Permit CITY OF TIGARD ELECTRICAL PERMIT
° — Q PERMIT #: ELC2006 -00643
COMMUNITY DEVELOPMENT I I ISSUED: DATE SSU 11/9/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DB-10500
SITE ADDRESS: 09585 SW SHADY PL ZONING: R - 4.5
SUBDIVISION: THE RAZBERRY PATCH LOT : 004 JURISDICTION: TIG
Project Description: (2) branch circuits.
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: 1 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:
LENORE WOODWARD THREE PHASE ELECTRIC
9585 SW SHADY PL 493 NE 3RD AVE SUITE B200
TIGARD, OR 97223 CANBY, OR 97013
Phone: 503 - 977 - 5540 Contact #: PRI 503 - 263 -2558
FAX 503 - 651 -3540
FEES
Description Date Amount Reg #: ELE 24 -390C
[ELPRMT] ELC Permit 11/9/2006 $53.50 LIC 128282
[TAX] 8% State Surcharge 11/9/2006 $4.28 SUP 4498S
Total $57.78 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: s .Q Permittee Signature:
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.
2006 -11 -09 a l in. 4,n 081980 5 '1 5 ai' i ill three p s r 'c Q0332/2 Q0332/2 32 /2
• OB /Gt: /2 004 13:28 F `Q � � �'1rti
r e eLec Vu-A' n _
Elects cal t Application, ' ;) 14 ;it OI: I:. INNF. ONLY
City ofTigard ppiif) Inc Lived — , / No, /� �f:
13125 SW Ball Blvd., Tigard, OR 97223 tt V 1 / 1 , Other Peek
Plume: 503.639A171 Fax: 503595.1960 ,1li ,l : _
Inspsrdon Lis= 503.639.4175 �. li p /{ - " ea A tea gel far
W
Internee sow.el -ttio d-ot.us `�. u �� f •• �6 4a Jl1' Neelfled edloth / Supplemental leferaletlen
•1 cr 'r P -d ''tiy 'I ar` a �. :, : ••kJ•' '�:-+,•
' ff "l �?_∎ji_ S4V4.-,ZI111A V. 1:1 {i71:(i�4' r'i ti 'S' ,: : ) _. :� a il ! ;.# f S. �,. . 4 , : ii +�:,.: 4
�' "c �.Y::S'r • t �m ;t .11 - I,h. : rllv�a'ti.i��r ?•�.�i:��. �: - -._ '. », :..� . • . ^-
p New construction m ' ,• dition/olteratioe/replacernant • Please check all that apply:
r]Servlce over 225 sumps, s;oenm'I QHazardous location
❑ Demolition 0 Other: _ ['Service over 320 amps — rnting ❑Duildna ova' 10,000 sq. ft..
,- ,r _,• _ �„ ,.,. , -- -q• • - .-- -::'•c-y,,; ; j ;n;r, "i ri%, g" 2-fandl dwellings 4or more new rtsidential
O tt '..' • ., , a -;. ,A. . 4,'...r , ; ; : `'� jJJ Y I : ;, . ^ , “ .1,. -1 = E .. `�'� i' 1 4 ,i. 'TvSi 2 of 1 -sad y
IF : � 5` c : +; jy };� / r'e I � ^ . : r+•.vw< :. ; ' +r _ ; 1 T � �1�: ...,Si..,
' n d ystem over 6 00 vo -ena units iri sec structure
�I a 2- f�++(ty dwelling ■ Commercial/industrial ❑Accessory building DFeeda9, 400 urea or more
❑8uildin; over Once stories
■ Multi- . , • • r Master builder ❑ Other. DOecupartt load over 99 persms OMaatufactur etructtttrs Or
,. Y .. .., _ ,.. _ °.�T;.— -Y. :9.: Wr�c7 i ', T • ['Egress/lighting P 1 V park
`T,ir 5 . 1'. .-7 `, •1'i .' . ,'� � Y •gi 'i` Jam^ i'.I I
e ° ,.I.. .!r+ -: r, ;�v `a`•f °' l ^in :iii i_.� u: I1 I at1
.�Ii :�''•`•�' R' �' S:G! •� . � .c.:...i�m.:': ,. z : . : -. E! ._._ i �.;:.1 LJ
❑Health'carc facility
Job po.: Job site address: • • S c. i s. �_ . -et • Submit A sera of plena with any of the above.
The above are not applicable to temperer/ construction =vice.
CttpVStaret/ b. a , & ■ C _ U et. z ,fi :'f ','` --i-r v"� 1'� •S i ' ; e- : i ,t. .
{' c l a : .e�.u ar �
s i i.1Li. ' - ..--..7�-1 .-„ .d'.i •i •
Suite/bldg apt. no.: Project name �f. _�i_ . fi nevttpdea Qty. Pas ' Teal ` " .
Cross street/directions to job site: New redideedal &legit -or malts - family dwelling unit.
Includes attached garage.
1,000 aq. R or leas 145.15 4
Subdivision: Lot no.: Ea. add'1 S00 sq. R orportion 33,40 1
United enemy, residential 0111 75.00 .2
Taxmap/parcel no•: Limited energy, nrm- teaiaeorial 75.00 2
r . . . . . "'� T rt.: , . _- _.;.'aY �.•f`f a �!' .:IL(<!,'�
i :. , 1' or dules
1 � ' ' - - �r . �i'i?l-``r ..a ::1 7 . h:',i. A' � -'"'v T -cps; �,�
Each manufsetured mo
� daellina. service and/or fader • 90.90 2
M i ` ` � ,' : _� * Services or feeders Installation. alteration, and/or relocation
/ s 200 .tope err less 8030 T 2
_ 10615 2
�Zr..lr =2,r:, :i.� i -. -`-: r •.'..:1
''.1 ' 11.,' :.�. - a � 5 1 .1.A 16
�'- ';�`�': � .J. ,.1,.:r..�.; l � :n?' 401 area to 600 amps 160.60 2
0
601 amps MI 1,000 IMP 240.60 2
1„ - Ova 1,000 all or volts 454.65 2
R,eeeelnetre only • 66.115 2
�� _ Te auvieei or feeders lastailatlota, alteridea, and/or
City /Stef4lZIP e g i a � C T r e eo
phone; (�)� � 200 tamps or leas 66.85 l
Owner installation: This installation is • eing made on property that I own which is not 201 amps to 400 spa _ 10030 2
intended for sale, leans, rant, or eaatchang - according to ORS 44/. 449, 670, a d 701. 401 amp a to 600 am 133.75 2
Owntr ti Date: Branch circular— new, alteration. or extension, per panel
> - 7 ,. 1 7 : ' ;.` _f , ' • .:., . : ' � . .` 0 , � " i - :i . •, .. A- Fee for branch eieeuift�widt
.. .. .�... • .... ..T. _ ...... . __. - -. �.1..i C.:. .:. 1. _. ,. _._ __ '.L2� - .'J J.': aerytce or Ibeder fee, tech
6.65 2
gare+r,eae tletmC
branch circuit
B. Fee for bra nch circuits
Contact na1e: withoni service or feeder tire. k 46.85 Lil t.C 2
arch branch cinuit _
Address Each add'I b r a n c h circuit 1 645 , 6 , ( 2
dty/Stri&Z P: Miscdtannoua (service or feeder net included)
•
Pump or Sri • ;on circle 53,40 2
p} et ( ) Fax:: ( ) Sign or outline lighting 53.40 2
8 Signal nireuit(Y) or limited -
�,�_ .. y • ,, '-: ' ,• • .` ; i � ` � 7 , r�g}-p i!^ 0,'I`'' � energy panel, altet'ation,or
i;; ^ _i , .:.. ., ,'a 'i1�.=.' -- --.! 11 IC',d. yes( -- - " ' - t K' • If� ' '. --' ��
= _ 3.' .4 : _: '.S" ;� J �L:7.i. � r L a�'c„ a tClIfan. Paget 2
1 7 �I/ *! .. a
Each additional inspection over allowable in any of the above • Address: a r l Per inspection 62.50
• C1t taieiZtr. i r � Investigation • -• hosts (r (err min) 62.50
�' (_1:5 Industrial plait • a hour 7 3.75
r � , flex: (fie ` y f.'....J11.- . • , �.• t ► : u. . u : .t. ; 1t ca n ;
CCe Lic -:i. : r..t - =CZ `!J _Y 1 mot: Subtotal .e.:L _
Elceencien signature, uire:d
S ,1 � gr , Plan review (25% of permit it fee)
uprv. m4 l L
w Sea surtbarge (8% of permit fete) 4....a
Print mime" s
•11 � • • ,t+l y la i? .' TOTAL PERMIT TER s9..9--9
Anthori2ed a 1 �• I /.�i I . Tan permit application aspires Ka permit to ROI obtained winds 119
signature; .� • l� :� ��.
Or atter It sat bean =mired as Complete
If Della: • F." nwtindoroA• set by Tai-Cove , tteibbna Instry du Smw:a• Beard
Print Dan= •• Naaberof inspections par peradt snowed.
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