Permit ` CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00584
1 11 DEVELOPMENT SERVICES DATE ISSUED: 8/12/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136AD -04000
SITE ADDRESS: 11513 SW PACIFIC HWY ZONING: C -G
. SUBDIVISION: PACIFIC TERRACE LOT : 007 JURISDICTION: TIG
Project Description: 6 br. citcuits.
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: 5 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:
SMITH, EDITA M E C COMPANY
833 NW 170TH DR PO BOX 10286
BEAVERTON, OR 97006 PORTLAND, OR 97296
Phone: 503 - 706 -0350 Phone: 503 - 220 -5377
FEES Reg #: ELE 26 -45C
LIC 49737
Description Date Amount SUP 4040S
[ELPRMT] ELC Permit 8/15/2005 $80.10
[TAX] 8% State Surcharge 8/15/2005 $6.41 REQUIRED ITEMS AND REPORTS
Total $86.51
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- 2 -2344.
Issued By: / 464 Permittee Signature:
--gi
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.
08/11/2005 20:42' 5032205347 PAGE 01
r Ele Permit A ppliga4oir. .
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• City of Tigar
13125 SW Hail Blvd., Tigard, OR 97223
>� / � E:42) Perrmt No.,
Phone: 501639.4171 Fax 503.598.1960.. -. _• 2 2005 ' Plan _ z?
Inspection Line: 503.639.4175 'tf I Otha Permit
(m:& . www.ci.tignrd.oLUa = , - No nBedlMt uhod s ee PAg e Aide I Data /ey
CITY OF TIGARU x Ini
, .: , sappl8eneahl lalbrawdoo
0 New construction . ;. ter ..,
� e ddidoa/alteradoNtzplacemrnt , • � Pleas c . eck at that ,
,L TA{ .,, .;.
apP
0 Demolition Other QSeavice over 225 comm'I ❑Hazardous location
amps,
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.
of 1- and 2- family dwellings 4 or more new residential
I - gad 2- fartnly dwelling r: Commercial/industrial 0 Accessory building CISYatem over 600 volts nominal units in one stnreacre
Q Muhl- family 0 Master builder ❑ Other: ❑Building over three stories [Feeders, 400 amps or more
t: -; ";: �, - ... ;; :..; ,_:. ... .,; .. ;: _, ❑�� persons red stru to
r ..., ,. , . ; I , .. .1.1„''' Manufa res or
-
c
,. 0EgreSdlighting Plan RV park
Job no :: ( _3 Job site address: \ \ S ‘3 Sly S' C. t t C_ .01 facility ❑Other.
—
t6 ubrnit 2 seta of plans with any of the above,
City /Spate/ZIP: T
45.,..) o r The above are not applicable to temporary construction service,
Suite/bldg. /apt. no Project name: F qh ( v . '► I, . .. � . .. . ..,^ I ,.. '} „fr s N't ., v.
Cross street/directions'to job site: �"°"p`r°a R•• Tau*
ow resi . entlal single- or multi-farm dwelling unit.
Includes attached garage.
1 ,000 sq. ft. or less 145.15 4
Subdivision: l Lot no.: Ea add'? 500 sq. ft. or potion 33.40
Tax map/parcel no Limited energy, residential III 7500
ylll i �- , ^ i y ., Limited energy, non - residential 75.00 2 -
:. 1 1 t ` Each manufactured or modular
�1errss ! e C ic Y ■ c t'il �h�.. C P AQ O 1 t T 1 dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
>..„ o S (.d
1 c,` c, 200 amps or less 1.1111 80,30 z;
t •, > { ' ` Ol amps to 400 attars MI 106.85 Ell Name: ti n :\ '(b1p tta\ A ` _ 1 � 401 aka ro 1,0 amps 160.6o � �
M 1�-� �. 601 amp to 1,000 snips 4 6
Addy: `S \, ‘,..• �, P ' (� ' << over 1,000 amps or volts
III 'II
NI
Ciry/Star 'ZIP: ` e ' � Reconnect only 11.1 66.85
Phone: o9y1� O f7 �� ) , , Temporary feeders inatal4hon, alteration, and/or
Owner _ O I5 200 amps or less 66.85 I
Natio Tyi ns tss being made on property that I own which is not
intended for sale, least, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 100.30 2
401 sines to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
' I " i .. "` t . ' A- Fee for branch circuits wit
Business Berne: service or feeds few, cash 6,65 2
branch quit
Contact one: • • B. Fee for ranc circuits
without service or feeder fee, % 46.85 y` gs 2
Addles: each branch circuit
�_ Each add'1 branch circuit is 6.65 a'3-as 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) l Fax: : ) Pump or irrigation circle 53.40 2
l Sign or outline lighting 53.40 2
E -mail: Signal eimuit(s) or limited-
energy .' "'.a.:1-.-‘',--:::::: exten on Describe alteration, or
. ,. ........ . -., si Paget 2
Business mane: F C C . v- , As.
Address: Pb Qhu ` ats Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: r\ 0 2 , 0,'' 4c -, Investigation per hour (1 to min) 62.50
Phone:
Industrial plant per hour 73.75 II
(Sul )aab Fa x (S01) a - JU1Z,
ti
,,.. .,,..., .._... . , ' .; ,.,. _..''..�. h er i5 ): .T.`��'. 0...:
CCB Lc. :y0 ) 3 1 Electrical L.ic.: c— L1.5C. Suprv. Lie.: Subtotal g 6 \0
Suprv. Electrician signature, requ. 3ga,/ Plan review (25% of permit fee)
Print Warne: Date: � � / State surcharge (8% of perms tee) C �A
° 1'G % " 2 r " <--'
TOTAL PERMIT PEE c i S
Authorized signature: This permit applicadoo expires if a permit u not obtained withi ` 180
days titter by it has h occ ero ty accepted a complete
Print name: Date: Fee methodo [ti Cn Bui Industry Service Board
" Number of iospecd ons per permie allowed ing Industry
i :\amldipglpwm C.Permw4pp.doc 17/03 440-46 13T(Itwl/GOhYa/6B
p liP OF TIGARD e • . ,o
uiLDING DIVISION PERMIT #: ELC2005-00584
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: @/12/2005
F)hone: (503) 639 -4171 jil
Inspection Requests (24 Hrs.): (503) 639 -4175 °` -_ I
INSPECTION WORKSHEET FOR DATE: 9/1/2005 TIME: 7:14AM PAGE: 91
SITE ADDRESS: 11513 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PACIFIC TERRACE LOT #: 007 TYPE OF USE:
PROJECT NAME: FAMILY MARTIAL ARTS
DESCRIPTION: 6 br. citcuits.
OWNER: SMITH, EDITA M, PHONE #: 503 - 706 -0350
CONTRACTOR: E C COMPANY PHONE #: 503-220-5377
Inspection Request Scheduled For: Date: 9/1/2005 Pour Time:
Code # sp- • Description Confirm # Contact # Message
199 -ctrical final 014719-01 5 2 Y
Corrections /Commen • - ons:
c n)
\v - /
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `y- i IV v 8 L t Date: a - 1- O. Phone #: (503) 718- 2Ati,■