Permit ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2005 -00634
�e•II!�, DEVELOPMENT SERVICES DATE ISSUED: 8/29/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BB -19300
SITE ADDRESS: 10274 SW ELISE CT ZONING: R -
SUBDIVISION: RIVERVIEW ESTATES LOT : 039 JURISDICTION: TIG
Project Description: (1) service, (3) 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: 1 • W /SERVICE OR FEEDER: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
MEGAN BOSCACCI WINNER ELECTRIC INC
10274 SE ELSIE CT 5950 SW PROSPERITY PK
TIGARD, OR 97224 TUALATIN, OR 97062
Phone: 503 - 524 -1931 Phone: 638 -5028
FEES Reg #: LIC 14794
Description Date Amount SUP 2825S
ELE • 34 -150C
[ELPRMT] ELC Permit 8/29/2005 $100.25
[TAX] 8% State Surcharge 8/29/2005 $8.02 REQUIRED ITEMS AND REPORTS
Total $108.27
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: - r J1 11v C� Permittee Signature:
1
•
_"` 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.
..... 41r y / Z U /ZUU4 09:38 FAX 5035981960 CITY OF'TIGARD RI001
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Electrical PermitiiiipileitiOn '-' FOR OFFICE USE 01\1.1'
City of
13125 SW Hall Tigard lvd, Tigard. OR 9722
- '2 0 ---- "" i .MM,1„.. i tal2i
B.3 ! ':-. /.:' '' , P1211Roview
Phone: 503.639.4171 Fax 503.598.1960 ( ). 1 : r,,.. ',cid ikhL:? , _ i i DatrA3 : Other Permit; I
Inspection Line: 503.639.4175 G t \ ' '....:!J- Dote Ready/Tar El See Page 2 for
Internet www.ei.tigard.or.us sulUDI,Ne7 '4' ' ' . Noonewmetnaa:
MIZI Supplemental Information
1 0.;11,!;::.,.., .....:Yilli!ii7;iiPIIIS:111.11r.il:'...;1:.100.Pt!',01/*I0*(11:Ni'.];', ; l' '..;,:::i.,!..;:';',1,, 7'.....:!:::':;R::..111.1;11..V1'.::':!...)14SI4tig*lilT:1;::::..::..:.
ID New construction glAddition/alteration/replacement - Please check all that apply:
OService over 225 amps, comm'l OBaxardous location
0 Demolition 0 Other:
. . . . OService over 320 amps - rang ting 1 over 10.000 so. ft.,
Pilitifillgi ',. .:. :::::;.i1ii:i.Pii i or 1- and 2-family dwellings 4 or more new residential
■ 1 and 2 dwelling 0 Commercial/indrutrial 0 Accessory building 0Systern over 600 volts nominal units in one structure
CIBuilding over three stories °Feeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
DOccupant load over 99 persons 1:Manufactured structures or
i i A lif E r .i' l .:1;.1.',, Ii . : .;i1 ON ',00 . 400 . 000i0 .0:i;60 1: 110. 04 #4 4 $1;:if;:' ! ..!TqfP , M;:.: . ;... ' '.. EIEgreselighting Plan RV park
1
Job no.: Job site address: / (3 21 1 y z E ,j th's.. c f
011ealth-care facility 00ther:
I- Submit 2 sets of plans with any of the above.
City/Statc/ZIP: 77b tez, 04- q 7d a q The above are not applicable to temporary construction service.
Suite/bldg./apt no.: _ P. roject name: C.
I 665.10 C. v
' 4 , Ili; illitliIT::•.:' :V.:' : :1::/:i:itPP,tsigOtt, Olitt' : ..:
nateriptian I_ Qty. 1 Pee j , Totni ..
Cross street/direction s to job site: New residential single- or multi-family dwelling unit.
Includes attached garage
1,000 sq. ft. or less 145.15 4
SUbdivision: 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-residential 75.00 2
'' '.. '. . 11": 1; i1 .;1 ! i ii : i .i i ;!i i .114 : 4" :) .1. : "..:■iii . IIII 1 1 00 . 00040', ; j 0 1. .#.0*.iliKI: i ll , i i.'! : " .1 .. .1 :1 ":. :.;1 , .'i .,"1 •.1 ...i • .i• ' '. Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Services or feeders instaltation, alteration, and/or relocation
200 amps or less / 80.311 A 0. ,6 2
:
106.85 2
i i ' . 1 . :. .liainan; : 0. :: #.0PIT: .: . •.' I 2 4 : 1 1 aarnPsmps to 400 aaminii:: 160.60 2
—
Name: ' C C \ )c)\,, 601 amps to 1,000 amps 240.60 7
Address:
i
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
, z relocation
Phone: („--03 ) :5;Zrf -- /9) 7 / Fax: ( )
200 amps OT len. 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, tent, or exchange, according to ORS 447, 449, 670. and 701. 1 ,
401 amps to 600 amps 133.75 2
Owner signature! Date: Branch circuits - new, alteration, or extension, per panel
.
1 i 11 'l i gli . ! t ir:i . :■ :.. .: ': .: 1 1010. 4 4#40 : 000.0.0; 1 .!; : . ' ..' '..... : A. F f n e c e h der cire fe u e " ta ea w ch ith
6.65 2
Business name: branch circuit
—
B. Fee for branch circuits
Contact name:
without service crr feeder fee,
' 0... 46.85 LANS) 2
each branch circuit
Address:
Each add'I branch circuit 3 6.65 / 7 2
—
City/State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53,40 1 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53,40 2
E Signal circuit() or limited-
: r . : , • ! . ,' i'.!,:ii.::1;11;11'ili:,i:.!..',..;!if:..:',.•.,:',..:. :. :::! 1, CONTIVACTOgliillIS:.:;':1 ...;; . ':'.., i i'..g1T.;:::::.:: :. :: ..1' enel panel alicratkm °r
extension. Describe; Page 2 2
Business name: /i i 0 .1 ki- 1 gdg) c-
t \ Address t° ,
' Each additional inspection over allowable in any of the above
: 5i t C b SW. 05 leen--;11 RI'el'L gi
Per inspection 62.50
—
City/State/ZIP: 7 6 rV 6 4 ' 7 ogi Z' . investigation per hour (1 hr min) 62.50
I
Industrial plant per hour 73.75
Phone: (S)5 ) 6 g 6 g Fax: (6 ) 63 g h i 2 L k )
...
71 !ii:! .: ....i'''':' .'
)l CCB Lic.: ILI7g 1 Electrical Lic.: 34 ( - - I Suprv. Lic,: ..8 sub.., / z 6 ---
...
Suprv. Electrician signature, required: Oipit, tAkt Plan review (25% of permit fee)
- State surcharge (8% ofperrnit fee) Fi 0 Z_
Print nam A y
e: kc_ Lk, A Date: g— j-ef — 06
TOTAL PERMIT FEE JO C 2 7 _
Authorized signature:
Thit permit application expires if a permit is not Obtained within 180
days altar it hat been accepted as complete
Print name: Date: • Fee methodology set by Tri.County Building Industry Service Board
•• Number of inspections Der °emit allowed.
CITY OF TIGARD P ��' �/°�'� g
BUILDING DIVISION ...
A,.....
PERMIT #: ELC2005 -00634
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1992005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '`'I '
INSPECTION WORKSHEET FOR DATE: 9/7/2005 TIME: 7:08AM PAGE: 40
SITE ADDRESS: 10274 SW ELISE CT CLASS OF WORK:
SUBDIVISION: RIVERVIEW ESTATES LOT #: 030 TYPE OF USE:
PROJECT NAME: BOSCACCI
DESCRIPTION: (1) service, (3) circuits.
OWNER: BOSCACCI, MEGAN PHONE #: 503 - 5241931
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 638-5028
Inspection Request Scheduled For: Date: W712005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 015065-01 503-638-5020 N
Corrections /Comments/ Instructions:
- ;3
4
/ \ :'
ir..
I?~ d,
i d V
IV PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 4 .-- 1 — (99'-'
Phone #: (503) 718 -