Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00581
l� DEVELOPMENT SERVICES DATE ISSUED: 8/12/2005
2:1 eelIII
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109AD -12800
SITE ADDRESS: 14813 SW LOOKOUT DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT : 026 JURISDICTION: TIG
Project Description: branch circuit for power pedestal.
•
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 110):
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: 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:
WEST HILLS DEVELOPMENT WILSONVILLE ELECTRIC INC
15500 SW JAY ST PO BOX 845
BEAVERTON, OR 97006 WILSONVILLE, OR 97070
Phone: 503 - 641 -7342 Phone: 503 - 638 -5353
FEES Reg #: SUP 3854S
tion Date Amount EL 3
Description ELE 3 - 307C
[ELPRMT] ELC Permit 8/12/2005 $46.85
[TAX] 8% State Surcharge 8/12/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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- 332 -2 4.
Issued By: ���� Permittee Signature: M1 erl
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.
Aug 10 05 01:02p Wilsonville Electric 5036388804 p.2
�? ectrical Permit Application Mk t)rFlc1_ t sl: c)�l_l
City of Tigard 1 „�,/1L., N ��Y 05°. Mk
No _et 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie ,
Phone: 503.639.4171 Fax 503.598.1960 . 2005 . A , - 1 ' Date/By mit: Other Per ■
Inspection Line: 503.639.4175 ' ._" •' Date Ready/13y Id See Page 2 for '
Internet: www.ci.tigard.or.us Notified/Method: lL4l SupplementalInformatiort
1911V b i ij 1u PLA
❑ New construction ❑ Whii a�lieaotl'/iiplacement Please chock all that apply:
❑ Demolition Other: ❑Service over 225 amps, comm'I ['Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
0 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Multi- family ❑ Master builder ❑Other:
OBuilding over three stories ❑Feeders, 400 amps or more
V ` JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑RV par lured structures or
❑EgressA plan P
Job no.: I Job site address: / 7 r'I t3 5 - 1 ,.. r. t.,,,,, n, 'I f to ❑ Health -care facility ❑per:
Submit 2 sets of plans with any of the above.
City /State/ZIP: -r >6 J v' 1AC 7 A n L ?� / The above are not applicable to temporary construction service.
t FEE* SCHEDULE
Suite/bldg./apt. no.: Project name: /
� �
/r► l 7 '7 Description 1 Qty. I Fee. I Total I ••
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R. or less 145.15 4
Subdivision: ,..5k,4, r 1 Lot no.: Ea. add'I 500 sq. R. 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 Each manufactured or modular
M a dwelling, service and/or feeder 90.90 2
P 011 - , L — I� r `
1M- Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
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
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 I
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
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fcc for branch circuits with •
service or feeder fee, each 6.65 2
Business name: 1 s J L„ -1-• f�_ Q f _ p .) branch circuit
Vv`� �` r B. Fee for branch circuits / // /
Contact name: without service or feeder fee, 46.85 G�V, ! 2
• Address: each branch circuit
Each add'I branch circuit 2
City /State/ZIP: Miscellaneous (service or feeder of included)
Phone: (53) C / ` 7 3.4 a _� I Fax:: ( ) Pump or irrigation circle 53.40 [ 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Paget 2
Business name: J L- r >�ve d/ �+— —4 ..4
Address: p , r, rJ f s- Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: A ^ s .D 14 L, c: - t - -9 >71›, Investigation per hour (I hr min) 62.50
Industrial plant per hour 73.75
Phone: ( ' �) _ 3 '' t ELECTRICAL PERMIT FEES*
CCB Lic.: 7 Elec ellMr402 Supr Lie.: •,yam Subtotal 5/6 t
Suprv. Electrician si _
p gn • , re • { � Plan review (25% of permit fee)
Print name: �• _ _ / Date: v - State surcharge (8% of permit fee)
..•_?... -.1e a "' / R ,� j TOTAL PERMIT FEE n �
Authorized signature: fi' nI
� This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
. Print name: Date: • Foe methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i; lnu; ldingtPermits\t•'LC- Pum;tApp.doe 12/03 4404615 T(I0/02/COM/WFB
CITY OF TIGARD
BliOLDING DIVISION PERMIT #: ELC200 00581
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/12/2005
Phone: (503) 639 -4171 Sao 4 �I��
I
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 5
SITE ADDRESS: 14813 SW LOOKOUT DR CLASS OF WORK:
SUBDIVISION: ARBOR SUMMIT LOT #: 026 TYPE OF USE:
PROJECT NAME: ARBOR SUMMIT
DESCRIPTION: branch circuit for power pedestal.
OWNER: WE T HILLS DEVELOPMENT. PHONE #: 503- 641 -7342
CONTRACTOR: WIL 'NVILLE ELECTRIC INC PHONE #: 503-638-5353
Inspection Request Scheduled : Date: 11/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
11 Elec. cal service V 020978-01 503-638-5353 Y
Corrections/Comments/Instructions:
_ Y340 o
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
/❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /a Phone #: (503) 718-