Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00153
011 DEVELOPMENT SERVICES DATE ISSUED: 3/19/01
^` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 114 B B -02200
SITE ADDRESS: 16360 SW SYLVAN CT
SUBDIVISION: PICKS LANDING NO.1 ZONING: R -4.5
BLOCK: LOT : 036 JURISDICTION: TIG
Project Description: One Circuit - Job No. 35462
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: 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:
MILLS, CHRISTOPH M + MALEA A OREGON ELECTRIC CONST /GROUP
16360 SW SYLVAN CT 1010 SE 11TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: LIC 203
SUP 1302S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 3/19/01 $46.85 2720010000( Elect'I Final
5PCT CTR 3/19/01 $3.75 2720010000(
Total $50.60
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 -1987.
PERMITTEE'S SIGNATURE O. A � Q , ISSUED BY:
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
. MAR -19 -2001 11 24 , ' P.01/02
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Electrical Permit App
A
roecivcd•' Permit
l/ �6 no,Q�
l City Tigard . . - Pre Date ec pp ,r3 9 c ire / �, f 3:.
:I��; y of ) Va Ln Expire date:
CiryofTigard Address: 13125 SW Hall Blvd; Tigard, OR 97223 Date issued: By: I Receiptno.: • • -
Phone: (503) 639 -4171 ��..,
Fax: (503) 598 -1960 Case file no.: Payment type: ' • _ .,
Land use approval:
•
• •
C11'E: OF 1'f :1(;IIIT
O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvemanc a J-
O New construction O Addition/alteration/replacement 0 Other. 0 Partial
JOB SITE INFOft\lAT
Job address: 1 6 D s Y1 vin t; t . Bldg. no.: ' Suite no.: Tax map/tax lot/aceount no,:
Lot: Block: Subdivision:
Project name: Mi 1 s, Chris Description and location of work on premises: 1 ckt -
Estimated daft of completion /mspecdon:
('ONTR.k(°[OR :\PPLI('A•I ION •Ia-: S(•lll:D11.I: � •
Job no: 3 5_51_6 2 Fee • le ....4b iva
Business name: • D saipttoa Qty. (ea,) Tmal no. MEP
Orcgon Eloctric Group N n residential -sink a' nadtilonaly per
Address: • 1010 s,,E 11 th .Ave . dwellingtmitlnrindessnadredg c. •
City: Dprt 1 nri State: t7R j ZIP: 9721 4 Serrnir*mrluded •
Phone: 7 34 - 9 9 0 0 [Fax: ? 3 4 - 1 c — mail: 1000 sq, ft or less V 4
CCB no.: I E1ec. bus. tic, no: ? _ q 5 t^ Each additional 500 sq. ft. or portion thereof ,
03 Limited energy. residential _
City /metro lie. no.: Limited . 2
3 1 9- 0
Each manufactured home ermodulardwelling - -- - -1— V V
2
Sigrtatwe of supervisin8 electrician (teCuired) Date Service and/or feeder
Sup. elect- name (print): License no:
Services or feeders - installation • , •
alteration or relocation: . . .
PROPERTY OWNER 200 amps or less 2 •
-
Name (print): 201 amps to 400 am • - , 2
Mailing address:
401 amps 600 amps 2 .
601 amps 10 1030 amps
City: 1 State: [ZIP: - Over 1000 amps or volts '
Phone: JFax: 1 E - mail: Reconnect only • ' 1
Owncr installation: The installation is being made on property I own . Temporary services or feeders -
which is not intended for sale, lease, rent. or exchange according to v'd0u,alteratloo , orreloatloa „ •
ORS 447. 455. 479, 670. 701. • 200 amps or less Z`. •
201 amps to 400 amp s 2
Owner's signature: Date: 401 to 600 amps . 2 i
ENGENEEK Branch elreulta- new, alteration, ,• •
or extension per panel: - ,
• Name: , ,
. A. Fce for branch circuits with purchase of
Address: service or baler fee, each branch circuit : 2 ,
City: - TState: 1 ZZP: B. Fee for branch circuits without purchase
Phone: Fax: E of service or feeder fee, first branch circuit: 1 41:. 85 '
Each additional branch circuit:
PL IN REVIE V (Please check all that apply) Misc. (Service or feeder not lneladed): ' • • • 1
- Cl Service over 225 amps- commercial l] Health -care facility Each pump or irrigation circle ' 2
O Service over 320amps- retingof l&2 0 Hazardous location Each sign or outline lighting 2
family dwellings O' Building over 10,000 square feet four or Signal circuitCs) era limited energy panel. • •
O System over600 volts nominal 'mote residential units in one structure - alteration, or extension* •
O Building over three stories ' . 0 Feeders, 400 amps or more •Description: •
_ 0 Occupant load over 99 persons 0 Manufactured structures or RV pant Fsch additional inspection over the allowable In any of fbe abort:
O Egress/lightingplan - • 0 Other: Pct '
- Submit sets of plats with any of the above. . Investigation fee ,
The above are not applicable to temporary cotraatruettoet'service. Other '
Not all jurisdictio accept credit ca mine et please call jurisdiction r infe,mwen. Notice: This permit application Permit fee $ 4 6 .. 9 5
ns
O Visa O MasterCard V expires if a permit is not obtained Plan review (at _ 96) $ _ .
Credit care numb r: ' . V _ 1 I within 1$0 days after it has been Stare surcharge (8911) -- S _ S
• Esping accepted as complete.. TOTAL • $ 5 O 6
dame or rardhot&er as shown on emdit cad
Cardholder signature S • ••'"; ‘,1., ). tt p,�i � a 0 •
gnature Amount 1 440.1615 (600X014) •