Permit ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2006 -00548
h.i DEVELOPMENT SERVICES DATE ISSUED: 9/28/2006
c-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S125DD-03900
SITE ADDRESS: 09855 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT : 047 JURISDICTION: TIG
Project Description: (1) 200 amp service. Job #E317.
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:
DON LOVE S & A ELECTRIC, INC.
09855 SW VENTURA CT PO BOX 218
TIGARD, OR 97223 BORING, OR 97009
Phone: 503 - 452 -1788 Contact #: PRI 503- 658 -5368
FAX 503 - 658 -7257
FEES
Description Date Amount Reg #: ELE 3 -520C
[ELPRMT] ELC Permit 9/28/2006 $80.30 LIC 148014
[TAX] 8% State Surcharge 9/28/2006 $6.42 SUP 4833S
Total $86,72 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: T7 Yfj�4± Permittee Signature: �, 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 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.
Electrical Permit Appl •
roi, oi..1.1(.1.-. t st: oxi.,•
City of Ti Da Reccd em . : , Aks 0 : „ .. .........,-- - L. Perrin/ No.L ■ ,.... A-0 ) y
13125 SW Hall Blvd,, Tigard, OR 97223
Plan Review —
Phone, 503,639 4171 Fax. 503.598.1960
Other Perron.
Inspection Line: 503.639.4175 ' Date/8 :
,Awil.- , I,J;. Dato RoodylBy.
1 See Page 2 for "------
)14(
lutetnet: www.eLtigard or.us Notifiecl/Merbod: 1
Sapplomeotat information
:-.,'-1.M*0.0-7-70,t4,01Ay0,6,1"1*AtIMM.,S.AiNt.,..Are ' 1' , 1\ 1 . =, . 4 ..: •,i tit ,, ,.44.',i' : . : :; v •:f, FLAN HEVIEW
0 New construction 0 Addition/alteration/replacement Please check all that apply:
°Service over 225 amps, comml 01-lazardous location
, 0 Demolition El Other:
._____. ['Service ova 320 amps - rating DBuildng over 10,000 sq, ft.
.. ,,
c-A,1741?X.'cilt, cc)NPROPTAI:Pi6Vreite-"N'S'''-.)-,'Tie:t4n,L
.41sI c eor''
- and 2-etunily dwelling 0 Commercial/industrial ikej.e—ssory building of I- and 2-family dwell lilac 4. or more new realdenual
0Systcm over 600 volts nominal units in one structure
uilder
El
°Building over three stories OFeeders, 400 amps or more
Multi-family • EJ Master b D Other:
.,.,_,
. '"': ''' . . '. ...'.! POccupant load over 99 persons OManufactured structures
—___ or
. • " ■101i itit;S:044170.kAi..kitialrlikti.';,UIP'*..;q.'w-_,i,', Cingresdlighting plan 1W park - -
-
01 facility 00ther:
Job no.:E" • / . Job site address: 421•:te41101WITITIL......
Submit 2 sets of plans with any of the above,
City/State/ZIP:
; i ;•- -'-,. i ,.. ...., .. ,. The above are not aoplieahle In temporary construction service.
.—.— ?.Z:' ,' 'e,.. , :',.-.... , ', !. FEE" SCHEDULE
Suite/bldg./apt_ no.: 1 Project name:
• -
Description I Qty. I Pto. Total .'
Cross street/directions to job site:
New res idential che s d ing a k ra - g o e r multi-family dwelling unit.
I
1,000 sq. ft. or less 145.15 4
— _ -
Subdivision:
I Lot no.: Ea add'! 500 sq. ft. or portion 33.40 i
— Limited energy, msidenttal 75.00 2
Tax tottp/parcel nu.:
, .,......,,....,. Limited energy, non-residenti —
al 75.00 2
- . DE SCRIETION.:OF*ORk.V... , ...., 7 7 ' ...';':.'.4,7,::.:.?),!;+k Each manufactured or modular
___, 1 . t - I
titt■ . LAC r, r i\JE t, dwelling, service anclior feeder 90.90
Services or feeders installation, alteration, and/or relocation 2
.
200 amps or less I , 80,30 eb50 2
2
____ , ,..167 . owNER hk 4,..,1.71...:$*;,:%0N. rylincorr,....,;;; Fii,...Vi 40 20 1 1 =10810SO amps
1 ,.. \ -
amps to 600 amps 160.60 2
.0 i ( 601 amps to 1,000 amps 240,60
2 _
______
_
- Name:
__ _,„
Address:
Over 1,000 amps or volts 454.65 2
--- — Reconnect only 66.85 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
_
Phone: (505) 95 c,„2 1'»1._ i Fax: ( ) relocation
_ 200 amps or le.ss 66 85 -.—
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 Circuita— new, ancranon, or extension, per panel
0 Amid - ANT ,:;.1.:),..;..447,1,A.:,,z,i; • k1 . 4 7 4 -, 4 - pia . ci*TAcr,PERgoN•4.;,•,,T,cri A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name:
branch circuit
B. Fee for branch circuits
contaa name:
without service or feeder fee.
first branch circuit 40 85 2
Address:
Each add'I branch circuit 6.65 2
City/State/ZIP-
Miscellaneous (service or feede r not included)
_
----.
-
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) _
_ Sign or outline Halting 53 40 2
E-mail:
Signal circuit(s) or limited-
' - - '- ' . ‘; • `‘ ' , ,'-,k':''''2'XolkilrRAC •A'..C:0`i•;ieiiktVi: energy panel, alteration, or
extension Describe: Page 2 2
Business name: -5"'" —
_ic __ ..,
I
Each ,__ additional inspection over allowable in any of the above
—
Address: * 0 '- .31 y 21fil
Pcr inspection 6230
City/State/ZIP: 1 • ,. . 0 t ..di oi ar
Investigation per hour (i hr m,n) 62.50
Phone: ( i e , - • Le =Br: ‹ .41 . • Industrial plant per hour 73.75
•`,"',,..• ELECTRICAL PERMIT FEES
CCB Lie.: / _ _
61 Electrical Lic.: ' - - 20 L. Suprv. Lie.: 9/
•...
Subtt1 60;)
'
Suprv. Electrician signature, required. „..„..„. 7 / ./../. Plan review (25% of pcntilt fee)
Print name ......--
' .t-
,r A
State surcharge (8% of permit fcc) 10' L1 -...,
: r
--'
• ., •
, 6 it . .N . ■ ' . I Date: 09- zo_dc,
...-__. . TOTAL PEEtmr••e . ,
Authorized signature. ,464, ik‘lin
Mb permit application expires If a permit is not obtained withm 180
-
days after II has been accepted as complete
Print name: ...
, . -
Date: - 22 . - 04 0 • Pe methodology t.ot by Tri-County rtuilthug Industry service Hoard
i ' 4 ,
-
•• Number of per permit allowed.
ullitalding\l'ermittASI-C-PonmiApp doe 12/01
44 D -4615 T(IlV021COMVIDI
2 'd
eIO:IT 90 B2 daS
CITY OF TIGARD p4z k pr
BUIL SING DIVISION C ��, ,.�.w+�- G PERMIT #: FLC2006.00.18 Hall Blvd., Tigard, OR 97223 DATE 9/26n006
Phone: (503) 639 -4171 6 .
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_ ' "'I i l ..
INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: 7:06Am PAGE: 3
- SITE ADDRESS: 09855 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 047 TYPE OF USE:
PROJECT NAME: LOVE
DESCRIPTION: (•1) 200 am p service. Job #E317.
OWNER: LOVE, DON PHONE #: 503-462 -17811
CONTRACTOR: S & A ELECTRIC, INC. PHONE #: 503.6?-;8-5368
Inspection Request Scheduled For: Date: 10/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037569-01 503 - 730 -8695 N
Corrections/Comments/Instructions:
) /' 1 7--
/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ C , LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1, Date: /0(3 D& Phone #: (503) 718-
o d
_ ., , .