Permit Apr
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
*tel "_ DEVELOPMENT SERVICES PERMIT #: ELR2005 -00182
6 l, DATE ISSUED: 7/7/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S110BA -05000
SITE ADDRESS: 14535 SW MCFARLAND BLVD ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT: 015 JURISDICTION: TIG
Project Description: (4) t -stat wires.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
. Owner: Contractor:
WOOD, HOWARD & KATHY SPECIALTY HEATING + FABRICTN
14535 SW MCFARLAND BLVD 7500 SW TECH CENTER DR #120
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503 -516 -5388 Phone: 503- 640 -3607
Reg #: LIC 66578
ELE 34-34ICRE
FEES SUP 200LHR
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 7/7/2005 $75.00
[TAX] 8% State Surcha 7/7/2005 $6.00
Total $81.00
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.
Issued By: " > , � j e Permittee Signature: (2j
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.
07/06/2005 14:44 FA. 01003/004
ElectricalPermitApplication }} < - w 'Esc':+, R 1
�
i ce ! tl ® Datoreceived: D pernutno.,v /0)'
� �+
� , 1 > p ,, 1 City o s Tigard Project/appl.no.: - Expire date:
city ogard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 JUL Q 6 2005 nay lammed. Y. Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type.
Land use approval; CITY . , TIGARD
bun_D -' ,v -
, �t ,.. ..a .. _.' f] PE () PE
®1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family 0 Tenant improvement
0 New construction Q Addition/alteration/replacement 0 Other:. 0 Partial •
, M , VP 4. I, '"V'' , '- ri qtr r 5t .' , l0I{ 'SI 1 F IN1.0 l A TKIN - .- , `fi r ,�' r�
-rob address: , -.. .._
Bldg. no.: Suite no.: Tax map/tax lot/account no..
Lot; Block: Subdivision: (I t/a.
Project name: Description and location of work on •rernisea:
Estimated date of completion/inspection:
rifL (- ONTRA( 1011 `r1I'I'1:IC,A 1 1()N x,. " 2s 440 >v. c . 1, it I Job no.
Max
Business name: 1 ,,,, • oa NISI Total no. Imp
New residential -single or mniti-fanaly Address: , a o e -_ dweui unit. per III
City: - ,( State: 6 it ZIP: ^ L L1 Serdaeinduderk
Phone: Fax: E 1000 s.. ft. orleas 4
CCB no.: 1p r ` o Elec. bus. liC. no: Each additional 500 sq. R or portion thereof _al M
Limited en.: residential
City/metro1&c. no.: Limited energy, non-residential __ 2
Each manufactured home or modular dwelling ■■
Si: stun of au. - lain, electrician ( - ulred) Dare Service and/or feeder 2
Sup elect name (print) License no:
Services orfeeders- hutalhilion, 111 �l x_ ,:!t t 1'1{0I'1 It1 '0 ,1 \ VI( , = , alteration 0or1ealocationr .
. �. _ . _ 200 amp orleas Z
No=ne (print): if , 1 - A • • -- 201 amps to 400 am • s __ 2
Mall' , ± address: 1111111=1=1M1111111111 401 amps to 600 :..s �_� 2
601 amps to 1000 amps =i1 2
City' Std: ZIP: Over 1000 amps corv ___ 2
Phone: 41 Fax; E -mail: Reconnectonl _M-
Owner installation: The installation is being made on ptoperty I own Temporary semi= or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alterntlao, orreWcallon: .I
ORS 447, 455, 479, 670, 701. 200 011 or 2
201 , ,•a to 400 amps IIIIM_1111111111 2
OWner's sr . azure Date em to 600 ern .. ___ 2
.4 7Yr tk A* i X y r . ' FN( I' 11 ' 31 � < .: , . r' � Branch .+�. `.. � +iW �'��' Y•is �' - aew,alterotion,
or
Name: per panel:
A. Pee for branch circuits with purchase of
Address: service or feeder foci each branch circuit 2
City: State; ZIP; B. Pee for branch cimnita without purchase
Phone: Fox; E of service or feeder fan test brunch circuit 111111 - 2
Each additional branch circuit: _I=
�Pl RE' IF' V (I ' le • tint chi 1 1 tirtt `= Mlsc .(Servimorteeder not indndo4):
d Service over 223 amps- ommerclol 0 Health -care facility E ach p um. o Irrigation cin:le ■■ 2
0 Service over 320 amps of1 &2 0 Havudouslocation Each si:. or outline h. tin: ■■ 2
family dwellings 0 Buuding over 10,000 squats feet four or Signal circuit(e) or a limited energy panel, -
O System over 600 volts nominal more Residential units in one structure alteration. or extension* 2
O Building over threestonea 0 Peedem. 400 amps or more . ri dos;
D Occupant load over 99 persons 0 Manufactured strucmreo or RV park Each additional Inspection over the allowable In any of the above:
EgKSaAightingplM ❑Other Per inspection MI ∎1
Submit _ sets of plans with any oldie above. Investi : ation fee
The above are not applicable to temporary construction eezvlce. Other
Not all jwi.dretiooa accept credit cards, please c u jurisdiction for moo larotmoriop. Notice: This permit application Permit fee $
O visa 0 MasterCard wtpires if is permit is not obtained Plan review (at _ rYo) $
C1edit omd number: / p / within 180 days after it has been State surcharge (8%) .... $
accepted as complete. TOTAL $
Name of outfielder as shown oe credit card
S
�� Cemeeldor dpnaturo Amount 4io-. I5 (6g0C'OM)