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Permit i CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00432 '' _'' DEVELOPMENT SERVICES DATE ISSUED: 8/4/2006 Alit 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110AA 03200 SITE ADDRESS: 14060 SW 105TH AVE B ZONING: R - 12 SUBDIVISION: EMMERT'S WEST ONE LOT : 004 JURISDICTION: TIG Project Description: (2) branch circuits for NC & outlet. 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: 1 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: TRAVIS DAGGETT WILSONVILLE ELECTRIC INC 14060 SW 105TH AVE #B PO BOX 845 TIGARD, OR 97224 WILSONVILLE, OR 97070 Phone: 503 - 467 - 9708 Contact #: PRI 503 - 638 -5353 FEES Description Date Amount Reg #: ELE 3 -307C [ELPRMT] ELC Permit 8/4/2006 $53.50 LIC 75752 [TAX] 8% State Surcharge 8/4/2006 $4.28 SUP 38545 Total $57.78 REQUIRED ITEMS AND REPORTS 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 questio s to OUNC at 503 - 246 -6699 or 1- 800 - 332 -2344. /";1‘/ Issued By: J� Permittee Signature ,, _2Z:h.„ 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. Electrical Permit Applic * roll OFFICE USE ONLY 4 20 - / Received "` — r Permit No. �' t City of Tigard DaDate/8 : • • / Li i 13125 SW Hall Blvd., Tigard, OR 97223 AUG Plan Review aa' Phone: 503.639.4171 Fax: 503.598.1960 4 a '�N Date/By: Other P ermit Supple B( See Page 2 for Inspection Line: 503.639.4175 --dr'i Date Ready/By: /U�5 men CITY OF TIG °° °° -y teal Informahon Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method: 7 »s:n s. - ra ^ . : x,.ro- t ^dnia r, r .s.' ,,t._ v.. *; `iy : ' ;',:.#Yor ,49..fan >Ka a y a- tr?,t , Y - aM -, 'q� i i' - " .v ,., i :: . � , ,. +3 33 Ai. - ° `y V � r - . �° : i. ,, _ �� i ^� N h ; " ,� , 2 r r .e .,,Ft ,RETIE, ry la } . _ . , - ,. i'' . tiN rz r rvs :. rp' P OF WO - x.R, � 4 rr i 4 k ' tW S, / *r 3 PI,AI�i ' � , � - "�9tJ,'u f .'.tr� `.. ..';� s.. "'''3 Yf r��iu �kn �..R -.,, t { "�,r� Str.�.at'' �t�il.4tra.�7h�;,:�.�^�rr,.,N> k�, �..n ;ul,•;a`,.� ,t,,,.o�,a, Please check all that apply: ❑ New construction Addition /alteration /replacement ❑Service over 225 amps, comm'l ❑Hazardous location ❑ Demolition ❑ Other: ❑Service over 320 amps — rating ❑ Bulldog over 10,000 sq. ft. _ . „,:,...nm�,n ; xrrlxrs,+: »tn;' , e�um m: an: as, vr9w, taswxPva: r, it7r;: , :eft,�;'�: "i'F "- '44" {vY,, =.ig; ::s new residential r , ,e,K.:t,,:w; t:;a �s > ` i''s- f,::g '.�:1 ,4` ::r;�' . .;a t t Nt of 1 - and 2- family dwellings 4 or more :iu` , . , {•.:I:ite ,•. a .W r °1+ ;w;;..g� .^.G' z FsG,,A . {.O 4N'i tIJG ION , ai ii x iii. r! � n_ t=..: x. �.•;:+: 2�,>':^ m- �. f' �',., r' a�; �, vr�; lo+:., ^�'��?y •:sL�ar_v�a"ff e „arer7vn�l +;,.,,ero•.;,.t.M,+ �„ ^ t�,.'.. �^:3':. a�'.i ��''M iF �a; ❑System over 600 volts nominal units in one structure ❑ 1 - and 2- family dwelling ❑Commercial /industrial DI Accessory building Feeders, 400 am Multi- family ❑ Master builder ❑ Other: over persons red structures or ❑Building over three stories amps or more P ❑Occupant load o ver 99 e ❑M - er;k�et °:;'s.r, uexS13'<'s Y- .idi.�� Y;1 °” �, �"; =� r.' >, ::^, �V !ei " "�,+p� ", i ! ' �il ^FS�� "l � k R V , , t i r JJO� `Stn'P,E I dR'1lirAa'Rf �,' O ti lifia I('S' s7 - " .;r, ❑Eg ress / lighti ng plan p ark .t'r -till; .:._ .o+„ �.. ,� saou WAii.oil.. h;n. z,,,,,,'srr,,4i,I : ..s ,,. ,a .t �,,, -, aIkiiii .+4d ?$III4k r I ❑Health -care facility ❑ Othei: Job no.: Job site address: //,/ 6,� ,� / OS + Ai Submit 2 sets of plans with any of the above. City /State /ZIP: 2 --y kV-6 The above are not applicable to temporary construction service. `� �, G 1 /� / �"' •i -_. r K' . ',' ;?t `,, t , ; �' y., i a' g:'rc m [+1 i„4�P dy Sy,t' #n. -n i att. . Nina R to rer ;t�11wT+i *',S HI•3f1L7t% ,'° �' t' i f4 tiwe,l S N xis :}' Suite/bldg. /apt. no.: Project name: Description 1 Qty.' Fee, 1 Total Cross street /directions 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 I Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 - ,n, vi..w'r,� ^-' A-.. s. �m--. r ;.:^- �re+ rac y� , :;:,:�t�, ^tvr' fifv�v'y a�'� aV i' " "� i. f : r: ,�p a, ION= OF_ W.Oi<ZrK. ,: ;n `r r) .t a ;gil ::.a: Each manufactured or modular `��_l,. .� °Li:�;��PP'r,;�r•r '�;�: „,Rfi'�:.cc sd„ 4L S��s) �',.„._ sr- u, 3: k�. �. ta', k# x !^,vr.un +u,.:`.�3:�} „ ter + �fi .a£N7�: .���,. ,a 3, iS =a "r;,�.5!.r,.:tw.t.,:.•.Ort �f'F,u iiid'ii,: „� n�` ” "' °' "' _. `�` � dwelling, service and /or feeder 90.90 2 e- 6-QA ( / f 4 0 t' - 22. - -r - Services or feeders installation, alteration, and /or relocation / /// 200 amps or less 80.30 2 ✓,, ;: ' �i,- parr svG, , �i,;r � ,p - .2;s;, , :'..�:�s , ,; , ,� 201 amps to 400 amps 106.85 2 '5''::'": - - a d ru nr c., .r pa,r , -'a: = r, a' * - ° ha ` rta"�'iM r, r ' 1 9 I^� v ,j t. r'� + {+' P i - r- y .. ] , i R3TY OWN1 ,. d Vita . a)f , T: ,k igOiK 9, x. 401 amps to 600 amps 160.60 2 Name: .-[') "" �_ vi �A t 601 amps to 1,000 amps 240.60 2 l Over 1,000 amps or volts 454.65 2 Address: Reconnect only 66.85 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 I 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, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel „ " „,..... ,: ... ... A1:.,=t'.W4: ,, ,,.., M ,c ^' �m:a''a`J' i n . • r - '.1', ■T t. i Frvp `�i(;.i' + i F 'AP PL' IC 9 t 1 00 ... ,, p ' ' si 4. i5_ ., . ",i CONTA T; P LS , ,OP ...,.. ,, r A service or feeder fee, each / 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, / 46.85 2 each branch circuit Address: Each add') branch circuit ( 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- JZ ry,:, „,;= °,, ,,Y,F .^ ,e,s -... ��,' a .a ; ,iP/ :1 a ( energy k, , r E � t C©NtTRAC� 0.tet, ;. rt5 W` Ed ” i7rG T ` 7 gy anel, alteration, or P t. W « ' „�_ r,_ a �. d,- t, , i. rr, 'u ,. Page 2 2 - - extension. Describe: Business name: ( L 47 1g_ a.4Q-ir1►P., Each additional inspection over allowable in any of the above Address: p i /1, �j Per inspection 62.50 City /State /ZIP: '_ry _ r p �` ,, A - � Investigation per hour (1 hr min) 62.50 VC/ f IL-5" V/ 4.4.4., t _ 17"` Phone: (�, ) 3 G J .J �r3 - '3 -/� J �i 7 , CCB Lic.: -� S Electric:) 0.2 � � v. L ' .: Subtotal \ j Si) 3 Suprv. Electrician signature , re. 1r-.. / t� 'wr�'. Plan review (25% of permit fee) / State surcharge (8% of permit fee) Y k Print name: / , r ft ' L .n I(�fT7J�lyll v D•te: ,Q� _ i t Lam° TOTAL PERMIT FEE s 7,i s e Authorized signatur / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i \Buildine \Permits \ELC- PcrmitAoo. doc 12/03 440- 4615T(10/02/COM /WEB CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELC2006- 00432 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2006 Phone: (503) 639- 4171��4n lilt Inspection Requests (24 Hrs.): (503) 639 -4175 „�._ ° •I ... INSPECTION WORKSHEET FOR DATE: 11/7/2006 TIME: 7 :03AM PAGE: 33 SITE ADDRESS: 14060 SW 105TH AVE B CLASS OF WORK: SUBDIVISION: EIIvIERT'S WEST ONE LOT #: 004 TYPE OF USE: PROJECT NAME: DAGGETT DESCRIPTION: (2) branch circuits for NC & outlet. OWNER: DAGGE.I I°, TRAVIS PHONE #: 503.467 -9708 CONTRACTOR: WILSONVILLE ELECTRIC INC PHONE #: 503-638-5353 Inspection Request Scheduled For: Date: 11/7/2006 , Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 039370 -01 503 - 638 -5353 N Corrections /Comments /Instructions: . I �C .. .� . :Iv ic 4, $ ( , I 4a a , S5' U SSy R eisflik I(Z W ALL Ne ovM I ANSA_ The electrical installation defects noted on this report shall be corrected and an inspection request made within 20 calendar days per OAR 918 - 271 -0030 ❑ PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ( FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C `\'d 0 L.E Date: IA 1 0 Co Phone #: (503) 718- 1 - . CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2008- 00432 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/4/2006 • Phone: (503) 639 -4171 4 0401 it Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/1/2006 TIME: 6:56AM PAGE: 27 SITE ADDRESS: 14060 SW 105TH AVE B CLASS OF WORK: SUBDIVISION: EMMERT'S WEST ONE LOT #: 004 TYPE OF USE: PROJECT NAME: DACCLI I DESCRIPTION: (2) branch circuits for A1C & outlet,. OWNER: DACCETf', TRAVIS PHONE #: 603- 467 -9708 CONTRACTOR: WILSONVILLE ELECTRIC INC PHONE #: 503 -638 -5353 Inspection Request Scheduled For: Date: 12/112006 Pour Time: Coo - - • • - - • Iescri•tion Confirm # Contact # Message 199 Electrical final 040550-01 503-638-5353 N Correc is - _ _••■•F$ - - '. s: • SS I PARTIAL APPROVAL ❑ CANCEL '\NO ACCESS L ►. LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED f Inspector: .- N 6 6 l Date: i b 6 Phone #: (503) 718- 21 I b