Permit 4 , ' gCITY OF TIGARD ELECTRICAL PERMIT
1
PERMIT #: ELC2005 00 35
,0rra DEVELOPMENT SERVICES DATE ISSUED: 3/7/2005
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 112AA -01000
SITE ADDRESS: 14100 SW 72ND AVE
SUBDIVISION: PP1992 -007 ZONING. I -H
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: 4 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: 3 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:
WILLIAMS CONTROLS INDUSTRIES INC ELECTRIC WORKS INC
14100SW72NDAVE 9122 SE 67TH AVE
TIGARD, OR 97224 PORTLAND, OR 97206
Phone: Phone: 774 - 6444
FEES Reg #: LIC 48251
tion Date Amount SUP 26
Description ELE 26 - 484C
[ELPRMT] ELC Permit 3/7/2005 $66.80
[TAX] 8% State Surcharge 3/7/2005 $5.34 REQUIRED ITEMS AND REPORTS
Total $72.14
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: Onion law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OA - 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at,(503)
246 -0699 or 1-800- v- 344.,
Issued By: Permittee Signature: 67 "
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 639 -4175 by 7:OOpm for an inspection the next 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.
SENT BY,: ELECTRIC WORKS INC; �C�� , 50541; MAR -7 -05 2:13PM; PAGE 2/2
U3 /u4/2uu 13; 39 FAX 5035981 CITY OF TIGARD 0001
- art • p k1416
Electr><caJ Permit AAD canon , Rp 1O lt oI I I C F. I. SF ON 1.l' .
City a>YTigard C1NNI 0 .ION _, JAYD l remnr P/ "'- —z� .
13125 sw n 1 Blvd., Tigard, oR 47223 / �L0ING >> tan
noun : 5 03.639.4171 Fare 503491.1960 6U o�rs�e
lalisechaa Stoma www.cl.dgard.or.us r Line; 503639.4173 .-1. .: _� - � ,'p, .: / 1 See Pase2 !or
.,s www..tiginL _
er_us , N � , / 6� 1 Sepplusetwel lwiannntion •
TYPE OF WORK PLAN REVIEW
['New eoaslrucdon Addition/altaationimplac-0ment • Please dwelt all that suety:
❑Demolition tither Cider** over 225 amps, coming ONasardoes location •
O o � o
CATEGORY OF CONSTRUCT 2- fanadyewed :a rr
4ormonew o
ION at I
❑ 1 - and 2rfaaily dwelling Commer illrmdusvial 0 Accessory building Oars over 600 structure
value nominal units in ens uctu e
Multi- ily � Mastei bolder 0 Other: C78ur1diai over dime stories OPoedesa, 400 amps (gloom
JOB SITE INFORMATION AND LOCATION D low l RVOA V put eaaea structures or •
,✓ 0�
Job ao. : Job site address: /Lf /b U 5"44.) 7,? 1 Der.
Submit � ran orphan with �y of the above
Ciiy/Statte/ZIP: 7- , � 045 e`C O q7�7./ 4. 'Ire above arena applicable to tentrualtY eon9cNCtoa service
Suite /bldgJapt, no.: Projectname: w /W9 /Alf e.satOto[S » I i Qd MC* ' SC '.1
1 t4.. l ions I •• ,
Cross Streaddirsatiion9 to job site: 1 4f) C l z y .. New residential single - er moah
t mfy dwelling t:
g un
111elpdaa ■amcsed
•
�� .� 1.000 s4, R or WI 145.15 4
Subdrldslon: Lot tto.: Ea. add'l 500 rq. R. Dr;ceden 33.40 1
Tax ma atcel no_: - "` United soar +g L residwgal 75.00 • • 2
map/parcel Umlaut eaatgy, non•oealdenetal 75.00 2
` DESCRIPTION OF WOK. Each msavfaeomed or modular
AllefZ 4 , u.-) /7 r/F Service or [seed errs
,F.ZtY ervo seeed/ar teener 1 9090 _ Z
ds tt>9talblfton, altaratioa, and/or relomtloa
200 scow or leas 80.30 2
O PROPERTY OWNER 1 O TExA,rrr - 201 amps to 400 amps _ 106.0 2
401 arnps to 600 iu9 160.60 2
Name: 601 sins to 1,000 amps ` 240.60 2
Address: Over 1,000 amps or volts 454.05 2
Rued only 66-83 _ 1 2
City/State/UP: Temporary services or feeders lnetailadon, alteration, and/or
Phone: ( ) _ 1 Fax: ( ) reloa:ton
200 stop) erlese 66..15 _ 1
Owner lnstadatton: This installation is being made on property tbat 1 own which is not 201 to 400 amps 100.30 2
Intended for Bale, lease, rent, or whom accordlns to ORS 447, 449, 670, and 701. 401 to 600 atoms 13175 2
Owner signature;_ bate: Beane* dmatra _ new. alteration. or axtmdon, Der nand
0 APPLICANT i 0 corm= PERSON A.rac for lama circuits with
service of ruder re, each 645 2
Business natee: • blanch chunk
13. Fee for branch airman
Contact name: whew: se v1cc or keder fee, 46415 ej 2
• "•" each branch emir
Address: Bach add') breach cfrcult ? 6.65 10 a 2
City/State/ZIP; A9acellaaeaus (service or feeder not included)
Pump ocirrigadon chute 53.40 2
Phone: ( ) 1 Fax:: ( ) shit or outline lighting 53.40 2
E-mail; Siva) circuit(*) orthnited
• alteration. or
CONTRACTOR os Dana= Par 2 2
p Business name: &Lee/4 /c £(4 C ■' '
___" q/.2.2 SLR !v7 6 /i • 1 10 \�/ inspection over allowable 0f t 1 above 6230 .
1 5 City/Sink/71P: 10O,�TL..J4 C ? 7201 ' 1m' 0 n hou(1brmW 62.50 73.75
Phone: (p3) vii / 44I f, Pax: •( ) ev.rq/ a &Fp= o AI. PERMIT FEW Cat Lit.: r . AS Electrical Lzc.:.2t, Q Q c. supw. Lii.: ' 2 4.0 k p e
3trprtr. Elee4ician signature, - • ..
. - . ; _ Plan review 0594 of permit fee)
• !/ - �� State meant (898 orpe�ir fee) . .. t
Print name; 7gAk y / I Date: TOTAL PEBf PER .0 ,
Authorized signature: • This permit eppiieatks ne Ira penult is net oblaia.11 within 180
days after It 6a aeon sesaptedw complete -
Prior name: f Data: • Fee ourtbodology ser WIVI•Ceuroy &Map Lady genies Bond
es Number of inspections per peter allowed
Alarm: . .4.....J.11110...... now•des INDS Ma.r6lmta 4W5%
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00135
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2005
Phone: (503) 639 -4171 "Noll
Inspection Requests (24 Hrs.): (503) 639 - 4175 �� " I
INSPECTION WORKSHEET FOR DATE: 3/24/2005 TIME: 7:09AM PAGE: 61
SITE ADDRESS: 14100 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: PP1992 -007 LOT #: 001 TYPE OF USE:
PROJECT NAME: WLLIAMS CONTROL
DESCRIPTION: 4 Branch circuits.
OWNER: WLUAMS CONTROLS INDUSTRIES INC, PHONE #:
CONTRACTOR: ELECTRIC WORKS INC PHONE #: 774 -6444
Inspection Request Scheduled For: Date: 3/24/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002664 -01 6603- 774 -6444 Y
Corrections /Comments/ Instructions:
C./ F
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: mil/ -� y Date:3 -- --`-P L ' Phone #: (503) 718-
7