Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00141
DEVELOPMENT SERVICES DATE ISSUED: 3/12/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 12 CA -13000
SITE ADDRESS: 15566 SW 76TH AVE
SUBDIVISION: RENAISSANCE WOODS NO. 2 ZONING: R -7
BLOCK: LOT : 054 JURISDICTION: TIG
Project Description: Wire A/C unit
Job No. J05220
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: 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:
HUTTON, BRIAN D + DEBORAH A WEST SIDE ELECTRIC CO INC
15566 SW 76TH AVE 1834 SE 8TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: Phone:
231 -1548
Reg #: LIC 13306
SUP 1556s
ELE 26 -135c
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 3/12/01 $46.85 2720010000( Elect'I Final
5PCT CTR 3/12/01 $3.75 2720010000(
Total $50.60 EXPIPF
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE `�� � ISSUED BY:
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
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Al Electrical Permit AApplicatlon
4 ` r, Date received Permit n ,: efa/ as 1 ` /j •
,(� .,,I_ City of Tigard Prujccilappl.nt Uaplledime:
City Cgu,d Addrbae; 13125 SW Hon Rhd, Tig Olt 91223 UatvIIC'Jkd: 13y: I tiacefptuo.: •
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Phone: (503) 639-4171 -
I'NJC (503) 598 19L0 t•1`e_frlc Payment type:
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Laud use approval: ___ •
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Till:. 01' 1'1•,1t511T
i : 2 family dwelling or accessory 0 Commercirfinduklrial CI Multi- family 0 Tannnt improvement
a i' e. v comma:lun U Additio i/alterntiner rlace.rnent o Other:...., , , ,._•_.., __ o Part(gl.
,11111 51'1'1 INI•(IRI,IA1 It AN
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J SiF N p .
lob a Bid:. no.: Tax reap/tax leas IoUac cunt nn.:
Lot: Block Subdivision: •
prole name: .. . . , nii , , . Deauti jinn and locutiun of work on premises; 1„J r Ac.— . ..
Est11n• cerl date 1.11 cuxil ;c,IirnJins xcli :m
( (►11'Itr�4 :loci Arri.i/ :.vrioN I F1• :1•: SU IFi)1:I.I•
Job • t `� • _ ...
Buoia• 'N . 1 lac -t i U _ e D.rcr,ptiva ��
Addre pp my. reela r real -Aviv or ma! - • yler
,�r 2? %- - dwelnaa mat. loch dal ettaobcd
_ Stale: 4;1 z:P: IA IlVflutri t
CCB ixlec, bus, lie. nu. t Each addlllunal!OOs•. h. or portion :
�.� .. � �.1.k ... I.imruderub ,resilderlttLi 1 •
1'It111'1 2 Cit / etro lie. no.: 1-. - cited eeergy, non•reaidunud �� '
�et - p suATIADI1 electrician t 3 — Q S eacb i rraquraL home or mudulm dwcUlof SI .r -' royulrcd) Da® crvcetutd(u fee r 2 r CEO r. nametpdur); ► , �- T I.I: : no, , e rv lce or t Inr'1.)lgd dteralton er tnlocalltrl: .1111111111M
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'111'1' +�1 vl:It 200 amps ur lesr 2
• EMI silt : _ e 1• ICt lA 2A1 amps to 400 a -..r J ' II.. In •
Mellin add rt all: r - t - - 4 . 1 - 1...715100 a .s 2
EMI i 401 ampJ to 1000 tun lb MEMO=
State: Q 'ZIP: i 1 4.[.4 Over soap amps or vein _S
Pion (: �r Pax: E•natil' A` c• , tt n1 �__ .• •
Own.. • Instnlletlo)t The instillation it being made on I?topurty I own atepncu4wrTteau ee•
which . not utterrded fur sale, lease, tent, or exchangr occcrding to krta hirl,aMsrndNy or elucatlostr
200 amps or leas 2
ORS 4 455, 479, 670, 701. col amps le dOC amp: 11111_ 2
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Own: e e - n: Da.e: • 1 • o ' • L _ �__ •
• 1 N(:I'V 17• I( rime c cu a - now, atlorrt ea,
1 �- ort leti,siun per paoel:
A. roc for branch the:lite with purchase of
ESTI •
` _ service ir! rtrdor fae, r icIj b: a :tell ClKulf
EVA :date: 21P: B. [be }V1 brvrat civet tow 11h'x1t parr base
or ber-v1 :e o r f eeder fee lint Drench circuit: 2
Fast: Fs mall: � � �- , •
�o :n aIltloncl branch circuit: NM 1'1.. \ HI' 11 %%; II I'lealer ehcck'al1 Ilk.' apply) e. 'eyelet or oteer not brttude• . •
Q Seml. over 2 2 1 anrps.cornmerda1 0 11ee1W -cur fatale' Cads purup or irrigation clrela 1111 2
CI Semi •.over310 on'rpo.wt1n /oft &2 ❑HuaarddusIncminn Frith al. noroutt)ncjjhdrrg
(MI) dsv 1ihy 0 Hut dlr,p r - er 10, :O1) aquarz fvetf arm Simi circuiqu) ur a llm eucrly pmtel,
1111K1 •
iSysar over 400 veto'nomlrtol mars ra aifrnUalunit&Inmteolracrurt fill eratipn.orexinitton' •
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GI Build •gwetthrecaluriea O Feeder,, 4fi0 au{tor more uDt..rcrl•t;on.
LI Owl. e„Iloodo.erB9perno, r] _ k FaII aAdhlonal impaction over tlleano +toble tio� 'aline'bore:
0 Earesp'h6luing 1 C)tls� Per i.wim t4on —1---J 1 i
Submit _,_, sets of plaice With any of Ill a above, Invest! • Acton fee
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e above Ore o01 u • cable to temporary Construction settler. OIMr • - i
d leave mcep, erotlll cm*, blues° wll jLfII' Il,t, roc hse 44,,,, Notice: This permit epplicoliarr Permit fee ............... $ .
O Yll► ❑ MaelelCmd expires if a perrnil h not obtalnrd Phut r View (at -...., ,) S _..__ -.•' _
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Cradle eta numtrrr _ 1.R ". r°L ' � w Jroce t1 p tz tetl a 18O ti c n a np y€ �lf�ota. er It hoe been State surcharge (1399 j $ S � � � !
y TUT JU
-- S. r e d rerdltolrlsr sr i tiown on ei odlC - - -
v L'udVotd ar rlynovuu -`— -- - mime i —.
• -- 4,1 4461514111KIIM) '
EXPIRED
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TO - d LL90 92L 20S OIN13313 3QIS 1S3M Wd SO:90 TO -LO -21UW