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Permit '` CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00228 1i DEVELOPMENT SERVICES DATE ISSUED: 4/1/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S111CD -08700 SITE ADDRESS: 15930 SW SERENA CT ZONING: R - 4.5 SUBDIVISION: KERWOOD ESTATES LOT : 039 JURISDICTION: TIG Project Description: Alteration of existing 120 volt service. Job # TG26a1. 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: 1 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: BIELEFELD, ROBERT AND DRYER ELECTRIC INC LESLIE A 9409 NE COLFAX ST 15930 SW SERENA CT PORTLAND, OR 97220 TIGARD, OR 97224 Phone: Phone: 503 - 771 - 5667 FEES Reg #: ELE 26 -1142C Description Date Amount LIC 153466 SUP 2876S [ELPRMT] ELC Permit 4/1/2005 $80.30 [TAX] 8% State Surcharge 4/1/2005 $6.42 REQUIRED ITEMS AND REPORTS Total $86.72 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: ,- 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. 03 -30 -2005 13:44 FROM- ..?.- T-933 P.018/043 F -594 11.011/2 15:12 FAX 5035981960 1.111 ur 11 un.u. . Ele ?!rmit Application 9rt-Dr: iIFII,h. IlSE ONt V City rd : en• veit P� rxnttNo.:, (. D La ors — r —�X � C .2 .� Q. a 1 25 of Ti sw Hull H Blvd-, Tigard, OA. 97223 Ylau " - ew i l Other Permit: one: 503.6: 9 -'1 . '";;; I '-' , - , 71 Fax: 5d3.599.196D ''''t crtn Date/13 . " efspeetion Line,, 403.639.4175 :- .t!se - II pats Ready/By: I 1 _ I is Scc Pagel far t . :ettem w•:d et ww tigard.or.ue NeeZettMethod: J Sbpptement'dlInforatstian ■ • -� r -,� I i - 1 r: , - a 1 , .� ..,,IF Bra :, I ;: fvlu".Fr9 yG` ,!5 1 1 - iii ,: r i , ,•r�,:.r :.,. J New ea tie otiOA ❑ Addition/alteration/replaooment Please check ell lh3 alaply: ©Se. vice over 225 snip:, comm'1 []H;txu•dou; locanon DC1001iliCll ❑ Other: • _ ❑Se vi a ovtr amps- rz *'ng 08ui1dag eicr 10,000 ;q. fl., '- i +r I .� 1 ., `.3''',''''''! , . , ,: I_ . ; %i ''4 F 'r n i j� 1t711 of 1- and 2• family 4wellin° 4 or Tore hew residential l J 1- and �iierily dwelling Q Colrmercialb dustri.al 0 Accessory building r3System lover 600 volts nominal units in nrie strrlcnne OIBuiding ov co flee stories ❑Feeders, 400 amps or more Multi-faa�l ❑ !blaster builder ❑ Other: Manufactited structures or ��, , � Ocwpantl ,ra 2 over 99pa'9otu ❑• i rl + 1 r l is r REgress Aigh in;:piarl RV pt�k ElOthe:: `'' �IFlealth•citn facil:q� © lob no.: Job site :.. � �iA /I 1 ��� .. j G� �P '� pb eci 2 set of of with any o£the above. 'iy /State/LT' ^ 4 .r� ► . 7.1-"r77:'..77'.--':. + = above are not a.r,,licable to temporary consatictioa service. ii _ 1s ... �fn1,;1..4'::).:'": . L I ' 0,'''' .nite/bidg. /si lt , s0.: }' +joetIIatae: �.� I __ — i 9 Gaaeciption Qty, i F ae. n i Ct toss street/cire coons to job site: - tKcw residential single• or rrnth•fnmlly dwcl11n unit Includes attached gel age. ,� 3 0 L S• `,,r) C. 1,000 sy. ft. or le 14S.1 ! S S ubdivision: T Lot no.: Ea. add'l 500 sq. ft. or portion 33.44 • i I. Limited cnergG reside Limited 2 I fax ma t•el act: / tier 75.04 • --1 map 7 r , I , _ r . ` ,—. c*-. --•--'-' 1 re lit° enerr , l'e n-T''sid' n - .. i , i Ir- • 1 ' , " Each =maim a wl ar modular r . dwelling, se rtt�e eu�'ur feeder 90.9Q 2 �'1 figs • MVO it / _ Ser ekes or fee is installation, tilt Wien, and/or reiocatl • n . SiALI � , r 200 amps or less Mu 80.3oi �tflitMt i i 2 01 tans to 4 4) 0 amts 106.85: 2 • , 61 r..;: p � _ : . _ , i 401 amps co 600 amps M 160.60: : 2 erne: � 3 601 amps to 1,003 amps 240.60' ' 2 O'• '° Over 1,000 cs or volts . 454.651 - 2 4�dzass: ��n�nap — 1 RecOnnect only 66. 2 ity /State/ZIl': Temporary a i-vkei or feeders in=ItaIlation, alte!•atioa, and/or '�'�.... relocation 'ftone: ( ) Fox: ( ) 200 asst's or leas 66.85i - 1 ,,Iwner ttletalInittal la: dow This installation is being Invade on property that I own which is not 201 amps to 400 am 100.301 2 ctenckd for r a1; lease, rent, or exchange, according to ORS 447, 449, 670, and 70! . 401 amps to 600 amps 153,751 z Awner signature r __Date: Branch circuits - new, alteration, or extension, Per panel 1 r ' I , ; '1 - i , � - ,: 7 -.. , , , ..7:::, , � . , A. Fee for bra cii uits wirh ` I _ ‘ 1 , - , . -- ' .. : . . � . , . . _ .... • _ .. • .. .. .._ _ . , . service or It:e@ er fee, each I 6.65 2 • +usi lamb Circuit i >zess Haas: T.�...�� _ B. Fee for brar,ct oil cults Ontect name :: wirhwsr sen'ie.: o::t•eder fee, :16.65 2 dress: • each branch. c irc lit ddress: - Each add'' branch c.r:uit 6.65'` 2 'ity /State/ZL ?: Miscellaneous: (ter''ice o r feeder pot included) -I. _ 1 Pump or irrigaticn circle 53..4 2 .hone: ( ) � Fait:: ( ) Sign or outline liELIttng 53.40 2 : ',mail: T Signal ctrauitZr) arI :mitred r I:r T ,i;{1 energy panel.,sltl:rnlinst. or �: } . us'm ass names: 1 1 . L. :.. � , ,.:.... ___ � extension. lass cr.b,:: I Page i i 2 3dress• / Iii , / l` Rl e 1. ' - Bach additional I o::don over allowable In any of the above ` � i Per inspection 62.5 ity /State/2I ?: d �I �N / r I' ov d J Investigation llerhour (1 iu rnin) I — 62.50 i y � r �� Induezleislantsetup). %3J_ hone: ) _ /,‘,.• � _ � I i-' o I,: _11141 -.''`'; ; . y ..�� 7 _ a ;qe-; .;; r 1 I ..l t�, n, : :J, u a ';i3 Lic.: Electrical Lic.: Strprv. l ic.: ^ T R Subtotal ' ' Aii • a Flan review (25% of perrtlit fee) tprv. Blectrioiaa sigh ra, tequirul: - - -.— =_ — 3I414 surcharge (Pk of pe-mie :ea) 0 :vtt name: .• a Aata: �� �• . /I � TOTAL PERMIT FEE .40 1 !) 1 Ia. '- udtorized s :.gttonne: This perralt applica; in expires it a permit Is not oblpine with n i = 0 days slid. (Chas been aeceprad as complete ' • :int mune; Daze: • Foo =awls) logy u• :t t y Tri.County l?fuilding indzaQY Sery :ce Board - Number ortesp:crilm. per permit atlolma .Itd:oavemiPIE:CPerroaAppatoa ta/09 4ac.461rI(10ro2/I0M/WEa - - CITY OF TIGARD • . • BUILDING DIVISION PERMIT #: ELC2005r00228 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/1/2005 Phone: (503) 639 -4171 :°d'rl I�`I � Inspection Requests (24 Hrs.): (503) 639 -4175 =� ' INSPECTION WORKSHEET FOR DATE: 4/8/2005 TIME: 7 :10AM PAGE: 37 SITE ADDRESS: 15930 SW SERENA CT CLASS OF WORK: SUBDIVISION: KERWOOD ESTATES LOT #: 039 TYPE OF USE: PROJECT NAME: COMCAST DESCRIPTION: Alteration of existing 120 volt service. Job # TG26a1. OWNER: BIELEFELD, ROBERT AND, PHONE #: CONTRACTOR: DRYER ELECTRIC INC PHONE #: 503.771 -5667 Inspection Request Scheduled For: Date: 4/8/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004118 -13 503.516 -3125 N Corrections/Comments/Instructions: 0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: u-e-dA Date: -/ f - V S Phone #: (503) 718-