14098 SW SPRINGBROOK LANE 14098 SW :SPRINGBROOK LANE
/\ CITY OF
T;G p R D T ELECTRICAL PERMIT
CITY
#: ELC2003-00468
QEVELOPMUNT SERVICES DATE ISSUED: 7/31/03
1312.5 SW Fla' Blvd., Ticiard. OR 97223 (503) 639-4171 PARCEL: 1S133CC-00800
SITE ADDRESS: 1409E SW SPRINGBROOK LN
SUBDIVISION: PEBBLECREEK ZONING: R-25
BLOCK: LOT : 001 JURISDICTION: TIG
Prciect Description: JOB NO.05.2740 Wird A/C
__ RE_SIDENTIAL UNIT __TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LT3:
LIMITED ENERGY: 401 - 6U0 amp: SIGNALIPANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'I_Ilk' ;PECTIONS
0 - 200 Limp: W/SERVICE OR FEEDER: PER INSPECTION.
201 - .300 amp: list W/O SRVC OR FDR; 1 PER HOUR
401 - 600 amp. EA ADD'L SRNCH CIRC: IN PLANT:
601 - 1000 ainp: _ �--- PLAN REVIEW SECTION
1000+ amp/volt: ,�ES UNITS: > 6J0 VOLT NOMINAL
Reconnect only: _ KDR>=225 AMPS: CLASS AREAISPEC OCC: _
Owner: Contractor:
LAGOMA.RSINO,JAMES G+ANNE M EVERGRE ELECTRICAL CONTRACTOR
14098 SW SPRINGBROOK LN I, 23861 S 442ND
TIGARD,OR 9-1'223 . U �}) 7SAN OR 97055
Phone: 503-590-9087 ne: 503-868-4608
Reg a: ll( 136311
1 11 3-4720
_ EES I, 44RIs
Description �Datc- .`..... Amount
II'.LPRMTJ EIX Permit $46.
�I nz 85 - Required Inspections
ITA 18%State'Cax l I u t $3.75 Elect'l Final
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 dome 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 tha 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)2466699 or
1-800-332-2344.
Issued By: I s Permit Signature: i� v
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 6394175 by 7:00pm for an inspection the next business day
01 29/2002 15:21 FAX 5075981980 CITY OF TIGARD 002
lElech ical Permit Application
/ "Dwecivad: Perynitno 00 -,r6
City of Tigard ProJeetfappi.no.: Expire date.
(•uy of Tigard Addmm 13)25 S W Hall MV4M Date issued: By: Receipt ho.;
Phone: 503 6;39-4171 ---
Fax: (503) 598.1960 Case file no.: paywent type:
Land use approval: 11 3
Kr.2 family dwelling or accessory 11MIUdfliNlertilti iitdurMal O Multi-family-- O Tenant improvement
Ll w
Neconstrucdon =D AddiUen/altr.ranon/replacement Other O Panial
lob addrr�. _ t �Y I I31d , rev.: Suite no.: Tax mapitax lot/account no.: -
Lot: 'Block. Subd vision:
Project name: Tle.wription and locution of work on premises:
Estimated date of comple6ordin5pection: r�
e
Job no!Li; •• (y �� _ Fee Max i
[knelt ton _ Qty (ca) llutal no.It, p
Bu3iness name: Jar }t`C.Ct1 lC .4TtL-6s1 Itewrs�nttewttal srt[M urttwdUiamlh P► _
Address; �, . �) " t n dw.•kMunit Ineludo;mttadsdGars�t•.
I State: -{ ZIP: c t-ae_) sier.isr inewdetl'
Phtsne: . ,c Fax: E-mail: 1001".9 n nr le" 4
CC13 nm; I Elec.bus.he,no: - I-,ZL Fachaddditional 500$4.n.or Portion thereof
1 t+' Limiledenn ,reeldonUal 2
City/metro lie.no.: Ljc'c'�� Limited energy.twn_rasidenual
T 7 J Erich manufacture 1 home or modular dwelling
Sl�gnnt or supervising a-rieian(required) _ Date Service and/or feeo-r 2
Sup,alta-name(Print):CIrA K.t L.icsnse no:�j ( > rrirxa or fttedns• allation,
assts t w reloaelitsn:
200 amps or leas 2
Name(pnnt): !(ZO 201. s to too cope -`- — I
s to 600 amps
Mailing address-
601 bo.ita401 pr o Ooo — —_ -- -- i
M arnp
1 --"I-'
(.lty: St�tte: Llr
Over t Cat voilb
Phone: ,.) t7- C Frt' E taut' Reconnectonl>--
Owner inslr+lladon:The installation is being made on ptoparty I own iemporstyservicesarfee tie"-
which is not intended for sale,,lease,rent,or exehauye according to Insaallttioa,at6erirf;on,orrd«ytioa
ORS 447,455,479,610.701. 200 ampsotWit. — 2
01 amps to 400 maps 2
Owriei'S Si nature: Elide: 401 to 600 arnn_ 2
Brerach r-ircttt. era,ahet+dm,
of rxtnrawn per PHK I:
Name: A Fee for branch clicoiu with purchase of
Address: service or feeder fee,each branch circuit 2
City: Slate: 7.1 P Fee for brunch circuits wi ut putorin
- of service or leader(M lust branch circuit: ( lQ�. 2
Phone; Fax: E-mail. -
Eacfi additional b e7roelti
IMMEMbc.(Serwit erfsderoot
1:75ervicn rerallwrpreantroceeial ❑Ilea!ch.anfaciltey Each pumperlMgodondirle 2
O S trier over 320 amps.nting if 1&7 0 Hazatdc us Incatfoo )Je eh si in a L 1 _ 1 2
fomilydwellings Q buildi gover 10,000 squats tres tau:or Signd cireuitf,t)ora limited energy panel,
O SyaNm ova 600 volts nominal more n tidential units to•.ne snuaum altera"an,of estensian' __ 2
O Bvilding aver three rtofles 0 Faders,,400 amps or,note •pe%d Hon: t�e
L Occupant load over 99 peisotn (:l Manutarturrd stn,tutsu tx RV park EacA additienat hap•Aion over tAeswbte M�of 6e above:
❑FgtcalllghdnEplan 17 011ier Vexinapealun
Submit__sets of place with arty of the above. nvuugauoa ha --
The above fare net appUaibk W tateportry cyniMmectloa eerrke. Otho
Na all))add tial+e"V,!t..io cards.rrraw evil Iurrwamea far man in w"WIM Notice:This permit application permit fee.....................S
Q Vlst O MastafCatd -- expires if a permit is nut ohtmited Plan review(at 9f,) $
,:
Credit .a nems./._— within 1 R0 Joys after it has heen Slate sumhta�e(A) $ s.i
waccepted as cvmH!Ar 'TOTAL .......................S
tr it�tw`on aaetI sad --
c.rde�a si�suuc_ �-- 3 4soJets rfYUolcVrn
08/04/2003 13:34 F.A—k 5(135981990 C'T1' of TIcaRD 4001
Building Division
Applicant Request to Cancel I"crrnit
TO CITY OF TIGARD, B1ITL )ING OFFIC-L46L
131.25 SW Hall Blvd., Tigard, OR 97223
Phone; 503.639.4171 Fax: 503.598.1960
FROM: Applicant Name: P-Pe--
Mailing Address:
City/State/Zap: ��DdAA
Phone No.: --
i
Fax No.:
PLEASE CANCEL PERMIT APPLICATION AND REEL N i PERMIT SES,IF ANY,
FOR THE FOLLOWNG:
1'caTnit No.: �. GCJJ _ � � ��Gd/'>,oz_: r
Type of PC=. 'V I
Site Adam. � � � SLA---) Sig ri ri�brt C-
Subdivision:
Lot No.. y
EXPLANATION:
C ro iA- r)4 ) 44is
Signature; -- Date: 3 _
Print Name:
Route to Admin.: _ Date.
Permit Canceled: Date: t3v.
Refund Procemed: Date:
is�Puildm�RhrtrK�RegC,neelPermitdd� OM
Zoo FA XVJ Ot:ZT COOZ,9n. 90
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