Permit ,, A CITY OF TIGARD _ ELECTRICAL PERMIT
PERMIT #:
DEVELOPMENT SERVICES • DA TE ISSUED: 8/10/2005 ELC2005 -00576
A I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110BC -03800
SITE ADDRESS: 12325 SW WINTERVIEW DR ZONING: R -7
SUBDIVISION: THORNWOOD LOT : 009 JURISDICTION: TIG
Project Description: 1 AC br. circuit.
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:
PHAN, STEVEN GRF ELECTRIC •
12325 SW WINTERVIEW DR 15460 SE PARADISE LN
TIGARD, OR 97224 ' MULINO, OR 97042
Phone: 503- 204 -3390 • Phone: 503- 829 -4146
. - FEES Reg #: LIC 76751
Description Date Amount SUP 3-48
ELE 3 -484C
[ELPRMT] ELC Permit 8/10/2005 $46.85
[TAX] 8% State Surcharge 8/10/2005 $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. Speaalty 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- 0- 332 -2344 '
Issued By: Permittee Signature �`7-� �� ...
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:
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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.
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(Aug. 9, 2005 4:03PNb Gilt tlectric uecie it iNo. 3271 P. 1 p. 1 9
l Electrical Permit Application Received 8 I fo Electrical ,
,
of . Date/By. GS 1,) Permit No. E ).005-e70-20
City oR Ti and Planning Approval Sign.
g Date/13y: No.:
•-• 13125.SW Hall Blvd. Plan Review Other -
Tigard, Oregon 97223 Dateiny Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land use
G I ` Fc, Dale
/By. Case No.:
Internet: www.ci.tigard.or -ust c :' 1 Contact ,yuq® See Page 2 for
24 -hour Inspection Request;, 503-639-4175 - Name/Method: (/6\ , Supplemental Information.
•
" : flan` - f24^ ;i4`%:iir'iF, E,ti1R0 • F "1 : ,f: + +.J: :1r4 :,1; :1!i•;i.: -' ^; .- ;1PILANIREYIEW:(Please check ill apply) ` '
• New construction • Demolition 0 Service over 225 amps- ❑ I-lealth.care facility
Addition/alteration/re •lacement I ter.
commercial over ❑ Hazardous over er 10,000 di i Oh
_ . � . 0 Service over 320 amps - rating of ID Building over 10,000 square feet,
r ,)v ;r, y , t; ;:h;= ;:' JC �� , u tl o . UM! 0 TV • , •-'...; - I & 2 family dwellings four or more residential units in
- 1 1 & 2- Family dwelling 0 Cot3unerciaVlndustrial D System over 600 volts nominal one structure
ill Accessory Building Multi -Family 0 Building over three stories ❑ Feeders, 400 amps or more
ry y 0 Occupant load over 99 persons 0 Manufactured structures or RV park
Master Builder 0 Other: 0 Egress/lighting plan 0 Other.
1%,': .: -. . •,'yam 1. a- , Q� :►S b 71► 'JQl I ,ilr'[Ql!(.a Y a LOCATION V . - , : Submit sots of plans with arty of the, above -
p, .,I The above are not a . licablo to tern orar condiruetion Service.
Job site address: _ 1 a3 3U-) a) �n V 1 ) '6 r • . FEET: SCHEDULE; L, - -
Suite #: Bldg. /Apt. #: Number of inspections per permit allows
Project Name: 'zta,,•iptiou t Qty I Fee (ea; Total
Cross street/Directions to job site: New residential-single or multi- family per
dwelling unit. Includes attached garkge. ,
Service included:
1000 sq. ft. or less 145,15 `
Each additional 500 sq. ft. or portion thereof 33 40
y
Subdivision: I Lot #: Limited energy, residential _ 75,00
Limited energy, non residential 75.00
Tax map /parcel #: Each manufactured home or modular dwelling
Sir. :., "1-1g.:7:4 t 1tu.•i;"'F 1. ► &I: fi . ., O
a Pw44ORK` ="" ..
, .. . , `r`! serv an d/or feeder 90.90
Services or feeders - installa(ioo,
alteration or relocation:
A n 200 amps or less 80.30
F ` • 201 amps to 400 amps 106.85
y y 401 amps to 600 amps 160.60
: -MMAf � �gr'L`�:1dii��nlY tr i :! . ..' ` NL,, , 601 amps to 1000 amps 240.60
Over 1000 amps or volts 454,65
Name: _ Reconnect only 66.85
Address: Temporary services or feeders - installation,
alteration, or relocation:
City/State/Zip: 200 amps or less 66.85
Phone: 1Fax: 201 amps to 400 amps 100.30
:: S.Z ..':r ,i :. :l�l ' • :sx,T � IRS r.:44 -zs:5, � 401 to 600 amps 133.75
p O Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee. each branch clrouit 6.65
Cl /State/Zl : B. Fee for branch circuits without purchase of
p - - service or feeder fee, first branch circuit 46.85 90, a
Phone: I Fax: Each additional branch circuit 6 65
E -mail' � Misc.(Service or feeder not included):
r:l.."'Lk , • g . ."; {i9a=;v -rr Each p untP or irrigation circle 53 40
d:: <'" c • - . l"L = r' ' Each sign or outline lighting 53RD _
Job No: Signal circuits) or a limited energy panel,
alteration, or extension Page 2
Business Name: G A -AM - Description:
Address: 1 -•(p o S, P r ,, c l1 4 .0 ,
/ Each additional inspection over the allowable in an of the above
Ci /State/ Zi e : A/ : , / L Per inspection per hour (min I hour) 6250
Phone: 5 - g1x ci r if / y 1, Fax: 51)3 - 8 zri - 5 - 2 1-.7 Investigation fee: -
CCB Lic. #: 1 -) 5 Li # :, 3 - L. ,� r' ° . ; , • F'• „j •iElectricel erhiit •�'eestr :: +, •,-'
_ Supervising electrician - � \ . y Subtotal S 'r Ile, -'15
signature required: '- s ' ^ Plan Review (25% of Permit Pee) S
r
PrintName: VV, VV, J ir„,,., (,,,, - 1, q 1 1_.ic. #: i to Sc $ StateSurchar a 8% of Permit $ J
' `1 TOTAI. PERMIT FEE $ , 6,4
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: • Date: ]80 days after it has been accepted as complete.
*Fee methodology set by Tn - County flu ilding Industry Service Board.
- (Please print name)
i\ Dsls\ Pcrrrr;tForms16lcPcrrrdtApp.doc 01/03 -
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00576
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1012005
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 �' 111 ..
INSPECTION WORKSHEET FOR DATE: 10/11/2005 TIME: 7:08AM PAGE: 89
SITE ADDRESS: 12325 SW WINTER VIEW DR CLASS OF WORK:
SUBDIVISION: THORNWOOD LOT #: 009 TYPE OF USE:
PROJECT NAME: PHAN
DESCRIPTION: 1 AC 5r. circuit.
OWNER: PHAN, STEVEN, PHONE #: 503-204 -3390
CONTRACTOR: GRF ELECTRIC PHONE #: 503 - 829 -4146
Inspection Request Scheduled For: Date: 10/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017907 -01 503-233-6566 Y .AM
Corrections/Comments/Instructions:
% ^ ,ii" 6 �3 rl �� ���/rf%—� G'3 /<
/316_ iyo n ovi-
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4 . 1 3 ASS / - PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
/❑ FAIL -'ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 _` Date: lG�! /�'U•� Phone #: (503) 718-