Permit CITY OF TIGARD ELECTRICAL.PERMIT
PERMIT #: ELC2006 -00436
DEVELOPMENT SERVICES DATE ISSUED: 8/4/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 1 S134CB -04600
SITE ADDRESS: 12310 SW NORTH DAKOTA ST ZONING: R -7
SUBDIVISION: ANTON PARK LOT : 008 JURISDICTION: TIG
Project Description: (1) branch circuit for A/C unit. Job # 51205.
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: I 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:
CLAIRE LLOYD SUNSET HEATING & COOLING
12310 SW NORTH DAKOTA .0607 SE IDAHO
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: 503 - 590 -1023 Contact #: FAX 503 - 234 -0439
PRI 503 - 234 -0611
FEES
Description Date Amount Reg #: ELE CI 17
[ELPRMT] ELC Permit 8/4/2006 $46.85 LIC 161085
[TAX] 8% State Surcharge 8/4/2006 $3.75 SUP 46385
Total $50.60 REQUIRED ITEMS AND REPORTS
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: 1� „_ Permittee Signature: '' f 1;b\
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.
Fluti 04 06 11:47a p.3
4,
0 i;t8
Electrical Perm Applicat
U � i -� I t►It t)I' It I 1 tiI: c1\1.�
City of Tigard
,•* . Dat ei 9
■
13125 SW Hall Blvd., Tigard, OR 97 '77FIM DazeJB : 9 t'/ I Plan Re
�1 / l
Phone: 503.639.4171 Fax: 503.598.1960 a ‘• r. „, aielaview
1,
Inspection Line: 503.639.4175 (3 1-; ' :_ {I(i Date/By: Other Permit
Internet: www.ci.tigard.or.us P � F ', Date d/Me thod• Anis O l f I S opptemeot See Page al 2
�!� Nottfied/Me / or
lo fo
a sf : : 2 v .e + :.. rr :a s r f t,s A,.._ : rj �f �
❑ New construction ® Additio , • • lacement Please check all that apply: c t r: , �� t�M " `' x.
❑Service over 225 amps, comm'I ['Hazardous location
❑ Demolition ❑ Other:
" t `�; :R� a -z �w « �, . ,; ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
:..,.? ,, ..:. ; ' ir k ,• ' S. .n.. , C_ g 4, z',... �r ..
of 1 -and 2- family dwellings
�.- _d. 4 or more new residential
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 OFeeders, 400 amps or more
u w k H a , � builder
� ,, �,t , , * f ❑Occupant load over 99 persons ❑Manufactured structures or
.s. ... ,.tt. :.a.e.a,.,. +L,s_ ; �......�...: x V VV3" „F':� '' a >, ; -i r' 0 Egress/1ighting plan RV park
Job no.: r; Job site address: � _ } ir <"1 i --) }>(� t�G ❑Health -care facility ❑Other.
(2 Submit 2 sets of plans with any of the above.
City/State/ZIP: —1 . ! f' ( ",y- ( • z -
1 ' 7 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: `
Project name: Lk Ei( '� .r ' ;eV-1 9 •; °+d o t om' n,- 'V''..: ;r 4F5it f?
J , Docripiien Qt. Fe.. Tout ••
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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
�''"" t , o/� v m , F . �, Limited energy, non - residential 75 "00
2
ER cam. ' r ` "'+�a ��__.._ saw Each manufactured or modular
i A;D:ir .LL CC.L. C - dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30
k M, a *°`) tr•! aY s a . 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: "(a} l ods_ 601 amps to 1,000 amps 240.60 2
Address: 12 �, .71 C s�; nu--,r-1-(7, `Ltc.,6r!'I-.A. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: T \ c,.. k 61 '3 D 3 Temporary services or feeders installation, alteration, and/or
Phone: (,. }'3 )5c. I 023 Fax: ( ) relocation
or
Owner installation: This installation is being made on property that I own which is not 20 amps to less 00.30 1
201 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. amps to 400 amps 100.30 2
Owner signature: 401 amps to 600 amps 133.75 1 2
Date: Branch circuits - new, alteration, or extension, per panel
' }'!�" H > A. Fee for branch circuits with
�� `����� +.^.`� ^P&`v�rtie '""tl > R`•I a. ...'r. • ;
Business name: service or feeder fee, each
branch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee,
Address: first branch circuit ( 46.85 4 -upg5 2
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
E-mail:
Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Z-",--'7. T - ` ... F ':",i;L: X ,,., i 75;777:777.7----' ^ r^ „ }p••-+iin-•rav?Y ;', 1 I e ant
._.. • �- s.�'a- i,L'P.��,�.,�•t�,zt r�- °������,;.,aw,M� -.,,�: 3..i.,x - , ; �' Panel. alteration, or
Business name: Sunset Heating and Cooling extension. Describe: page 2 2
Address: 0607 SE Idaho _ Each additional inspection over allowable in any of the above
City /State/ZIP: Portland, OR 97239 Per inspection 62.50
Investigation per hour (I hr min) 62.50
Phone: (503) 234 -06 j 1 Fax: (503) 234 -0439
Industrial plant per hour 73.75
}ol-;:V';w:. F}Y.``t,......;C ', :. 5..2- 'Yr; s: �,
CCB Lie.: 161085 I Electrical Lie.: C117 (Suprv. Lie.: 4638S
Subtotal °j .'
Sub total s &`t
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: ��w & i I it G SS ✓ I Date: 6 j ^ J L}- 01 - -
State surcharge (8% of permit fee) j ��
Authorized signature: J l TOTAL PERMIT FEE GC .j 6
This permit a expires if • permit is not obtained within 180
Print name: ,�17(i,� r l w days after it has been accepted as complete
� 1 I Gam I Date: `� / y l i�t� sr y ti
� Fee methodology set h Tri - Coon Building Industry Service Board
**
Numbs of inspections per permit allowed.
rlBuildinglPe mi ssELC- PennicApp.doc 12103
aaawtsrptvovcotww®
CITY OF TIQARD
BUILDING DIVISION PERMIT #: EL.C2006 -00436
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2006
Phone: (503) 639 -4171 ;.�i ;''1I
Inspection Requests (24 Hrs.): (503) 639 -4175 �� ' __..
INSPECTION WORKSHEET FOR DATE: 9/29/2006 TIME: 7 :06AM PAGE: 79
SITE ADDRESS: 12310 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: ANTON PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: LLOYD
DESCRIPTION: (1) branch circuit for NC unit. Job # 51205. 9/7/2006 Add 1 branch circuit.
OWNER: LLOYD, CLAIRE PHONE #: 503- 590.1023
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503 -234 -0611
Inspection Request Scheduled For: Date: 9/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037255-01 503. 2340611 N
Corrections /Comments /Instructions:
(-1 /�
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL II CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� q 0/0
Inspector: i►,r a Date: t ,6 Phone #: (503) 718-'