Permit • CITY OF TIGARD ELECTRICAL PERMIT
7 PERMIT #: ELC2005 -00939
;,. DEVELOPMENT SERVICES DATE ISSUED: 12/6/2005
- - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103AD - 04000
SITE ADDRESS: 13040 SW 107TH CT ZONING: R - 4.5
SUBDIVISION: PATHFINDER LOT : 030 JURISDICTION: TIG
Project Description: Panel change & (1) circuit for saw.
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: 1 W /SERVICE OR FEEDER: 1 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:
DELBERT MCCONNELL WEST SIDE ELECTRIC CO INC
13040 SW 107TH AVE 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 443 -4811 Contact #: FAX 503 - 736 -0677
PRI 503 - 231 -1548
FEES
Description Date Amount Reg #: LIC 13306
[ELPRMT] ELC Permit 12/6/2005 $86.95 SUP 4654S
[TAX] 8% State Surcharge 12/6/2005 $6.96 ELE 26 -135c
Total $93.91 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 questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: 5_11.2,
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
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.
4 >~;i ec tricaI Permit Application FOROFFICE USE ONLY
ketxived .� J
t:'ity of'Y'i�; :>trc� � '" _ 1�-� —�Js� t' unit NU. :J� L/��(� �
} nal�rnv:
1.1125 SW Ilan Blvd., Tigard, OR 1722 e l'
Lm 1 L :view
Phone: 503.6 3'1 1171 Fax: 5()3.5')X.17(,0 ` ,r t ` A (him' Venial:
1 i Rsic/Ily:
hc.pr :c :Iinn I iac: 50 0.6.X7,41'/1 Jtil : Prase keady Illy: ---- --- --..... Ju.(K •+ m se,: rags Z Ior --'
Illie n.:l: www.c:i.li};aul.or.u.^, . ,C O ° L. - Noiilicd/Mt'llloc1. J I Supplemental Information
- -- --
TYPE 01: Wt)[ i -, J- MAN R),VIrW
❑ NCW cutistreetiun dc} till i ` ''' T /I't,4) �� ' H ilt( - -- Please check al that apply:
�t74
n llCllioI t u)f 1 Otl�• ❑Sl.lvic.r. over 225 amps. comm 'l I]I Iarartlous location
_ -.— --- -... -. ..._...-...._._._._...............__ ..... ..............................- ❑S.avicr 1v.r.32O amps ratio ❑livildut:, over 10,(1(10 sq. TL.
• ('AT4;GURY OF CONS'1'IZIJ(:'FI(IN of I - and 2- tanlily dwellings 4 ut' mole new t :Bit1l:nlial
v
1- and 2- f;lmil dwelling (. 'oniirwrc:u'1 /industrial ❑$ystl:fl uvcr 40(,1 olts 110111inal WIiLS in unc sink:hilt
_ y ), U L] Accessary building
. Iviulli- tanlil [] Master builder n Otllci f Iluildin over three stories ❑1yanlcrs. 400 amps or stare
_....- --
--.--._...... ❑Uccupallt load 4,v1.3 99 pci:,uus OMainitlietured structures or
.10D „SITE INFORMATION AND LOCATION ❑ Egress /Ilghtingplan RV park
Job no .,‘ 7•&5)L1 Job site address: 1 ' j2)4,,4 L_ U 7 ' ❑1 pcailh -cart: t;lt i)it .. -- .
- -_ -- ,� - -_ S^ _._�— . .._... _._.___... � ... submit _ sets or plans with any o f ' above,
City /Stale / %II': �' z The above are lit ppl it ii 41 iii tempoial y COnst IlkC ii,11 ',u vl420. _LI.,_c_C.;"v r i 1 / p
1 F EE* SCHEDULE , • f
tilnte /bhip.,. /apt. no.: Project mane: t ' - -- - ,,
I , - • t -,� _ _..!._ .... :• / Dewrlpduu J.. 1)ry. I Ere Turxl I .
CUSS Sio ti/directi lo job site: New residential single- or multi - family dwelling u,nir_
-_________ _________ _.__._..._.._ ... pu'lt[th;yaual'heell ; a[' :tt;o.
1,000 sq. Cl. or less 145.15 4
SUbdiVisiOn: 1 Lot no,: ha, add'I 500 sq. 0. or portion :33.40 I
-- - -- - -- - - - -- - - Limited energy, residential 75.00 2
'f'ax map/pa/eel no,: - - -_,_- -- -- ._..._.._...
-- .._. -...._ ...._. .. ...... -- - -_._ -... I,irpited energy, non-residential 70,00
DESCRIPTION OF WORK u
-. --- - _._._.... _ ^ Mach nunuluclurcd or modular
I ' tiwcilin�„ scrvi<:n :,„,v,,,, 1 7 ().00
\ 2L'" - L- \G2 e^ �' '� L— = C_ +r !' { !- 3 ticrvitr•s or Cccdc['. installation, a and/or relocrtlini
— I CG
2U() amps or loss .t 8(1.1(1 9(: .31 ) 1
i'ROt t iC'fY OWNER 0 TENANT 201 a�ryts (II 40(1 amps
401 --- ...... n0I amps to 6(1 amps 1410.(,0 _
- " 4f, �'�"',.Q.r f / 601 amps lu 1,U0(1 :[[tats 240.40 2..
Address:
C Over 1,01)(1 amps or volts 454.65 1
2
-00 am or v -
[' v�i��Z . - -
_....... - ..._.. - -- L - - -- - -... - ILCt:nnnccton 66.5
City /Statc /LIP: 'Temporary services or feeders installation, utteran its, and /or
•
relocation
Phony; (t ) Lt LI$ i ( fax; ( ) t
�(/ y. - 200 amps nr le 6(1.85 1
(honer instil !Winn: This installation is being made on prop that I own which is not 201 ;unp;; to 400 amps _ 1(0.30 t
intended for soli:, Icase, Or exchange, according to ()1(S 447, 440, (X70, and 701. 401 Hoops to 600 amp. -- 133.75 __ - _
Owner sit;natulu: f Date: Branch circuits -new, airl•1•U(iuu, ur OKteiltinrn, per panel
l_..... ....N.
❑ AP I�I.II :ANT ❑ C;AN'1'A( "I' PERSON A. I'cc. tor hi: c'ircuit. with
- -••_ -.- -- - service or 1ccdcr rec. each 4 f ((��
Ittisiness name: --- br_nual circuit— (,. U/e Z
-_ ....
U. I•eC IUI• n', nt:h circuits
Contact name: without service or lender r e,
46.10 '
cpch branch circuit
Address _—
I:ach :WWI brand' ciicu'I 6.05 -.
City/State/Z11 Miscellaneous (service or seeder nor included)
- -- - - - -- I ' - - 2
ulp Or i ti q,;gion circle 53,40
Phone: ( ) I I ( - ) -. - - - -- -
___. __._-- _ -..._ .. _.. 1ip,n or outline lighting 53.40 2
i( -mall: Signal circuit(.) or limited-
. _. _ ..... ..._ _.._._......._......_.. ...._. ....- --
CON'fICA( "1 OR energy panel, atteraluoit, t»
- -- - - - -- -- ._..._. - - .. - extension. Describe: Page 2 2
13u5incss name: West Side Electric Co., Inc.
Address: 1831 SE 81'0 AV E. t;,n-i, additional inspection over ollnwahle in any or the above -
Ibr inspection 62.50
(7ily(Stltc1 %IP :P(R'tiANI),OR 97214 lnvesligaliunperhour(I 62.
}'bone: (503) 231 Fax: (503) 734 -0477 [,tduet,,al plant per hour 73.7h
- - 1 :i.K(l'lt PERMIT FEES* ...... -_
CCB Lie,: 13304 Electric,; l•1.ic 2G -I35C; rv, 1 it:,; `; 5' ` — - S oral 6.- vC_ • Sup rv. taectriciun si re -� , � I'li t review (25 %uf perritil -_
/77 � _7/ � ., / / ( Sialc, surtt :u };c (1s' %. of-permit ' • Print name: l' t< ( ? Wi. '� I ):Itc: / U ? 1 Q I AI Pfr `
1 1' it 1 Z
- --•-- .._... -- �( L-- �.... :� > r —..._. u .. T ,KMi FEE t . o (
Authorized signature; This permit applicitinn expirtx if a perutlt ii epr pld-ained within 1x0
. _...... _.___---•'--_._._ --... •--...--- '-- "- --- -- - -'- dsyi utter it bus been uo er1utril in erlmplr•'r
Prins IlLiillC: l I )ate: • fee uteuuufulu)y set by Tri- (:ounty Ituiltlia); ladunry Service ituertl
. . ._.....- -_S —_. _...... -- - — 11 .
------ - ....- - •� C�IUNhef of'cnn�pec:nuu4 per LR'elflll ull4wer,i.
i atlia, sigh, nnl,tl.IC tr,..,,l App,l,.c IJU. 4411 44,1.1''( I a). 1('OM /WIElt
2 ' d LL90 - 9EL C EOS) • 00 0 T -moo T aP I S zsa(h eB0 : L0 SO 90 oaa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00339
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/5/2005
Phone: (503) 639 -4171
Inspection, Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/8/2005 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 13040 SW 107TH CT • CLASS OF WORK:
SUBDIVISION: PATHFINDEF� LOT #: 030 TYPE OF USE:
PROJECT NAME: MCCONNELL
DESCRIPTION: Panel change & (1) circuit for saw.
OWNER: MCCONNELL, DELBERT PHONE #: 503- 443 -4811
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503- 231 -1548
Inspection Request Scheduled For: Date: 12/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 023158 -01 503•231 -1548 N
S d3 S 168o
Corrections /Comments/ Instructions:
!_.r- / a r OW- ( OVA s
pi PASS P� AL APPROVAL n CANCEL n NO ACCESS
n FAIL LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Ins ecto • Date: / Phone #: 5 p � ) 718 -