Permit f. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00417
rw DEVELOPMENT SERVICES DATE ISSUED: 6/16/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136AD-04001
SITE ADDRESS: 11539 SW PACIFIC HWY ZONING: C -
SUBDIVISION: VILLA RIDGE LOT : JURISDICTION: TIG
Project Description: Install more soffit & wall pak lights.
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: 2 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 MILESTONE ELECTRIC
BY NORRIS + STEVENS 1800 NW 169TH PL. SUITE B700
520 SW 6TH #400 BEAVERTON, OR 97006
PORTLAND, OR 97204
Phone: Phone: 503 - 645 -5323
FEES Reg #: ELE 34 -6I8C
•
Description Date Amount LIC 153480
SUP 2113S
[ELPRMT] ELC Permit 6/16/2005 $60.15
[TAX] 8% State Surcharge 6/16/2005 $4.81 REQUIRED ITEMS AND REPORTS
Total $64.96
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: � � j+� eor Permittee Signature:
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.
„
Electrical Per i • n 1.0R 01..11(T, USE ONLY
Electrical
City Of Tigard C Maiming Approval Sign
13125 SW Hall Blvd j i `i '� 1 6 2005 Date/By: , Pemnt No.:
' Plan Review Other
Tigard, Oregon 97223 F TIGARD Da : Permit No.:
Phone: 503 -639 -4171 Fax On - 1l (.- . 1 Post-Review cw Land Use
Internet: WwW.Ci.dgard,oLttS ( ' y: Case No.:
24-hour Inspection Request: 503 - 639 -4175 • -” • 11 " Name/ Juri
ca See Page l rot
Name/Method: it I Supplemental Information.
t�� �7r v ,T. u � ? yam
L'Q :..�.�1 :i�7 �,�I' l ��i. ' �,. �i :. ij�.�1yy � � ��{'���7 �, � t ..
,_ . :�M'4i _r��.1!'i1� - , f? , Faf , JEN {T 4 ' '1';.3 i. „�. z"'I)I �.r �, i - ' t bi r5 i"�
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.� „r- .7.dfd. e.�Al �•' >'.ftt �'_'1.� ��.v- �.:?`T ��i 1.��',�In� :�;'iG��w�' :
IS New construction I Demolition ■ Service over 225 amps- • ■ Health-care facility
W. • ddition/a e laeeent
lteration/rm III Other: Ot commercial El Hazardous location
- . If r l a :,i c n r+ f;t emu° ti �t i O t r:;, ❑ Service over 320 amps - rating of ❑ Building over 10.000 square feet,
� . 1 & 2 -Fa- rm - �v _, , , i ) ... x. i�`a2 I & 2 family dwellings feu or more residential units in
. 2-Famil dwcllin: [► '' Commercial/Industrial ❑ System over 600 volts nominal one structure
0 Building over three stories
• A.ccesso Buildin 1 I I Multi -Famil ❑ Fes, 400 amps or c rone
• Master Builder 0 Epees/lighting over h o 99 persons 0 plan O rfact:trt d gpu or RV park
! _ ' � Othe 8�� E plan ❑Other:
f tn:l °i r A 1' - I) + ! •Ir � _i ) j t, i. ;' ,.. `:fit .liff.,
- 4,.S�k tD „I.0 .�
. „ ' 118 Submit sets of plans with any of the above.
Job site address: /, The above are not a livable to tem ra construction service.
1.
Bid: JA • t. #: Number of inspections per permit allowed
Pro'ect Name: S ' +4-4 '‘,_ _ Description Qty Fee (es.) Total i
Cross street/Directions to job site: _
New restdeaua4slogle or mWtl -faml� per `
dwelling unit. Includes attached game,
Service !winded:
1000 sq. ft or less 145.15 4
Each additional 500 se. R orpottion thereof 33.40 1
Subdivision: Lot #: Limited e'er', residential — • 75.00 2
Tax ma • / •steel #: 1- °rued energy', non residential 75.00 2
Each manufactmed home or modular dwelling
y y __ 4 �hi service or ceder 9090 2
i Services or feeders - lestaledon,
� .� alteration or relocation:
• s. 200 amps or less 80-30 2
1- 401 amps to 600 maps 160.60 2
201 amps to 400 amps 106.85 2
r Over 240 60
: , ps tO 1000 amps 2
Name: 66 85 or volts 4 2
Address: Temporary services or feeders - inatelladon,
Ci /StAte/Zi alteration, or relocation:
Pone:
200 a or less 66.85 1
Fax: amps to 400 amps 100.30 2
Pt J i . .. r9 :c, : r ' •„ iC i;li 401 to 600 amps 133.75 2
. .. ;c,. Broach circuits - new, alteration, or
Name: extension per panel:
Address: A Pee for branch circuits with purchase of
service or feeder Elie. each branch circuit 6.65 2
Ci /State✓Zi .: B. Fee far branch circuits without ptcehaae of I
Phone: Fax: service or feeder fee, fast banch circuit ! . 46.85 7Il 2
Each additional branch circuit 2_ 6.65 j3 le 2
E -mail: Mise.(Savioo or feeder not included):
:I
:,;,'. ,:: '�; Each j•, ' sign or 1 Y 53 2
,:, Each �.
Job No: • 10 ” , . 2
Signal circuit(s) or a limited energy panel,
Business Name: / - 0"..e. E - Descr alteration, or ofrerneion Pale 2 2
Address: : 0. 4/ rut/ - ” 4 ' , . ( le. B 00 »esrnpnon:
Cl /State /Zl r : _ • ter y � O 10 Each additional Inspection over the allowable in anyof the above:
Per inspectionycr hour (min. 1 hour) 62.50 -
Phone: i , —....r32-3 Fax:.SZTS Ti— . . 3 Investigation fee:
CCB Lic. #: /5n d • Lic. #: 355 —( fir:
Plan Re
si a ature r . aired: � Subtotal ` $ :.. O
Review 5% of Permit Fee $
Print Name: ,. � ' :- .21. M1 State SurchargeS8% of Pe mit Fee) $ _
Authorized TOTAL PERMIT FEE $ jt
Si
Authorized Notice: Tills permit application expires If a permit is no ob tained within
• �� 7J
Date: 180 days after It has been accepted as con D lete.
r
'A _ C *Fee methodology set by Tri-County Building industry Service Board.
(Please print name)
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CITY OF TIGARD
BUILDING DIVISION D PERMIT #1.0 2t-
13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED:
Phone: (503) 639 -4171 , N °�h�'4P i ii y
Inspection Requests (24 Hrs.): (503) 639 -4175 - ' iia� L:_ I
INSPECTION WORKSHEET FOR DATE: $... I q .. 06 TIME: PAGE:
SITE ADDRESS: 11539 ' W PA G Z. W . CLASS OF WORK:
SUBDIVISION: J LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: "a V i
V
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
VA
Corrections /Comments /Instructions: GL■S
PASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED P lr•7n• -, ir•
' - ` Date: - I r' C) La "-' P hone - #: '(503) -718=