Permit • CITY OF TIGARD ELECTRICAL PERMIT
A ' PERMIT #: ELC2005 -00528
DEVELOPMENT SERVICES DATE ISSUED: 7/26/2005
i
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135CD -14100
SITE ADDRESS: 09580 SW PIHAS ST ZONING: R -4.5
SUBDIVISION: GREENBURG PINES LOT : 012 JURISDICTION: TIG
Project Description: A/C & WP plug.
•
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 WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
AZEVEDO, JAMES SOHLER ELECTRICAL CONSTRUCTION
9580 SW PIHAS ST 41131 SW BURGARSKY RD
TIGARD, OR 97223 GASTON, OR 97119
Phone: 503 - 579 - 2112 Phone: 971- 832 -0807
FEES Reg #: LIC 158285
Description Date Amount
SUP 594S ELE 594S C
[ELPRMT] ELC Permit 7/26/2005 $53.50
[TAX] 8% State Surcharge 7/26/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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: " P, �'�, Permittee Signature: SZ-� (2.
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.
• `'
RECEIVED
..........................At " `'a Mat. nyliaur+.awvu FOR OFFICE USE ONLY
City Tigard JUL 2 6 2005 DatdBy Received Q . �i ' Prnrdt No. = (�,ZDd�G�)'
!3125 25 SW W Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598. Y OF TIGARD D tel By_ icw
�..• DateJ Other Permit:
Inspection Line: 503.639.4175 BUILDING DIVISIO ,..!....4-' ,1 DateReady/By_ t V 0 see
Internet: www.ei,tigard.or.us NotiNotified/Method: ) f ( SupplernenuleZ rma'on
❑.New construction 16 Addition/alteration/replacement Please check all that apply:
❑ Demolition Other ❑Service over 225 amps, coming ❑Hazardous location
, ❑Service over 320 amps - rating ❑ Buildng over 10.000 sq.
CATEGORY; OF > CQN yJtiJGTIUN•; .. ... of 1- and 2- family dwellings 4 or more new residentia
71- and 2- farnily dwelling ❑ Comntefcial/mdustsial ❑ Accessory building ['System over 600 volts nominal units in one structure
Multi- family ❑ Master builder 0 Other ❑Btaldm m
g over three stories ❑Fenders, 400 amps or mo
LUCAT - 4. - ❑Occupant load over 99 persons ❑Manufactured structures
'
308 51TE:'Ily A •. T :..: 701� ❑Egrnss/lighting plan RV park
Job no.: I Job site address: ['Health-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /Starerzrn: S W P) H -A S ST pp temporary C The strove are not applicable to ors construction service.
SuittJbl J t no.: `
aP Project natter~ A_ c / (/J � = . ' . , ': I FBE: SCREDULl .
L1? Det°1ttion ' Q7 • I ,_ I Twal
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Iodudes attached garage.
1,000 sq. R or less 145.15 •
Subdivision: I Lot no.: 1 'a- add'1 SOO sq. ft- or portion • 33.40
Tax map/parcel no.: Limited energy, residential 75.00
t
Limited energy, non-residential 75.00 •
•• . DFSCR TION'OF - .WO$IC" : - •:� : , - ... Each manufactured or modular
PIC C2.1.1.-e4 ("J , e , 19/1 dwelling. service and/or feeder 90.90 .
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 • PROPERLY OWN! t" "' .. - . 201 amps to 400 amps 106.85 .
Name: 401 antes to 600 arms 160.60 2
( M 6 A 7 F V E D 0 601 amps to 1.000 amps 240.60 2.
S
Address: , O 5 IA) O I HAY Over 1,000 amps or volts 454.65 2
City/State/ZIP: r f �s f} de 1 I q Reconnect only 66-135 2
p 7 d .23 Temporary services or feeders installation, alteration, and/or
Phone: (5-63 ) S 747 c p I �a I Fax: ( ) relocation
installation is being made on 200 amps or less 66.85 ' 1
Owner installation: This ins
intended for sale, lease, rent, exchange, ion is g property that I own which is n ot 201 amps to 400 amps 100.30 2
ge, according to ORS 447, 449, 670, and 701_ 401 to 600 a
signature: amps amps 133.75 2
Owner
Date Branch circuits — new, alteration, or extension, per panel
_ br. PPLICANT :. .: ` :: . -. ..:. TONTACI .; %: r ancch circuit
. Fee for branch circuits with
A . : : . .•.; •:.., service or feeder fee, each
Business name: 5' D ii. F l o .�f-r', c / C-4, N S 7 , branch circuit 6.65 2
Contact name: n / I I T B. Fee for branch circuits
I '4- <'!N_ t l� without service or feeder fee, ' 46.85 f , ' 8S- 2
Address: t I I ? I s t� g .,,,A.,-, k r j c Each a dd'I b brah c r
1 G1 1 6.65 a _65- 2
City/State/ZIP: C . s ,, r.../ r.../ U 9 7 1 sn
. &Useelleons (service or feeder not included)
Phone: ( ?a — o P a 7 I Fax:: (S63) 9 8 .5--- �Pj Pump or irrigation circle 53.40 2
E
V Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
: • . ;•.! . . ..' .: . . • - . . :CONT t:t4tr'QR :.. :: - :'•- ., . . energy panel, alteration, or
extensi
Business name: S° 1, le"( E / &c-r i me. I Co ,✓ S T on. Describe Page 2 2
Address: Each additional inspection over allowable in any of the above
City /State/ZIP:
Per inspection 62 .50 j
Investigation per hour (I to non) 62.50
Phone: ( ) I Fes ( ) Industrial plant per hour _ 73.75
CCB Lic.: / S 1:3 8 Electrical Li t!_ 6( 7 S
Ei,:tt-T PERMIT FEES'
_ Subtotal
Suprv. Electrician signature, required :j W�� -' Plan review (25% of permit fee)
Print trams D State surcharge (8% of permit fee)
f i TO TAL PERMIT FEE Authorized signature: . 5-7. '
�(� This permit application expires if a permit is not obtained within ISO
Print name: -1-6-t (%"°‘ / k tux '- w days after it has been accepted as complete
/i _ I Date: 7 j°' /6 S` ' Fee [methodology set by Tri-Canty Building industry Scr eice Board
" Number of inspections per permit allowed.
111 o 0 degtlPmoitAELC- Pamitiwo.floc 12/03 a�n.s <. m.nws.i- r.v..uee
•
b BLOT -SBG -COS J aiyog eoC e6S :90 SO 92 Inc
(OF TIGARD . _
BUILDI DIVISION PERMIT #: ELG2005 -00528
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2042005
Phone: (503) 639 -4171 ��. " 'r9irglh�ly'��(i I �
Inspection Requests (24 Hrs.): (503) 639 -4175 _ -' 4 4 :_..
INSPECTION WORKSHEET FOR DATE: B1112005 TIME: 7 :05AM PAGE: 17
SITE ADDRESS: 09580 SW PIHAS ST CLASS OF WORK:
SUBDIVISION: GREENBURG PINES LOT #: 012 TYPE OF USE:
PROJECT NAME: AZEVEDO
DESCRIPTION: A/C & WP plug.
OWNER: AZEVEDO, JAMES, PHONE #: 503 -579 -2112
CONTRACTOR: SOHLER ELECTRICAL CONSTRUCTION PHONE #: 971 -832 -0807
Inspection Request Scheduled For: Date: 8/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012551 -01 971 - 832 -0807 Y
r _____
Corrections /Comments /Instructions: 5 5" Z
21 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPEC ION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: 1S (IS Tone #: (503) 718-