Permit A S.
.3u n,12 08 11: Ron Cox (5031 364 -7818 p.1
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Electrical Permit A li ciE D
Pp
L poem City of Tigard N 1 3 2008 r /3 0 8 X N." Na.: L LC/o.og -.003 ° 131255 Hall Blvd,
ti .619.4iPi r 303.390. v �
�/ y /± Y ' dhaP?a7il:
:t.. r,, b5100: oO Liire: 503.659.4 or., ®� 1 �1J+��V I DiwP.c net: aa r I SQ 2I
eaarar
haemet: www.tigard°T 9F iIhjC n!v! )ON NonRe6k le,tT ®
J sem.�.�lrororm.etm
am ` PLAN ' . .
o flewconstruction AdditiOdeterationfreplaeemertt Fine dad' as doll IP* (submit:Dm of ghat Wilma checked beim).
0 Senior Or feeder 400 maps or more ❑ Dean over Om saes.
O Dcma li000 0 Odom: here a Os arslable i n esaecm 0 Naraas and bo ns:dr.
CATEGORY OF COPRSIRVCFIO r - mums 10.000 amps at 150 oohs a ❑ Flavin beild;tys.
lee ro ot>red. or esopels 14.000 ID Or note °aecrpaed
end 2- fsrnay dwelling ❑ Commercial/industrial ❑ Accessary building amps for all other ingindi ws. Wines.
❑ Molri- family 0Mosterboater ❑Other. ❑ epuma Q2atsaruseor7S AOr
IIVFOAMATIOW AP03 LLOCATIV!r - a ] finew aw s Intl separatel diked system
y
JOB SITE -
. Q_sd0id000r.ertortta0or Q'h►•. "6 "s a -- .
Job no.: I Job site address: / D 04 O 5 rviv rr ll 10511P °r mote. t>ee
1 � v � 7" I O Seeor awe resilemlal=tits. oda
Crty /Stafe2lP �'` rlol , O 12 0 t{eear erne fIthti . 0 supply voltage lbr mat dean
f , ? a 9 1� zZ 3 p as t amps remote.
b0osals
Suitcbldg.;apt no.: I n. L� rfJrr�f FEE SCHEDULE
Cross suer/directions to job site: o.>ntpna. j Qrr• I re. I Twee 1 • '
New realdendal sink- or awlriJamity dwdEng gait
faelades anaebed garage.
Subdivision: I lot 00.: i 1,000 sea. R. err less , 141.15 4
Ea add'I 500 sq. A. or portico 33.40 1 I
Tax tnapJpareel no.: -
Limited energy. residential 75.00 2
BFSCtolrnON of WORK r..ilaabove tr. e.1
I ( f
a e t 1 n 451 l p KC.. h . f - /ba i / S, l4-r -� of - m s leads] ( h gove�
s4.I 75.00 2
1n. ` vltl• CP1-G(- , Sorbian err feeders ioiu&b ba. alteration, utrdf.r ndonden
' 200 +ropier less 1 3O 80.30 $O. 2
PROPERTY OWNS /' CI 7T:P1ANTl 201 saps M clap snips !06.45 2 2
Name: e_ d. x ■ 5 I v o e.104.. 6g a ./e It,
401 saps b 600 amps 160.60 _
asps to 1,000 amps 240.60 , 2
Address: /0 e5 " M c l r o C7
Ovu 1,000 amps or r0I 454.6$ _ 2,
City/St ate gor OR/ / 7- z.nz. Temporary s ervices or fe edersimvll:i0kalteraion,aadfor
�J ex tens �� 66.35 — t
: ( Sa.>� ) bty_Q�gB I Fa":( ) 209 an7o
Owner Iosrallatian: This installation is being made on property that 1 own which is not 2filaspsro 400 am • 10030 2 .
intended for sale, tease. rent, or exchange, =ooaling to ORS 407, 449, 610, and 701. 401 mom to 599 amps 133.75 3
Breach circuits - stew,alteration. or en ®oa, ter pond
Owner signature: Oak: A Fee for tenth araae with
• 1�APPLICANT 1 ❑ CONTACT PERSON ' • above service a feederks,
6.6.5 2 brooch tiraiit
• Bu sin sharer.
� = I' B. Fee for breech ci coats
4) C ,_ 1 _ � wish i Savior or feeder fee, 46.85 2
GonIHC[ name: � f Ebert tramp cicircuit Address: W � ftici ) � y3 r f) 3 0 /r 4) � add, wrench circuit 6.65 2
Mia eellaseaos (s01 ni ors ce or feeder i.Naded)
/�,� �y C�r�) Each manufactured a modular
CigYSIBteIDP , !P� 1 /a yL dweD'oaserviceendl r feeder 90.90 1 ; 2
1 Pban en- 3 -- f Fas :: ( 3 6 1 . I Reconnect '
ally 66.35 Z
E-meiL � -i� /p G eiv . tom Pump or inis;aaiol circle 53.40 2
CONTKACTOR Signes a 53.40 2 •
Business name gild, � to Sigpal circuit(r) or limited -
energy pawl, °Itoration. or .
- Address: c_ V C 14 yetesO( rarnsian. ()crake: Pa i 2
1 . City/Stare/ZIP: Each addtdosat bonbon over alowabkla of the above
Phi inspection 6230
Phone: ( ) 3Air Fax: ( ) Investiyeooe pet hoar ti nr east . 623D
CC33 Lic_: , j i • - EEETANE Supev. Lies: 95 lndionial plentper has 77.:5
ELECTRICAL PERMIT FEES
_ Subtotal: I W EI a 30
:7f};�r Plan review j23% orpesmit heel:
f5 r / i � W 1 J L � � �r s o n e surcharge t 1 2 % orperetlt leer 1 c . to yam/
MI . ., signature: / �/ I j� l TOTAL PERMIT FEE , 21 •1 7
this pem& applfugea cipher if mer mole b oat Maui .s4..10i. w°
Dale days .o iarasaem weeptedast°ap�'-
- + Mahn of ineps:Koss aawred per press
)s5jtor Vembitz.C./ew.:App doe enhy`aa r'Y+J°IS7Irr DN!°¢8 .
td 6917Z7Z4 InWS (MS '} IN 0 91 :170 90 01. ur r
6•d 9917ZZZ£OS _lobos unS . .IN 0 £v.66 80 £6 unr
CITY OF TIGARD '
BUILDING DIVISION PERMIT #:ESC 2oo'8. 343
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 l il
Inspection Requests (24 Hrs.): (503) 639 -4175 F :..
INSPECTION WORKSHEET FOR DATE: 6.2,$.. o v TIME: PAGE:
SITE ADDRESS: ) 60b0 S W rno V t' ( - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: pOWras. l o S6LAR 60v -
OWNER: PHONE #:
CONTRACTOR: � -- PHONE #:
Inspection Request Scheduled For: Date: 0 -244 Pour Time:
Code # Inspection Description Confirm # Con # Message
Corrections/ o ealnstructions:
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1KPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `� L Date: 6 Z 6 Phone #: (503) 718- s- .