Permit gpir
CITY O TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00277
' "Nr l DEVELOPMENT SERVICES DATE ISSUED: 6/19/02
, o ' 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S1 12 D B -00600
SITE ADDRESS: 15205 SW 74TH AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: Installation of 200 amp or less temporary service.
• RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
DENNY MEYER ROBERT HAUSER ELECTRICAL INC
7340 SW LANDMARK LANE 1091 NW CORPORATE DR
TIGARD, OR 97223 TROUTDALE, OR 97060
Phone: 503 - 620 -2086 Phone: 503 - 674 -0147
Reg #: ELE 26 -402c
LIC 13476
SUP 1553S
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 6/19/02 $66.85 2720020000( Elect'I Final
5PCT CTR 6/19/02 $5.35 2720020000(
Total $72.20
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 yo - to rules - adopted by the Oregon Utility Notification .
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0680. You may obtain copy s of these rules or direct questions to
Permit Signature: y Issued By: # A1 J 2
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
i i w - -
SIGNATURE OF SUPR. ELEC'N: �- ��� DATE:
LICENSE NO: f ,55 S
Cali 639 -4175 by 7:OOpm for an inspection the next business day
City gfTigard
Electrical Permit Application
City of Tigard
Address: 13125 SW Ball Blvd, Tigard, OR 97223
Phone: (503) 639 -4171
Fax: (503) 598.1960
Land use approval:
PROPERTY OWNER
PLAN It LVIFWW"`(Pieace died. all that aPPI9
:lOB SITE INFORM ATION
E -mail:
Descri ��
New t'eaidential - single or atulti tantlly per
dwellfn[txi it.Iacludes attached garage.
Senioeincluded:
1000 sq. ft. or less
Each additional SOO sq. ft. or •orison thereof =11111=11011
1111
MO M
1111
1 1 I
Limited One" : y. residential
Limited energy, non- residential
Each manufactured hone or modular dwelling
Service and/or feeder
Semen urrenders- installation,
alteration or seloeation:
200 amps or leas
Man
no. insp
201 amps to 400 amps
401 am • to 600 amps
601 amps to 1000 amps
Over 1000 amps or volts
Reconnect only
Temporary niervices or feeders -
Installation, altcraGon,orrelegation:
200 amps or less
201 amps to 400 amps
401 to 600 am
Branch circuits - new, alteration,
or extension per panel:
A. Fee for branch circuits with purchase of
service or feeder fee, each branch circuit
B. Pee for branch circuits without purchase
of service or feeder fee, first branch circuit
c tadditional branch Circuit:
Misc. (Service or feeder not Included):
Each pump or irrigation circte
Each alga oroutline lighting
Signal circuit(s) or a limited energy panel.
alteration, oreatenaion -
•Description: _
Each additional inspection over the allowable In any of tbe
Per inspection
I nv c ti ti on fe
learner
Business name:
Address:
City:
Phone3-67
CCB no.:
Sip:; etcct. _ngiog
Alt lie. no_: (rj 6I
nature o su tsing a ectrician (required
Elec. bus. tic, no:
State: ZIP:
E- mail:
Bldg. no.:
tion and location of work on
/ — o c /
Suite no.:
emiscs:
Tax snap /tax lot/accoutit no.:
O "1 & 21amily dwelling or aocessory Commercial /industrial
0 New,construction 0 Addition /alteration/replacement
Job address: / 6 O 7-¢ ,4-0E,
Lot: Block: Subdivision:
Project +name: /t't E YE i g 5 t G Descn
E st;ntatedkdW,of.com tenon/inspection:
CONTRACTOR A PP) ; ICATION
Name (print):
Mailing address:
City:
Phone: Fax:
Owner installation: The installation is being made on property 1 own
which is not intended for sale, least, rent. or exchange according to
ORS 447, 455, 479, 670, 701
OWnet's 3 i ' late: _ pate:
0 Service over 22S arnpatrommerciat 0
0 Service over 320 amps•rating of I &2 0
family dwellings
0 System over600 volt: nominal 0
0 Building over three stories
O Occupant load over 99 persons 0
0 Egress/tightingpinn 0
Ntmt ardhoWer u shown on cwdir CSrd
T O 01j
cordbotder siaaaruae
Health -care facility
ttazordou :location
Building over 10,000 square feet four or
more residential units in one structure
Foeoets.400 amps or more
Manufactured structures or RV park
Other.
Not all jededie¢otn accept c1edit cads. pitasc tall jutisdistioo for mac Iafertnation.
0 Vise O MasterCard
Coedit card numb=. ,
I I
Expires
Amount
Q2Iv I,L d0 All J
0 Multi - family
O Other.
Submit ^ sets of plaits with any of the above.
The above are mot applicable to temporary cottsttmctiOD service.
Notice: This permit application
expires if a permit is not obtained
within 180 days after it has been
accepted as complete.
O Tenant improvement
0 Partial
Permit fee $
Plan review (at 12) $
State surcharge (8%) $
TOTAL $
. 7 j.
440 -4615 (bDWCOt i)
096T88CCO5 P!, LC :ZT Z00Z/8T/90