Permit A t I TY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00436
�; DEVELOPMENT SERVICES DATE ISSUED: 8/30/02
13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 PARCEL: 2S104BD -05100
SITE ADDRESS: 13789 SW ROSY CT
SUBDIVISION: ROSE MEADOWS ZONING: R -7
BLOCK: LOT : 010 JURISDICTION: TIG
Project Description: Installation of (2) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT 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: 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:
MICHAEL ZIELINSKI TICE ELECTRIC
13789 SW ROSY CT PO BOX 15009
TIGARD, OR 97223 2139 SE BELMONT ST EXPIRED
PORTLAND, OR 97293 -5
Phone: 503 - 590 -0500 Phone: 233 -8801
Reg #: LIC 166
SUP 2586S
ELE 26 -126C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 8/30/02 $53.50 2720020000( Elect'I Final
5PCT CTR 8/30/02 $4.28 2720020000(
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1-800- 332 -2344.
Permit Signature: eril /97°V)G /e,9-i70l1 Issued By: xfjpitze 1-X-e—•
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 639 -4175 by 7:00pm for an inspection the next business day
08/29/2002 10:40 503 - 872 -8290 TICE ELECT.SERV.DEPT PAGE 01
19/10;00 - 'I?1JE 08:00 FAX 503 598 1980 CITY OF TIGARD Gb 002
Electr P er
mit Application
n A9tareceived: a yq /0 ?i Permit no. :elestij77_ -0Oya
• A 141 • 'ENO) ....Ti.. t City of Tigard ■ PtojeeVappl. no.: fixpiie data t -
A ddvea: 13125 SW Hall 131v�', �Q 97223 ,,
Ct y af'rgard Data haled: By: }'Receipt no,:
Phone: (503) 639-4171 2011
Pa*: (503) 598 -1960 • AUG 2 • Q Case file no.: Payment type:
Land use approval: ' . of ill.3 •
1 R I & 2 family dwelling or accessory CI Commercial/industrial t7 Multi-family U Tenant improvement
New construction e
XI Addit(on/alteration/replacment O Other: C) Partial •
JOR SITE li \(�(1RNIATION '
M / Bldg. no.: Suite no.: ex tax lot/account no.:
N Lot: Block: Su • • "vision: • . s' /0 fieb S/ ■
c, Pro'act name: Mike. Zielinski (7eac i • ;on and location of work on premises: micro & welder outlets
t estimated date of cons • IWan/inspecti0o: • 9 iff 02 '
• a (' tJN'IIIACIOIt AI'1'Lit :.�l ION i k:1: SCIIL1►u1.1:
n
ti Job no: 99.6683 tolt
D d • no. Imp
Business name: Ti ( ..4 El eCt''1 ' co Nevereside:OW -'high or Mirl4- (+dolly per
Address :. pn Rn,r 1.5009 drelWtaw041ndodeilttachedW+ to
City; . • . _ • •,. Z>p a a • 9ailoelnciuded:
t
1 State: E•mall: 1000 ft orla$a • 4
Piton:; 5 / _ .: 1 Hach cdditlonel t 1 to Nos tberoof 4
CCB no,: • • Elec. bus: tic. no. . - limited matIy. malamute)
City/ • Re. no.: 1 • Limited at _+ son- raidwltict
. '. —y414 • 3 29 02 Eneda rianufaaan hor
d aof& rmdulardw ling
S : it lire of iilb alectric reV 9e aod/or feeder 2 Date Sm vice:orfeedora WWlation,
• ! t/ • ! Ucanae no: :. Adoration or relocation:
' 1'It(JL' }:lt1 . 200'atrps 2
�. 201 a . i io400 •. • 2
-`:i + 'ter - - -- 401 a ... a to 600 amps 2
r
• Mailing address: • 19 ' r' ; • R 'S CT • , , .5101000 IMP aa — 2
City: 0".i.-...7.41,. - - .. �''-. °. - Lj1' ar t0
ov 00 anipsorvelfa 1 2
Phone: 590 -OSOD Fax: B-mail: Raconnectaoly - 1 _
Owner installation: ma installation is being made on property I own Temporary swims or foods/a - • -
lasbillosion, alcanfioe aloeaebn: •
which Is not intended for sale, lease,•rent, or exchange according to
2C0 amps of 2
ORS 447, 455, 479, 470, 701. 2 01 smpi: - 2
Owner's si. ature: • . Date: , 401 to 600 amps 2
. ENGINEER Brandt ctrcait, - aeW, alecn tut,
Of es:tamioa per pow:
Name: _ A. Fee for bra cireuiu with purchase or 1 46.:5
Address: scr4en or feeder foe. cart bnncb dresit 2
city: State: ZIP: B. Pea
eerrl « w f «daF C u a,f a�t,r oir 1 6. t5 2
Phone: Fax: . • 8 -mail: Eactr a d dldonal brsndidtcUlt: .- . I
LAiN
1' REVIEW (1'Iru cl tcli :ill that aliply) Mae. (Sanice feeder lot inciaded)s 2
0 Semler over 235 sL�nps•wtttmetsiat 0 Healdt.eetsta�ity 13adt pump or trrigtsioo pitch
Service av sign or outline lltUes I 2 !
ll 310 nn ntuting of lea o uxerda
Building over a 10, Signal dneulgs) or a limited energy pawl,
letttil�•dwellings o 8tldi� over 10,On0squarafO� four or � � I 2 I
J
oSvetemovsr600voltnemieut • monsreiduulal units in one structure alteration, Of extension' ►t
o B- il d leg cover three stones l] Psalm, 460 mot or mots •Dascri tI w :
o O,.cuFanl t old over 99 per+on+ • U Manufactured etr. Cl rea to RV out gait addli.onal Inereati orer the allowable Is say of die alarm
1111 Egressit:ghdngOhm ' 0 Otter. Perlaapectloo l r _,
.. Submit _ sett of plans with any of the above. • lnvestigedon fee '
•The above arc not applicable to temporary ceMl
uatotloi moles. Other - -- •
ct jun:claimwoo credit cards, plea c all judadietioo for more 1t ctu,olw. Notice: This p*nntt application � �Il fee $ —53 50
V woo
I. ..w, its 3 MasterCard expires if a permit Is not obtained Plan review (at _ 96) $ • Cr cue twm0er within 1 g0 days attar it has been State surcharge (8%) .... $ _4 - 28
• • 1 .. ' - _ accepted as complete. TOTAL $ S7 7R
$57 78
Car .. olds Mpwwe • ' Amami 440445 040/1=A :
- EXPIRED
•