INC. 1 360 666 4673 p.1 , - Electrical Permit Ap _ -,: ; i i FOR OFFICE lc LSE ()NIA' � ® / p A City of Tigard Rooeiycd r) 1`ccsnitNo. =� / Dawn • V 13125 SW Hall Blvd., Tigard, OR 97223 SAY . r PLn Review a, Permit: 503.639.4171 Pax 503.598.196 / t y 3 2 On�C -....-Pry �i f ' i Da2daX h See P y for Lion Line: 5Q3,63) 4175 v - =J.. base Ready/11y: r //� r sir dIMd1'd: /(J Nr n 1laferwsrioo humid; www_ci.tigartt-or. CITY OF NW;Gt — �- — ill Q New construction r1 Addition/alter ti i i'ciila0eMenI rlcasc check all that apply: ❑Scrvicc over 225 amps, oomm'l ©Hazinlous location C] Demolition Other_ - LServicc over 320 amps - riling 0 B3uildreg over 10,000 sq. IL, cxrEcoR' OF CON ,TRC'CTION of 1- mud 2- family dwellings 4 or more new residential building � � �� over 600 volts nominal units in one structure 1- and family dwelling Q Commercial/industrial Accessory DRui ov t dies QFeak�s, 400 amps or muse tvI ► tlti- family ❑ Maettx builder Other: El load Ovcr 99 persons 9Mnnofaeturcd slnicturcs ar JOB SITE INFORMATION _1/440 LOO(:A\TION C3 EgressllighiingMain RV park ❑ Flatlth.cnc iat:ilily ��� Job rte__ Job site address: 131 w sit) e t tt` Submit 2 sets of plans with any of the above, • City/State/ZIP: k r, • f d 6 The above are not applicable to temporary construction service:_ - -- FEE' SCHEDULE n Smtclttld aft no.: Project nttmc °am os _ o- l'•_- MICEIllil Cross street/directions to job site: New residential sinric- or multi fassily dwelling snit. _ /edaeies attached garage {,000 sq_ 1L or Ices 145.15 Subdivision lot no.: Fa add'l 500 sq. IL or portion 33.40 II - � Limited tasergy, residential 75.00 EN . i - ax map/parcel no.: Limited energy, ►- ridemia1 75.00 D1ttSY RLPTION OF WORT: Each manufactured or modular u \ - r I d•.dlietg, service and/or Cecile 90,90 Ma C ���c \ 1 �� L.i L L y A' V• Services or feeders inatrltatioa, alteration, aadlor relocation 200 amps or less 80.30 2 a.6 4°el 201 amps W 4011 amps �J 106.85 �� ruOrElr1 r OWNER — � 0 Tk =1V ANT 401 amps to 600 amps 160.60 Nance: . - 4 ' \ '' 601 ampsMA 1.000 amps 240 • Over 1,000 amps or volts - Address: Reconnect only 66.85 _ 2 City/State/ZIP: 'Temporary srervlces or rcceierx i istallatwn, alteration, aaiiior rcktcation Phone: ( ) Fax: ( ) 200 amps or loss _ I 66.85 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 intended for sale. tease, rent, or exchange, according to ORS 447, 449, 670, and 701 _ 401 amps to 600 ampes r 113.75 owner signature: - Dote- — Rriach circuits — new, alteration. or extension, per panel )] C ONT.�CT Y A. Pee for trench circuits w ith - 0 APPLICANT - . service or ft+eder fee, click 6.65 Business name: V branch circuit - - _ a foe for branch circuits Contact name:. without service or feeder fee:, 46,115 12 5 2 oath branc arcnit Address: . Each add'I botch circuit 6.65 l i 2 City /StateiZlP• Mised Aseeaus (service or seeder not included) - Pump or irtiQaiion circle 53 2 Pbonc: ( ) tax- - ( ) Sign or outline lighting 53 2 E -mail: J Sagan! ciiCuit(s) or limited- C ON T1tAt'rOR =espy panel. alteration. or 2 1 cctensio . i]cs ibC: Page 2 U Businec5 name: CA t y. • V • C _ e lC � - Each additional inspection over allowable ill any o f the ab0s e .. cN, Address_ .e (� 9 � ' ['a inspection 62.50 N- Chi/Stan:air: 144 { Investigation per hour (t hr min) • 62.30 `7 - 0'- -3 tnnlusltsa) plant pi r hour • 73.75 p Rboin:: (3&20, ) 6 (44 •'04 Qns Fax: (��) dO 'ELECTRIC �I_ 1'ttRT41 I FEES' ;^ D 6 CCB Lit._ C13 1 Elceinenl Lie.: - e.: 3 ( l Suprv. Lie.: �►/l6,s _ Subtotal �PCO • — uprv. Electrician signature, required: - Plan review (25% of permit fee) a / / �3 7 State smrctwtpc(x % ofptt mit tee) ,� .� Au name: DOA G �� mac / TOTAL 1' gam tee) .5 . 4,. AUtltorizcd signature: mis peril appl�an mires era perudt i ant nbtamtd within 180 - - - - - • - _ - - - - eta”, after it huJarea aeoepttd ac complete -- - - flat t~ . J • Fee nrcti<odolocyy !n by In-Comfy Baitdler, Industry Servile Board Print name: t( �, C I��CL T ♦ r 3 05 •• Numb er ofinas�i� oewnii Allowed. V • I • t CITY OF TIGARD 1 BUILDING DIVISION PERMIT #: ELC2Q0S.00321 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/16/2005 Phone: (503) 639 -4171 %himas il lpnlp��ll il t Inspection Requests (24 Hrs.): (503) 639 -4175 'I-. INSPECTION WORKSHEET FOR DATE: 5/20/2005 TIME: 7:11AM PAGE: 88 SITE ADDRESS: 13165 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: MORNING HILL NO 4 LOT #: 101 TYPE OF USE: PROJECT NAME: BERQUIST DESCRIPTION: (4) branch circuits. OWNER: BERQUIST, KATHLEEN, PHONE #: 503 - 579.2920 CONTRACTOR: CROWN VOLTAGE PHONE #: 360- 666 -0995 Inspection Request Scheduled For: Date: 5/2012006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 007343 -01 503.679-7802 Y Corrections /Comments/ Instructions: IS... -... 6 IKLPASS ❑ _ PARTIAL APPROVAL _ ❑. CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED j( 5 / 77,7 Inspector: Date: 6"-'02-4 CC Phone #: (503) 718 -