Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00366
DEVEL SERVICES DATE ISSUED: 7/6/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 CD -01200
SITE ADDRESS: 09500 SW SUMMERFIELD DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT : 362 JURISDICTION: TIG
Project Description: (3) branch circuits for air handler & heat pump. Job # J29681.
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: I 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:
PHYLLIS HASS WEST SIDE ELECTRIC CO INC
9500 SW SUMMERFIELD DR 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: 503 - 620 -6709 Contact #: FAX 503 - 736 -0677
PRI 503 - 231 -1548
FEES
Description Date Amount Reg #: ELE 26 -I35c
[ELPRMT] ELC Permit 7/6/2006 $60.15 LIC 13306
[TAX] 8% State Surcharge 7/6/2006 $4.81 SUP 46545
Total $64.96 REQUIRED ITEMS AND REPORTS
•
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: Aro / Permittee Signature: S.Aft, 1",")1\0
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.
II_
� —
Electrical Permit 1t ' ma nv F r . FOR OFFICE USE ONLY
City of Tigard Reccivc1 // U Q
DaoJlt Permit Nn. / . 1im t(; O4p e
13125:m lio i n Blvd., Tigard, OR 972 q 1 — r`•. / y r
Ilan Review
Plume: 50.3.639.4171 Fax: 503.5911.U/60_ �� ( V 2UU ' ill' Datc/Ity: Other Permit:
Inspection Line: 503.639.4175 aa8t ea I' Date Rca4Y /l4y: )., El See Page 2 for
Internet: www.ci.tigard.or.ug v a M Nulirutl/MelhMl; Supplemental Information
o .1i Iali& P y cTIM PLAN REVIEW
El New construction 7.4 iAddition /aitcr.ition/rcplaccmcnt Please check all that apply:
❑ Demolition
• Other ❑Service over 225 amps. eomni I El l iararslous location
❑Service aver 320 amps rating ❑13uiIdng over 10,000 sq. IL,
CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 nr more new residential
1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
0l3uilding over three stories ❑recdcrs, 400 amps or more
❑ Multi ❑ Master builder ❑ Other:
❑occupant load over 99 persons ❑Manufactured structures or
... JOB SITE INFORMATION AND LOCATION ❑tigJess/lighting plan RV park
Job nu.: S,Z (f ' r ❑health -care facility ❑()flier;
68 1 Job site address: `�An 7 ( " 5 u . �' 4 c Submit 2 sets of plans with any of the above -
City/Stale/ZIP; -77,.0 p 4 , it ' ( 7 2Z The above are not applicable to temporary construction service.
/
Suite/bldg./apt. J r _ V Co - FEE* SCHEDULE -
no,: Project nam e: �_ 4 S ( 7 /Ch /144 c o Hi A ` 1r D..rr[Pr4,n Qty. I Noe. I To , �•�
Cross street/directions to job Site: New residential single- or mufti- family dwelling unit.
Includes attached garage.
1.000 sq. it ur less 145.15 4
Subdivision: Lot no,' Ile. add'l 500 sq, ft, or portion 33.40 I
- _Limited energy. residential 75.011 2
Tux map/parccl no.: " — I.imi tett energy, nun - residential 75.00 2
DESCRIPTION OF WORK B ach ntanufhctured or modular
—
�( dwelling. service and /or foxier 90.90 2
- W
--. .r v CCU tn.Q .•• • J i 1A0cC ..e PIA, e Services or feeders installation. alteration, and/or relocation
200 amps or less 80.30 2
" 201 amps kr 40(1 amps 106.85 2
PROPERTY OWNS ❑ TENANT —
401 amps to 600 amps 1 60.00 2
Name: u S S all amps to 1,000 amps 240.00 2
Address: € Over I.0(X) amps or volts 454.05 2
L.S L . `/ connect Re only _.
Y (i6.85 2
City/State/ZIP: - Temporary services or feeders installation. alteration, anti /or
Phone: (503 )6 Z.0 0 4 Fax: ( ) relocation � _ 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 antps 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: Brunch circuits new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee Ow branch circuits will, _..._
service or feeder Ice, each
Business name: hr,uch circuit 6-rr5 2
Il. Fee Ibr branch circuits
Contact name: without service or feeder fee,
46.85 qt,?5 2
each branch circuit
Address: ..
c �
Each add'I branch circuit " 6.65 `; . Z 0 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 I 2
( ) Fax: ( )
Ismail: Sign or outline lighting 53.40 2
," Signal circuit(s) or limited-
__ C ONTRACTOR energy panel, alteration, or
extension. 1k - scribe: Page 2 2
Business name: West Side Electric Co., Inc.
Address: 1834 SE B AVE. 0" Each additional inspection over allowable in any of the above
.. Per inspection 02.50
City /State/ZIP: PORTLAND, OR 97214
Investigation per hour 0 lir min) 62.■0
Phone: (503) 231 -1548 Fax: (503) 736 -0677 Industrial plant per hour _ 73.75 -
• L ELECTRICAL PERMIT FEES
(Y :131.ii.: 13306 I Eieetrical /I.ic.; • -135C Suprv. he.; _4654$ _ Subtotal ��)r 15
. —.. ...
r
Suprv. Electrician signature, require • , • • L ' _4' / AL _ t Plait review (25% of permit fee)
G / State surcharge 8% or semi( roc) ��- 1. Q'
Print name: J D :-7 7
/ o / t• ( P ) "
_ [2 , d �l _ .�. t 2 Q r 4 ur _...
. TOTAL. rEam 'f P EE 9 CI , 4 6,
Authorized signature: mi. Permit application expires Jr a permit is not nbta within MY
days after 11 has beer aeeepled as complete
Print name: Date: • 1 w nrertx
—. YY set by Tri C ounly Building Industry Service Hoard
•• Number or is pel :11 unc per permit allowed.
i.U)uildingteernuioi :r.l '- Pc. nil AM) due 12/03 440.45i.iT(1I1/02 /e'OM /001!0
Z ' d LL90 -9EL I E0S l • 00 o i.azo013 P I S sap e9E t 90 90 90 'MC
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006.00366
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/6/2006
Phone: (503) 639 -4171 • gJ
Inspection Requests (24 Hrs.): (503) 639 - 4175 � '!
INSPECTION WORKSHEET FOR DATE: 7/7/200 TIME: 7 :02AM PAGE: 60
VI/ ti TSB ,l,..ts'a'
SITE ADDRESS: 09500 SW SUMMERFIELD DR CLASS OF WORK: 1
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 362 TYPE OF USE:
PROJECT NAME: HASS
DESCRIPTION: (3) branch circuits for air handler & heat pump. Job # J29681.
OWNER: HASS, PHYLLIS PHONE #: 503 - 620 -6709
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503.231
Inspection Request Scheduled For: Date: 7/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 032796 -01 503 -231 -1548 N
Corrections /Comments /Instructions: /�
nf t t P✓ v,ie �O m i/c & . , \ r<
Z gwe > S 'i tL 0A61/(5 vdv(5i
X1 15 ^76_,
PIA-- v &A M 97c 7-< i
a"
P ❑ PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS
(/ ❑FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: HIP Date: 9. 9' 0 6 Phone #: (503) 718 - Z Lie—i