Permit A. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00740
r DEVELOPMENT SERVICES DATE ISSUED: 10/4/2005
' � I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133CD-11600
SITE ADDRESS: 11787 SW WILTON AVE ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT : 148 JURISDICTION: TIG
Project Description: Branch circuit for 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:
KATIE TINKER WINNER ELECTRIC INC
11787 SW WILTON AVE. 5950 SW PROSPERITY PK
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: 503 - 453 -4822 Phone: 503 - 638 -5028
FEES Reg #: LTC 14794
tion Date Amount SUP 34
Description ELE 34
[ELPRMT] ELC Permit 10/3/2005 $46.85
[TAX] 8% State Surcharge 10/3/2005 $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 -8 -
Issued By: Permittee Signature: 647 .42/7/9‘.... C - lion/
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.
ui/ZU/ZUU4 09:38 FAX 5035981980 CITY O F T I G A R D Q001
Electrical Permit App
: - .,1 .fc 1VED
FOR OFFICE USE ONLY
City of Tigard Received
permit No.e7C0? 0g25" 790
13125 SW Hall Blvd.. Tigard, OR 97223 SEP 2 g 2005 A P , Review
Phone 503.639.4171 Fax: 503.598.1960 /A,:.,;;..
Date/B : Other Permit: /yE4.200.3--evyyo
Inspection Line: 503.639.4175
CITY OF TIGA.L __
• i 1 ,1--' '''. 1 Data Ready/By. M Sea Page 2 for
Internet: www.ci•tigardor 171llneat■IGINEER IN .us Nourimimethot.e Mill Supplemental Informadon
_ ....,..
...:,:fifigfiFF:14;.::ililt::17tdipti:011yftgal:2;:. t .': L" 777 1 .. : 1 .4k01 it**0.:11T'.1 f.''.. ::.:. ...;,::.!..::: i.. •
0 New construction , Cgi - Please check all that apply.
['Service over 225 amps, comm'l pHazardous location
0 Demolition ID Other:
OSece over 320 amps - rating OBuildng over 10.000 sq. R.
1 i l ' " ii:■ 1, ! ; 11 ; :l i g.i4 . **.V„.411. ' .1■40 .' .. . ....J. iif Pii k..;'.:....:41i74.1:1P rvi
of 1- and 2-family dwellings 4 or more new residential
,
R 1- and 2 dwelling El Commercial/industrial 0 Accessory building 0Systesn over 600 volts nominal units in one structure
0Building over three starter °Feeders, 400 amps or more
.. ;,1 Multi 0 Master builder 0 Other:
_ °Occupant load over 99 persons 0Manufacturcd structures or
4:13.1:', V..410,:i1,# POrtf,4i#00ticit" _.!. fttit;N*10,04 !tt?..!; • '. 0Egressnighting plan RV pork
I Job no.: Job site address: i i 78 -1 'A) tAti'l. 7o a* v.- Submit a sets of plans with any of the above.
City/State/ZIP:
'5644 OK_ q 72.. 3 The above are not applicable to temporary construction service.
• I Ild i'.11A 0.:'' ::?? :::.:VAX:1111 tittiV!' '. 4. ' .:
Suite/bldgiapt no.: Project name: 7/
Desertpden I Qs7. I Dee. j
Cross- street/directions to job site: N ew residential or multi dwelling unit.
Inclu
- 1,000 sq. ft. or leas - 145.15 4
Subdivision: 1 Lot no.: Ea. add'i 500 sq. ft. or portion 33.40 1
- Limited energy, residential 75.00 2
Tax map/parcel no.:
, Limited energy. non.re.sidential 75.00 2
j % .1f,': .5 ,,;In ' il . ,.: • 'I • Each manufactured or modular
dwelling, service and/or feeder _ 90.90 2
Lib` 'Ce._ 4o,,_ AL liort Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
106.85 2
al•lik:;1...1:10.1M14,,IIII0V101Kg ■ . .1304 1 1EPrigt;i: . 0,4 1 0iii 41 T: •' .: ., Attila' 4 2 : 1 1 a urnPi nips : 41" 6,30 arnp ,
160.60 2
Name: /r/g 7/6 77AlkE. 601 amps to 1,000 amps 240.60 2
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
reloeadon
Phone: ( ) Fax: ( )
700 amps Or ICU 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 '
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. i 2
401 amps to 600 amps 133.75
Owner signature: Date: Brooch circuits - new, alteration, or extension, per panel
[1:ir I 1 ftilkt.: 1 1 1 #40.,0;: 6 1 : , .,•.! i , `. : z • A ' E s ec ! or bran fee ch der cire fec ui ::::
6.65
Business name: blanch circuit 2
B. Pee for branch circuits
Contact name:
without service or feeder fee, I 46.85 ii 2
each branch circuit
Address:
Each add'l branch circuit 6.65 2
City/State/ZIP: - Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53,40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
"
E
Signal circuit(s) or limited-
1143:1'. r!..: :•.‘. - =.i : JOITIgite*Ogiii ;::; ..;'• ..; . ' ....• i ii :..• '':•:.'•I't..■■ energy :lief, alteration, or
Page 2 2
Business name: (4 NAIL"- e. teat ic-
' Each additional inspection over allowable In any of the above
Address: 6q GI 6 tA3 n s re.A.1 PIK kc 42ij .
Per inspection 62.50
.
City/State/ZIP: .7Z, 4 L44./ 0 a; 6 1 041 investigation per hour (1 lc min) 62.50
Phone: (613 ) C "bct5 6o $ I Fax: (..,50 .5) 6....W LIZ 4 1 7-' Industrial plant perhour 73.75 ., , ., ,
CCB Lie.: it../ 14 4/ Electrical Lic.: 3+ c_ Suprv. Lic,: as 265
Subtotal •44,916'
Suprv. Electrician signature, required: 00,11,_ Plan review (25% of permit fee)
_
-
Print 12 1-2b..6aate j • 6....... State surcharge (8% of permit fee) 3, 16-
-
TOTAL PERMIT FEE &I, lb
Authorized signature.:
* This permit application expires if a permit a not Oita:mid within 180
days after it bat been accepted as complete
Print name: Date: • Fee methodology set by Tri.County Building industry Service Board
•• Number of inspections oer permit allowed.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4 /2005
Phone: (503) 639 -4171 Vi
Inspection Requests (24 Hrs.): (503) 639 -4175 • F '
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 85
1✓, af3S noR'owL-• -i,
SITE ADD E1I — S S: — 11787 SW WILTON AVE CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 148 TYPE OF USE:
PROJECT NAME: TINKER
DESCRIPTION: Branch circuit for A/C unit.
OWNER: TINKER, KATIE PHONE #: 503 - 453 -4822
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 503-638-5028
Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017500 -01 503-579 -4763 Y Z 470 QM
Corrections/Comments/Instructions:
"frk- N 0+ Ai A "1
PASS MI P. '. IA APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL % ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t
Inspe • or: Date: /0 O Phone #: (503) 718-