Permit ;:r ti. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00164
, '411' DEVELOPMENT SW Hall BId., Tigard, oR 97223 DATE ISSUED: 3/21/2005
503 - 639 -4171
PARCEL: 2S102CA -00926
SITE ADDRESS: 13260 SW VILLAGE GLENN DR ZONING: R -4.5
SUBDIVISION: VILLAGE GLENN LOT : 026 JURISDICTION: TIG
Project Description: Replace damaged meter base. Job No. 99.9754
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
FREELS, MARK H + KATHLEEN M TICE ELECTRIC
13260 SW VILLAGE GLENN DR PO BOX 15009
TIGARD, OR 97223 PORTLAND, OR 97293 -5009
Phone: 503 - 620 -2425 Phone: 503 - 233 -8801
FEES Reg #: LIC 166
SUP 2586S
Description Date Amount ELE 26 - 126C
[ELPRMT] ELC Permit 3/21/2005 $66.85
[TAX] 8% State Surcharge 3/21/2005 $5.35 REQUIRED ITEMS AND REPORTS
Total $72.20
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 a o . QAAR 9 -00 -8010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions•to OUNC at
503 -2 -6699 or 1 -800 -3
Issue By: I �� it ♦ 1 I k ' Permittee Signaturomp ; "1,016/ a -w`
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 INSTALL • TION ONLY
i .
SIGNATURE OF SUPR. ELEC'N: ` i ���� r � ,1 --�1 DATE:
LICENSE NO: 36,57
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.
83/18/2005 14:58 503 -872 -8290 TICE ELECT.SERV.DEPT PAGE 01
11•')5 ;:;AI 09; 9a •Ft CS i N.. CITY OF TIGARD @ 003
Electrical P 101(OlFiC USE ONLY • . • .
1 � 05 xie,tved S I ll o5 r% � ,, _ Permit No.: Fzz s -6041
• Cili o£ Tigard �;� Pi ' 3 123 sw : -lull 81.d., T;gar1. ORS I3 ^ 1n P. w 01116/ permit: ? n on e• 30. 6$9. 4 ill Fax: 507.396:1960 - P • l,; /i 04 _ 1 e a, sae rise 2 for
;� <peenor Lou- 503.ra39.- ,75 O ITi OF My ,7,,',!„.„ ; '. u Due Autryi8r �, Su ppleraeotal lnformtinn - L • lnterr.er WA W CI.tlptd onus Nal(r+drMCrhod: I _
New n3C fiction Please cheek' all Mu Imply:
[ ,s d'dit:dn!>;!teti9lVreplac¢ meat
05eav1ee over 129 amps, wmm'1 ❑N.a>vrdnua locsaer
C .Demollllon - ❑ Other: DService over 310 amps- rating OButldng over 10.000 sq. ft i
CA.r G . Olt F CO) 'IrRticTrDN . . .. of I. and 7•fan 1
tlly dwellings 4 or more ne�v resrdent:4I
OSYatem over•600 volts minis:al uniU ,n one stn.en:re ,.
I - and 2•fatnily dwelling 0 Con rncrciaUinduatrial ❑ Accessory building OBuilding over three stories OFoeOC^a, saG amps CT MOM
. ] M 4, tl•f .Milt' ❑ Master builder • • 0 Other iOccupatn loud over 99 persons Oh(anufactured slru:tu:cs o
.10g SITE INFORMATIO`I, LOP:AT ON • , O E y ress1ighdtp plan
Rv park
' OHcalthtare facility 000tcr:
. Jab .to.: 99.9754 1 lob side addrei ;c: 13260 SW - • t - - e at Submit sets cfplons with any of** above.
Tigard OR 97223
Tito above an not applicable to temporary evnitruetior. sen•icc.
• CIry g FLZ' SCHEDULE
Swie•bldg :•apr. no,. Project nsme' Kathy FreelS o i oa• 1 rrr, Tam I
' C ross S�eeG'direetiot5. to jOb arts New reaidenttal'single- or multi - family dwelling unit.
Includes attached garage. •
• • ' , • - 1,000 sq. ft. or leas •i 145.15 ! 4 i
i Ea s:d'1 300 so. ft- or portion, 32.40 1 ; • Sui,�.lvcion I Lot no.: l c
• 1 Limited energy, residentie) !..
T. an map parcel :to, • .. Limited s>sni,non•reRdcatia: 75.00 12 1
DE5CIZ(P'FI.ON .07 WORK . • • • each manufactured or modular I
. dweilii j cMce and/or feeder 90.90. 1 = a
• Replace damaged meter base sarvico or feeders installation, alteration, aodior rato;atien
• 200 amps or loss 80.30 1 2
101 amps to 400 Intpl 106.85 2 4
j] PROPERTY coon 0. TY1ttAfl7 401 amps to 600 snips -I 160.60 '2
• ^ ti;me v i 601 u1spstoIA00 ornpa 240.60 I ., 1 •
p„',,ere:c: 13260 SW • village Glen Over 1 amps or vole 454.
.Dr - 53 4
i 2
Over
only ,1, y 66.85 166 RSI 2
Cdr•• /SlLtaiZL': Tigard OR 97223 Temporary iervlcaa or feeders iasteU tlon, ilteratton, aad'or '
? .crc. 503) 620 2425. Fax ( ) relocation _ 200 amps or less 66.85 _ I
•' Owoer installation: This Installation is'being static on property that I own which is not 201 amps to 400 turps 100.30' ? 1
: ::erC =e for sale, lease, rent, or e , accor ORS 4.17.4`9. 670. end 701. 401 amps to 600 baps 133.73
O•.'ersrgn,ure: • Dote: 9rdochtltcuit a- new, alteration, orex tenxioa. per panel
-
A Rte f brsilcp circuits with 11 I
G AP PLI CK`1T ....❑ COP(T I
service or (ceder fee, each 1 6.65 ?
9:13:nod name' ' brunch circuit
- - 9- Fee for branch circuits i
• Co ca:: na.. e' ' • w ithout srn ice or feades fee, . 46..3 2
each branch circuit i
• Add --ess • t 2 i
Each add' / brantli circuit I 6,65
C r: Stax;ZIP Mlseellancout (service or feeder not included)
- I
• - - R Puntp Or itrigation circle 53.40 1 •
Pna -:: c )• Fax ; ( ) sign or outline lighting r I • 53.40 _ 2 = 1
•
c•r..4iI - Signal circuit(s) limited- I
CONTRACTOR • • . , • . • .. • . mangy pact, alrerauon, or
extension. Describe: , l Page 2 . 7
' 13.4ri. - : is n,rnc Tice. Electric. Co. ' i -
p(). -•X • • • Each addltia4al IdspeeIian u•ef allowable in any of the above 1
>�� cis.
Per inspection • 62.50 s i
C'r'.St_tc'211): Portland OR 97293 -5009
Investigation puhoUr(I tit fain) 62.50
! F ax ( 50"3) 872 -8290 Indusbial hour . 73.75 I
>;��� :. 503 233 =$801 ELECTRICAL paritarr PEES'
``B :.,c.. ' 166 I Elects-teal Lie.. 26 -126C I Suprv. t,ic.:/6,,s1 S ' Suototal 1. 66. 1 1
Lion. C;cctrtclail slgnatlsre. rtatllrCd: Phi =vim (25 orpemus fee)
q - • ' stile surcharge (a �. orison-nit foe' 5.35
• r- . -n _. J o sr.:,.... I Date: /sIaorzs
• TOTAL PM:MIT FEE 7270
• a _ir;^c.r,zsr: Srgns u c. 7511 permit appllaetme assure If • prrnrit le ant ebtalord within Itlu • • bay ark,' k ark son boon accepted bs cvmpl•la
P`� •
: 1a:: e . •• r • . I • 1 D ate L Z(D • Pre methodology urby 'M- Cow7 a„i14103 Ibdv*oyk w
rvtce s.r
a - - O N f a• Nurubtrof lrupectru io per ptrtnlr allowoa, •
..,,,.A.,, �.r �:,•.:.[ ; sr ,,. �. t ,p acs 1710 .•o�Flsrt %War /cOM/wxe
vt(ayoGlA—
CITY OF TIGARD
BUILDING DIVISION ', PERMIT #: ELC2005 -00164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2005
Phone: (503) 639-4171 . 4 14011#
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/31/2006 TIME: 7:05AM PAGE: 79
SITE ADDRESS: 13260 SW VILLAGE GLENN DR CLASS OF WORK:
SUBDIVISION: VILLAGE GLENN LOT #: 026 TYPE OF USE:
PROJECT NAME: FREELS
DESCRIPTION: Replace damaged meter base. Job No. 99.9754 c 'k- 92 2 4e
OWNER: FREELS, MARK H + KATHLEEN M, PHONE #: 503.620 -2425
CONTRACTOR: TICE ELECTRIC PHONE #: 503 - 233 -8801
Inspection Request Scheduled For: Date: 3/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 003253 -01 603 -872 -8202 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /� Date:' Phone #: (503) 718-