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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00521 DEVELOPMENT SERVICES DATE ISSUED: 7/25/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103CC -14600 SITE ADDRESS: 12051 SW WHISTLER'S LP ZONING: R -4.5 SUBDIVISION: WHISTLER'S WALK NO. 2 LOT : 093 JURISDICTION: TIG Project Description: Installation of A/C unit. 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: WILLIAMS, EDWARD HILLSBORO ELECTRIC 12051 SW WHISTLERS LP 21185 NW EVERGREEN PKWY #110 TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: 503 - 590 -9502 Phone: 503 - 439 -9666 FEES Reg #: ELE 34 -4399C Description Date Amount LIP 134481 SUP 4941S [ELPRMT] ELC Permit 7/25/2005 $46.85 [TAX] 8% State Surcharge 7/25/2005 $3.75 REQUIRED ITEMS AND REPORTS 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 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or 1- 800 - 332 -2344 Issued By: /52/6 Permittee Signature: � cv 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 07/25/2005 12:16 #169 P.002 " .. , r Electrical Permit ,Anpli E _ V E ) FOR OFFICE 1151 ONLY City of Tigard Received �/� 7��y�l �' Tigard ' Received / .. r� f (N Permit No.. w o .. ( e 13125 SW Hall Blvd, Tigard, OR 97223 JUL 2 5 t Plan Review Phone: 503.639.4171 Fax 503.598 1960 tg ^'Ut rl ! Date/lay; Other Penna Inspection Line: 503.639 4 175 ,.� L Date Ready /By a See Page Z for Internet. wwwet.ttpardor.us CITY OF TIce - Notified/Method Supplemental Information e PLAN REVIEW ❑ New construction a Addition/alteration/replacement Please check all that apply ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ❑Hazardous location CATEf:O OF CONSTRUCTION • ['Service over 320 amps — rating ❑ Buildng over 10,000 sq ft , of I. and 2- family dwellings 4 or more new residential Mc- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure El Multi family 1=1 Master builder ❑Other: DBuilding over three stories ❑Feeders, 400 amps or more JOB SITE INFORMATION AND LOCATION " - - ❑Occupant load over 99 persons ❑RVnark tared structures or ❑a en/lighting p P , OHealth -care facility ❑Other - Job no.: _ 4 0}.• o. site a. • ass: ' 4b ..4 4 Imo' • as. M Submit 2 sets of plans with any of the above, City /State /ZIP: , . , ei v2, The above are not applicable to temporary construction service. " FEE *.. SCHEDULE. ' `' Suite/bldg /apt. no, Project name: ' ' /A IA oeseription ' Qty. Fee ramp Cross street/directions to job Site: New residential single- or mull- family dwelling unit, Includes attached garage. 1,000 .. ft, or less 145,15 4 Subdivision: Lot no.: Ea, addi 500 sq ft. or portion 33 40 I Tax map /parcel n0.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 • i i • • DESCRIPTION OF WORK :- _ - ., ' • :, _ . Each manufactured or modular ``'' dwellin • service and/or feeder 90.90 2 IFA Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 PROPERTY OWNER 1 . . , , . : ' , . . : . 7 , . . . ; : . ' - __ 201 am.- to 400 amps 106.85 401 amps to 600 amps _ 160.60 — Name: Alin ( 4 Arj A 601 amps to 1,000 amps _ 240.60 IIIIIIII0 Address: , g a(ooJe) Over 1,000 amps or vole _ 454.65 —© Reconnect only 66.85 2 City/State/ZIP: Temporary service! or feeders installation, alteration, and /or Phone: ( 05 1 Fu: ( ) relocation 200 amps or less 66.85 S� Owner installation: is installation is being made on property that I own which is not 201 am .s to 400 am. • IIIII 10030 — 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: Broach circuits — new, alteration, or extension, per panel • D APPLICANT.' .''' • 7" ., .❑ .CONTACT PERSONT• < = , „ A. Fee for branch circuits with • service or feeder fee, each 6,65 2 Business name: . branch circuit Contact name: B. Fee for branch circuits wt[hrrul service or feeder fee, • • each branch circuit 46.85 , Address: Each add'I branch circuit 6.65 City /State/2i Miacellaneooa (service or feeder not included) Pump or in,gation circle 53.40 2 Phone: ( ) Flu:: ( ) - • 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: Each additional inspection over allowable in any of the above 21185 NW Evercrreen PKWY Ste #110 Per inspection 62.50 City /StateJZIP Hillsboro, OR- 97124 investigation per hour (I hr min) 62.50 Phone. (5 0 3) 439-9666 I Far: ( 503 ) 60 1 - 3 68 0 • Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES" CCB Lic.:1 34481 Electrical Lic.:3 4— 4 9 9C Suprv. Lie.: 4 9 41 S Subtotal 141'544-- Suprv, Electrician Signature, required. MOS i - Plan review (25% of permit fee) Print name: Joey Vitacco ' Date: i, State surcharge (8% or perm it fee) '�j -14' [��� TOTAL PERMIT FEE ,lieaiten Authorized signature: This permit o ez irei if s P Pt P permit is not obtained w' i u tsn , ,l days after It has been accepted as complete D V Print name: Date: • Fee methodology set by Tri County Building Industry Servic c a rd 't" Number of inspections per permit allowed istBnildin }1i'ermttM,C•ParmitApp.dec 12110 441144.1,IT(tu/12/COM/WED CITY OF TIQARD BUILDING DIVISION PERMIT #: ELC2005 -00521 13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 7/25/2005 Phone: (503) 639 -4171 gayp ni i i ,I Inspection Requests (24 Hrs.): (503) 639 -4175 �'. I INSPECTION WORKSHEET FOR DATE: 8/10/2Q TIME: 7:05AM PAGE: 94 SITE ADDRESS: 12051 SW WHISTLER'S LP CLASS OF WORK: SUBDIVISION: WHISTLER'S WALK NO. 2 LOT #: 093 TYPE OF USE: PROJECT NAME: WILLIAMS DESCRIPTION: Installation of NC unit. ' OWNER: WLLIAMS, EDWARD, PHONE #: 503-.590 -9502 CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439-9666 Inspection Request Scheduled For: Date: 8f1012005 Pour Time: Code # Inspection Description Confirm # Contact # Message • 199 Electrical final 013189 -01 503- 690-9502 N Corrections /Comments/ Instructions: • • • • • - S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718-