Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 - 10105
,.41,1 j A t.. DEVELOPMENT SERVICES DATE ISSUED: 6/16/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103BD - 05600
SITE ADDRESS: 12681 SW 116TH AVE ZONING: R - 4.5
SUBDIVISION: HUNTER'S GLEN LOT : 012 JURISDICTION: - FIG
Project Description: 2 CIRCUITS AC AND GFI
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:
MIX, KELLY C + WYNONA G SUNSET HEATING & COOLING
12681 SW 116TH AVE 0607 SE IDAHO
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: 503 - 705 - 6700 Contact #: FAX 503- 234 -0439
PRI 503 - 234 -0611
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 6/14/2006 $53.50 LIC 161085
[TAX] 8% State Surcharge 6/14/2006 $4.28 SUP 46385
Total $57,78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344. .
Issued By: Permittee Signature: 4 vi i �, .. / ,, f
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jun 15 06 08:15a p.2
•
i
Electrical ]Permit App WA. :
'le ` E® hull ()Hi( t: t si: O\1.\ '
City of 'f igard 1 1 Al N 5 2006 Receiv 131SW Hall BlvdTigard, OR 97223 Plan R f� Permit No �p b "' Phone: 503.639.4171 Fax: 503.598.1960 OF TIGAR ' "° .ttii;' l I Date/By: Other Permit: i I
Inspection Line: 503.639.4175 i �j `� �- Date Ready/By
Ct See Page 2 for
g BV 1N ( a ` plVl' ,,,at N otified/Method: J • Internet: www.ci.ti ard.or. �� t Supplemental Information
i t � , . fi s, i s ar+n -: ? . .„' lr- T:%:,4 d'� a ti'h , .e.�A '"r` }, '"` ' 1 ° +: _ .' + y y . ti tr•..: .. "" . . s:Y Fv"q�y,iy n v w �,n+ r ;�t'rw ,-, .
, *.., � t . :v< < t ; ,,- .. r '4 lF .�.5S } .. Mr � , }: .51* -e P, :"
Vr � , .. n 4 x g ,. .. t'•4 " I F ..,ge.w0 ; ' :4 : 'dom$ .. -v
; ' ss.rc... � �� � ,.. xa . {.h Px.J?.'�°•P_.3u4:Yi �', k£�Y u` "` � ;'�d s ..:.,..... ij: - v. . a :�..r.z.n� i.'k ,�. � lb.i.�,<teMa�„�rzrr�.s; +�'
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other:
❑Service over 225 amps, comet ❑Hazardous location
ctw x , i - a pia F a ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
,i spa 'r . 'v �', a ti I ,1 0 ,r ,. .i . , ,,. n x }, : i . ` U; , r of 1- and 2- family dwellings 4 or more new residential
{ i- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Et Multi - family ❑ Master builder ❑ Other: DBuilding over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
�
•' �s ik Rna at'I t ; ' IA) , w do `I r; �' ..:. t! 0,' t 2 :rc C're ifA f.i., ❑ Egress/lighting plan RV
,ans in4k, g$7i a,.'s,.,, ,1 14 oil ss' t` , * .� ��':u ��" . E ss/li tin Ian park
P
Job no.: 51 30 Job site address: `` 1 �' \ , t , "(� ❑Health -care facility ❑Other:
i �` �� t Submit 2 sets of.plans with any of the above.
City/State /Z1P: - {: oo,.y 3 The above are not applicable to temporary o tern at construction service.
j .
1:**.., ,w� ,•�:Y 7 3 „ k
Suite/bldg./apt. no.: Project name: �`v ':M w .:. "} _ e " ' �_ .`
,.sw
� ' Description �, Qty. • I Fee. f Tots!
Cross street/directions to job site: New residential single - multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: ( Lot no.: Ea add'l 500 sq. ft or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
. ti t``rg } K, °ate,,j , „ Iti ti { Limited energy, non 75.00 2
: ' ' k eFp .�{ "' 4 .:a �..:, rr' ' ;1 ,.
>,;,�,r ,'�r��,m����"�3��::�'�.; , .:.� <; �v�, . •.,� s`�'� {:s �'�;�? a'� d(�t Each manufactured or modular
dwelling, service and/or feeder 90.90 2
4 �
f ,' .. 4 ." rt J ,, Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
ots;r;ra --iq.s� °F -• ,•�+ „y ,•rh-:�+:, a~?r -'•:w 201 amps to 400 amps 106.85 2
"'"z:;f�t3' &•, atG,•.. , ^7e:.4?z,�r,. SE,<,:eF�ksF «: , N4r - ,.iw , -„'. t : s,'sx r
�`! .� s, . I r .,• z• .;` .:%�1." tc. i:T,'.. , xMFa x E, .'F '-° "° ?Y . , +.Y, - , A • fi r
. � t��',. ,_, Y ,u� v —. „ „ 1;.,.,n.., ...,. ..,. ,._ 1 , ,� <,s r, 401 amps :600 160.60 2
Name: r it,C -1 1 \ . 2/' v . m ,_; !YU 601 amps to 1,000 amps 240.60 2
{ i) „ Over 1 am or volts 454.65 2
Address: l ti' l `'cO., 114)
Reconnect only 66.85 2
City/State /ZIP: — C 6/ 1122: 2 ) Temporary services or feeders installation, alteration, and /or
relocation
Phone: (g) ) -- 3 crj - 1 4 r -'' I 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: Dale: Branch circuits— new, alteration, or extension, per panel
=ar ,z,F„ r 3 v' "° la�xt ",'�, (7 ' t � 7 y;� t e for wi
�:�;p..yy+zt l,fA 9 t " t 's ".A,� Y;xx+L•,v;..� i :i zb .:::. .v,At••: .".'1•,..yi'j'
'.JF,':.�1.'k.'.� +,1��:.. -�-'�. •.�.M,'.,i,�.. ... 1 .F. titi'�:"1v�'.'417 St. „5crc`�?<4 P,lb:rkY�L n....j,..e,,..F.r.�xk��.. V..e.'..tt:�?ii ?:LF� ^� „�:: A. F
t serve ice or branch feeder fee circuits each th 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
fi rs t b ranc h circui ( 46.85 LLL,,t 5 2
Address:
Each add'l branch circuit I 6.65 _ (AO.: , 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
`vv 3, 17'r " .t 1 t :sy ' . r ;gi die g , 1 enl, eration
ex tension . er ane Descraltibe , or Page 2 2
Business name: Sunset Heating and Cooling
Address: 0607 SE Idaho Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Portland, Olg97239 Investigation per hour (t hrmin) 62.50
Phone: (503) 234 -0611 , ., 5 PY.l:!"�.al ... ,.. ,+z:.hi•+5�:.4 .b / Fax: (503) 234 -0439 Industrial plant per hour 73 75
,� , w aw : . �.o t �: 4. y..., ,.'��.:.mJ
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CCB Lie.: 1610854, 'I Electrical Lie.: C117 1 l I� Su Lie.: 4638S ,0 Subtotal ; 5 3 5
Suprv. Electrician signature, required: `/ 101 1 Plan review (25% of permit fee)
Print name: 1 'a';.I.LtM ESS i/ Date: i(2) 1.1.0%,,0 State surcharge (8% of permit fee) 9 .:,),Z
E t � TOTAL PERMIT FEE L3 I .'�
Authorized signature: This permit a elpires ifs permit is not obtained within 180
• da ys after it has bee accepted as complete
Print name: C i k1 G� s , y y (S I (r` Date: .' i� t'C;') • Fcc methodology set by Tri -County Building Industry Service Hoard
- •• Number of inspections per permit allowed.
I:\ Bui lding\Petmits\ELC- PemitApp.doc 12/03 440 -461 ST(10/02JCOM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC12005 10105
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2006
Phone: (503) 639 -4171 irim l Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 713/2006 TIME: 7 : 03AM PAGE: 29
SITE ADDRESS: 12681 SW 116TH A V E CLASS OF WORK:
SUBDIVISION: HUNTER'S GLEN LOT #: 012 TYPE OF USE:
PROJECT NAME: MIX
DESCRIPTION: 2 CIRCUITS AC AND OFI
OWNER: MIX, KELLY C 4. WYNONA 0, PHONE #: 503. 705:6700
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503-23 0611
Inspection Request Scheduled For: Date: 7/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 032582 -01 503 -2.31 -0611 N
Corrections /Comments /Instructions:
*&) /9- i/P /"17 e <_K
_ uN ler frIpti-x. yo eehtt-fra MIA' z_z-/. y efiti7
6 # /0 e.‘
0110
f ei <T. s n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
. Inspector: P Date: 1 7 - 476 Phone #: (503) 718- Z--‘ 4/7