Permit - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00510
r.+�l f, DEVELOPMENT SERVICES DATE ISSUED: 7/18/2005
l
�'� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S125DB-09200
SITE ADDRESS: 07070 SW SHADY LN ZONING: R -4.5
SUBDIVISION: THE RAZBERRY PATCH LOT : 012 JURISDICTION: TIG
Project Description: A/C, furnace & GFI. Job #2396.
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:
DAVE WEIDNER HILLSBORO ELECTRIC
7070 SW SHADY LN . 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 452 - 8992 Phone: 503 - 439 -9666
FEES Reg #: ELE 34 -4399C
Description Date Amount LIP 134481
SUP 4941S
[ELPRMT] ELC Permit 7/18/2005 $60.15
[TAX] 8% State Surcharge 7/18/2005 $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: - Permittee Signature: pt sc
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.
• From:HILLSBORO ELECTRIC LLC. 5036013680 07/18/2005 09:42 #113 P.002
Electrical Permit AD14ation FOR OFFICE 1141: ONLY
rr:
City of Tigard V E I VE ; Ra c/8v�: .-/• permi NO.:
a & a� 7Ov
13135 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JUL 'l� {i11 n. Daten3v; Other Permit:
Inspection Line: 503.639,4175 1 8 2 �_ Date Ready /By: WIRE ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
.
CITY OF TIGARD . .
T �UNf [ p�' . • .. • • PLAN REVIEW
• ❑ New construction ("' Addition /alteratio ��1t Please check all that apply:
OService over 225 amps. comm'I ❑Hazardous location
❑ Demolition Other
- ['Service over 320 amps - rating ❑ BuildnL over 10,000 sq, R„
. - • CATEGORY OF CONSTRUCTION -... • .. of 1- and 2- family dwellings 4 or more new residential
C 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
QBuildiny over three stories ❑Feeders, 400 amps or more
[] Multi- family 0 Master builder 0 Other:
•JOB SITE INFORMATION AND, LOCATION ; , _..;. : :, . ❑Occupant load over n 99 parsons ❑RRlV park
cfured structures or
❑Egress/lighting plan P
, Job site address: /, 'p DHealth -care facility ❑Other;
Job no.:
1A 4 .4 • � , 4 -4 Submit 2 sets of plans with any of the above. •
Ci /Stets A i �77 The above are not applicable to temporary service.
tY PP P rY
Suite /bid Ja t. no.: 1 ' Project name; t/ a i�/
6w aercrrption I Qty. I Fee. I Total I'
Cross street/directions to _job site: New residential single- or multi - family dwelling unit.
Includes attached garnge.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'I 500 sq, ft. or portion .. 33.40 1
— Tax map /parcel no.: Limited energy, residential - 75.00 2
Limited energy, non - residential 75,00 2
• I0
-
.. ;.. ;.; ; DESCRIPTION OF WORK :;fir- _�;: _
•' Each manufactured or modular
_ .
L . a � , X 44 G F ( dwelling, service and/or feeder 90.90 2
j # 1'!� L —r ( � , Y Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 ' 2
[PROPERTY OWNER":'.... ...... L '- ; - .• , : -_ : :.. -
_ .. ❑ "TEN;INY, ° °, I ampsto 0 amps
�/ ' 401 am •a to 600 am • • 160,60 2
Nam � r V144 ' 601 amps to 1,000 amps 240.60 _2
A ddress: e,� � � t IA v Over 1,000 amps or volts 454.65 2
• Reconnect only J 66.85 J 2
C ity/S tate/Z I P: Temporary services or feeders installation, alteration, and /or
Phone: t ) ( Z, lq 1 Fax:( ) relocation
200 amps or leas , s 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits- new. alteration, or extension, per panel
" - • ' - 17 APPLICAN'Tr •:!:••::';:.--::::.::::•;-:'.-•. ; -• . -? ❑:CONTACT PLtRSON,..f: ^;c'"•` . A. Fee for branch circuits with
'service or feeder fee, each 6.65 2
Business name: 1 branch circuit
Contact name; B. Fee for branch circuits
without service or feeder tee, 46,85 .K2
Address: each branch circuit
Bach add'I branch circuit 7j 6.65 j' . 'O'Q
ce or fee
City /State/ZIP: Miscellaneous (service not included) , r —
Pump or irrigation circle 53,40 . 2
Phone:
( ) I Fax:: ( )
Sign or outline lighting 53.40 _ 2
E -mail: • Signal,circuit(s) or limited-
' CONTRACTOR : ? : • ........:: „ . „.: •[.. energy panel, alteration, or
extension. Describe: Page 2 2
Business name:
Hillsboro Electric L.L.C.
Address: 21185 NW Ev PKWY Ste #110 Each inspection Inspection over allowable in any of the above -
Per inspection 63.50
City/State/ZIP: Hi11sboro OR. 97124 Investigation per hour (I hrrein) ' 63.50
Phone: { 5 0 3) 439-9666 Fax: (5-3 )601-3680 Industrial plant per hour 73.75
.ELECTRIC AI. PERI4IT PEGS* -' •
CCB Lic.:1 3 4 4 81 Electrical Lic. :3 4- 4 9 9C Su rv, Lie.: 4941S 15
Subtoml
Suprv. Electrician signature, required: C Plan review (25% of permit fee)
Print name: Joey Vitacco Date: 1 1 � 0,� State surellar (Sala of pt rmlt fee) _ • I
TOTAL PERMIT PEE (,014 - q(61
• Authorized signature: . This permit application aspires Ka permit is not obtained within 180
days after it ban been accepted as eunrptete
Print name: Date: " Fee methodology set by Tri -County Building Industry Service Board
" Number of inspection: per permit allowed.
i:\ Building \Pcrmit\EL.C-Pcrnurapp.doc I2/05 4 411 - 1r 1ST( 111/Q2/CoM/WEB
CITY OF TIGARD
. A
BUILDING DIVISION PERMIT #: ELC2005"00610
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/18/2005
Phone: (503) 639 -4171 '' si ,� l
Inspection Requests (24 Hrs.): (503) 639 -4175 "__..
INSPECTION WORKSHEET FOR DATE: 8/2/2005 TIME: 7:03AM PAGE: 71
SITE ADDRESS: 07070 SW SHADY LN CLASS OF WORK:
SUBDIVISION: THE RAZBERRY PATCH LOT #: 012 TYPE OF USE:
PROJECT NAME: WEIDNER
DESCRIPTION: A/C, furnace & GFI. Job #2396.
OWNER: WEIDNER, DAVE PHONE #: 603 452.9992
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439-9666
Inspection Request Scheduled For: Date: 8/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012579 -02 503538 -2953 Y
Corrections /Comments /Instructions:
4 /.-- PAW CZ-- 4 b/, r___ _d A
r\/1, U°.1 /7 ti" f vg\t /ti p <10 'i F
b Ise, on/ A( 7 O /4 0 v 5 tak
C ,,, Ilb.
10 PASS M PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL "'ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: — Date: Phone #: (503) 718 -
w