Permit A.' CITY OF TIGARD v 8 ELECTRICAL PERMIT
PERMIT #: ELC2006 -00538
411 DEVELOPMENT SERVICES DATE ISSUED: 9/25/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BA -12600
SITE ADDRESS: 16365 SW COPPER CREEK DR ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 3 LOT : 091 JURISDICTION: TIG
Project Description: (3) branch circuits for new heat pump and furnace. Job No. R206884
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: 2 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:
KIM ALAN SCOTT A -TEMP HEATING & COOLING
15365 SW COPPER CREEK DR 16000 SE EVELYN ST
TIGARD, OR 97224 CLACKAMAS, OR 97015 -9519
Phone: 503 - 598 -9787 Contact #: FAX 503 - 557 -2990
PRI 503 - 650 -5014
FEES
Description Date Amount Reg #: ELE C55
[ELPRMT] ELC Permit 9/25/2006 $60.15 LIC 71878
[TAX] 8% State Surcharge 9/25/2006 $4.81 SUP 4821 S
Total $64.96 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 f • OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503-246-6 9 or 1 800 _
•
Issued : k • 6'..44 t,�, Permittee Signatur: • _42 !g
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: . C� DATE:
LICENSE NO: / / 9 / C7
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 :A -TEMP FAX NO. :5035572990 Sep. 25 2006 09:26AM P4
": ' • , :?',.2-'
cal Permit A i I lica FoR OI i 1( ■ r . i.l
' ty of Tigard ter: 9 aS d 6 ,icy Parma Nn. Ze "006o.... 06536'
13125 SW Hall Blvd., Tigard, OR 97223 SEP 25 2 1, i ,_ flan itoview
Phone: 503.639.4171 Fax: 503.598.1960 " ,..+ r a`.Fjl• Ude/B . • Other Permit:
/ Line ne. 503.639.4175 r •�.• •. - '+ :. ,sti ..__ _ _ ., I Notifl Dane ltoedy/By: im R See Pa ge 2 tbr
Internet: WWW- cl `- . - . ' /Mathod: ...r, C, Supplemented lururtuatlon
-
' i1.r(lY
0 New construction ddition/altemtion/repla ement Please check all that apply:
El Demolition [] ()t}ter: ❑service over 225 amps, connn'l ❑Iinzardous location
Q
..,..._. ,._ ... :. .__, ._ ...
,.......... '..' : CA`FEOIORY OF 6.0.1 $'1.0.(.'fION'. f 1 a nd 2- f(utul rating y dwellings 4 or more new residential l
(Intl 2fAtnil dwelling Commerciallinduslrial ❑ Aec esory building Dsy over 600 volts nowinnl units in one structure
El Multi-family ❑ Master builder ❑Other. ❑ Wilding over three stories ❑ Feeders, 400 amps or 'nor __.....: •......,— �............ ..,. _ .. Q()ccupant load over 99 persons QMnnuAcolured structures r
:,_.:..... ,. • ( ' J' IL : :•INFPORMA'1`.ION AND LCCAT:0 ' ' ' 0 F.grcawligltting plan RV lark
❑lletdth -arts Facility
r
Job � Job site address:/4 5 ' ,' ��' u �J/ ,d? 1W ,J j - 2 ants of plans with any ofthe a er: - - -•- • -
City/StatelZIP: -776 U2 eT 72 z y f The above are not applicable to temporary oonsttuction service.
Suite/bldg. /apt. no.: l Project name -. , L / �' ' - ..
:, - S('AED!OCE
Description i tin. I fee. I . , 7"
Cross street/directions to job site: New tetidetttlal tingle. or multi-family dwelling unit.
- - -.- - ,• .. • includes attached garage.
1,000 aq. fl. or leas 145.15
Subdivision: Lot no.: Ea. edd'1 50194. tt, or portion 33.40
Tax map/ptut cl no.: Limited energy, residential 75.00 '
Limited energy, non - residential 75.(10 '
. . _ .
"DESCRIPTION' OF WORK
:::: ~ : .... : . ' manufactured or modular
� ., ... Each n
dwelling, service and/or feeder 90.90 _
, 7ALc��'7 :14. 1 If/j ` _ _.J f Services or feeders lnseellatton, alteration, and /or relwattioti
200 amps or less 110.30
c::4; - 201 amps to 400 amps 106.85 •
/ ' 401 to 600 160 6 0
.. ,_.... . •• -•- .._ ... . . .. . . � . ,. ._..... • _.. amps • Name: ?('o l amps _...
` � 1 / I L. I� �w . _
601 amps to 1,000 Nnpa _ 24U.G0
j i n
Address: fy 6° s S' C z� 0�'�� C. 1r� Over 1,000 amps or volts 454.65 Resented only 66.85
City /Stata/Z1P_' , . /1 1 9 Z 2 Y T_._._....... Temporary services or feeders Indullatituy alteration, and/or
Phone: ) y Fax: ( ) relocation
g 1 g 7 200 amps or less , , 66.85
Owner installation: This installation is being made on prop(zty that Down which is not qpl motto dno snipe 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to fi(IU stops 133.75
Owner signature: , T
. Branch circuits •- new, attention, or extension, per panel
,. :...�..,.,� • PLI _ . _ - -
°� "�, '� ..�,i" � ,� P an f or brunch v " tt5 with
• -�••• . •_..,.....•.., strvicc or feeder fee, each
Business name: A.TI eft Inn branch circuit F Gs -,. _
- 1 - 6000 - 8 - E - Vvelyn - St B. Fee for branch circuits
Contact name: circuit 977015 wl /haul aer vloe or feeder fee, 46.85 6 i
Clar'irrrtl��, _
Address: (5 (t5fl -5f114 -- drat Well branch Each add'I ltratcircuit 6.65 ) 7
City /State/ZiP: 1Wseelizneoes (service ur feeder not Iaelnded) .
Pump or irrigation circle 53.40
Phone: ( .- ) Fax 5-9:325_12__-2_j__90___ ._.... Sign or outline lighting ...,.. 53.40 ...
E-mail ... .__ -,..- - � Signal cireuit(a) or limited.
M - • C ONTItatitiR enmity panel. alteration, or
;:' ::... •. :;- ' : ....,,,� _ • extension. Ueauribo: Page 2
Business name: A- TEMP Heating Codling, fnc_
bUlll► F. VC)Iyil ti t Each additional ittspeetion over allowable In any of the above
Address: Par inspection 62,50
��iti L'I'In r1iN J, OR 9701
City /Slate/ZIP: G Investigation per hour 0 lir min) 62.50 - T —
. '
..51):4) 1 - Industrial plant per hour 73.75
Phone: ( ) Fes- ( ) 1 IS PE RMIT +1'$E :
. ... .. .
CCB tic - /f'6 1 " [ectsica1 Lk • C KS , Suprv- ivies: gggt _ Subtotal E(Tr .�
Suprv. Electrician signature, required: - �
_/ • _ Yian review (25% of permit t> e) . _ :
Printtuu �h ' » l F2� ikon: 9' .2,4•,- d -• State surcharge FE permit -c)
_ TOTAI, Pit1Ll'1M:I 1
Authorized ' atu r Q ibis permit application expires Ira permit . not obts nod **in 1
Mom alter It has boon a ceoptcd • complete ! . /
Print name: C . - ? L Cat C'' Z C , 6I � • Fee m cth odntnu by Tri- County Buildinc tadu try 3nvic onrd