Permit C ITY OF TIGARD" ELECTRICAL PERMIT
PERMIT #: ELC2005 -00699
a � i �, l . DEVELOPMENT SERVICES DATE ISSUED: 9/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103DC -05700
SITE ADDRESS: 13720 SW 115TH AVE ZONING: R -4.5
SUBDIVISION: VIEWMOUNT LOT: 045 JURISDICTION: TIG
Project Description: A/C, furnace & exterior 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: 3 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:
DANA TAYLOR WEST SIDE ELECTRIC CO INC
13720 SW 115TH AVE. 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 684 -9205 Phone: 503 - 231 -1548
FEES Reg #: LIC 13306
Description Date Amount SUP 4654S
ELE 26 -13-13
5c
[ELPRMT] ELC Permit 9/20/2005 $60.15
[TAX] 8% State Surcharge 9/20/2005 $4.81 REQUIRED ITEMS AND REPORTS
Total $64.96
•
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: :/2.7,ts sZ Permittee Signature:
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 A) ca • 11\,`) ��6 FOR OFFICE USE ONLY
City of T'igalyd Rp ,,,,....:.4,,,, ,-- 13125 SW Hall lilv0„ Tigard, OR 97223 , OF �� ,r At Yla Review �� v
Phone: 503.639A 171 Wax: 503.598, 1960 CX G Q� 4,,, •; •,t1, � b Datc/B y' a ar
Other Pia: —
Inspection Line: 503.639.4175 �LQ�N _ g„, r r - _._,....._ —..._.
Internet: www.ei.li 8 ard.or.us �V ° N fifi J /
j 1 �t )�r Supplemental lu sec 1'a Ye 2 for
11 cNcd ud: _
furmntinn
TYPE OF WORK PLAN REVIEW
❑ New construction Addition /alteration /replacement Please check all that apply: - --
❑Scrvicc over 225 ;crops, conun'I 01 laaardous locution
❑ llenlUlifiun ❑ Other:
CATEGORY OF CONSTRUCTION - ['Service over 320 amps •• ruling ❑Buildng over 10,000 sq. 11.,
of 1 - and 2-family dwellings 4 or more new residential
zi
I - and 2-family dwelling ❑ Commercial/industrial 0 Accessory building ❑SyYteitl over 600 volts nominal units in one structure
Multi-family ❑Building over three stories [Weeders, 400 amps or more
y ❑Master builder [� Other:
JOE SITE INFORMATION AND LOCATION ❑Occupattt Inad over 99 persons C1MVnu structures or
TT ❑Egress /lighting plan }
Job no.: v. ' Job Site :Address: 1 -5_ 7 f J 1 n 0 HedIth -care (utility ❑Other: _ ______-
_t�. t -. 1� J FL,) l _._ ` `�� _ Submit sots of plans with any of Iha about.
City /Sta1e/ZIP; t 'r'J t (, •'� The above are not applicable to temporary Construction service.
Suite/bldg./apt. on Project nitmc: "1 - FEE* SCHEDULE
...__ Description L Vcy.1 Peg, -,. I-- Tairii
job site: _
Cross street/directions to
J - New residential single- or multi-family unit,
— — —_ '- Includes attached garage.
1,000 sq. lt. or less 145.15 4
Subdivision; Lot no.; Ea, add'l 500 sq. IL or portion 33.40 1
Tax map/parcel no.: Limited energy. residential 75.00 -- Z
... Limited enopy, Don- residential 75 -00 2
Each DESCRIPTION OF WORK - manufactured :ulufactured or modular
T - — —
_ _
/ - .— �-/ dwelling, scivicc and/or feeder _ 90.90 2
�f y� ��( "� / � ,� ,� `"( 6� / � '�' v y� • _
Service([ or feeders installation, alteration, And/or
200 amps or less 80.30 2 •
----- ROI�ERTY OWNER --� 0 TENANT - 201 amps to 400 amps 106.85 T 2
Name: \�- O - 401 antps to 600 tops i (10.60 ^ 2
r cr V(J�t ^t �� v- T - 601 amps to 1,000 amps 240.6 2
Address: C Ovet 1,000 amps or volts 454.(15 ~ Y_
7 (_ v ��_ - Reconnect only 66.85 2
City /State /ZIP; w-
i Temporary services or f eeders installation, alteration, and /or
Phone: C /3 �r Y "l ,�r Fax: ( ) relocation,
200 amps or less 66.85 1
Owner installation This installation is being made on property that 11 own which is not p
201 amps to 400 am s _ 100.0 2.
intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: _ _ _ _ Date: - Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT J ❑ CONTACT: YERSON A, Fee for branch circuits with •
service or feeder fee. each
i3usiness name: branch circuit 6.65 2
Contact name:
- "- 13, Wee for branch circuits �
,. __ without service or feeder fee, [�
Address: • each branch circuit ' 46,85 /j,.'- 2
_.. L"ach a44'1 branch circuit 7 - 6.65 . i3 L 3 2
City /State/ZIP: Miscellaneous (service dr feeder not included)
Phone: ( ) Fax (~ ) Pump or irrigation circle _ 53.40 2
—,"- L Sign or outline lightin 53 2
E- mail:
- Signal circuits) or Limited -
CONTRACTOR energy panel, alteration, or
extension. Describe; Page 2 2
Business name: WEST SIDE ELECTRIC CO.
Address: 1834 SE 8 AYE. • Each e
additional inspection over allowable in any of the abov
— ._. — Per inspection _ -- _ 62.50
City /State/ZIP: PORTLAND, OR 97214
Investigation per hour (1 hr min) 62.50 _
Phone: (503) 231 -1548 - f `ax: (5Q3) 736 -0677 Industrial plant per hour r 73.75 —
CCB Lie.: 13306 ws S � ELE TRICAL PERMIT' FEES*
Electrical Lilh 26 -1350 Suprv, Lic. /
�.. C Subtend 0 r i s
Suprv. Electrician s ignature, required: i _ � j /,� -
> [r.4 i 2 A y _ . .4 t Plan review (25% of permit fee)
Print name: , L� „ � 1 : \ 11 n • ; D ate C • ` I - �-ry.' State surcharge (8% of permit fee) £-1 f ? 1
TOTAL PERMIT FEE 6 Z
Authorized signature: r - -- �'i'htx permit application expires If a permit Is dot obtained within 1x0 --
—
day% After it has been accopted as complete
Print name: Date: • Foe methodology set by Tai- Comily (Building industry Service Doaad
T, - - '-'- ' •• Number otinspeetiuri, per permit allowed.
is U3uildingTermirvV.;t -C -Pe nritApp.doc 12/oJ
440-4015T( I 0/02/CpM/WP.is
2 'd LL9D- 9EL(COSI •oo o 't.v4oa a pig a. sarq dTT:ED So GI daS
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2005 -00699
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/20/2005
Phone: (503) 639 -4171
A u p I ''t
Inspection Requests (24 Hrs.): (503) 639 -4175 ..._._.:.
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7 :03AI I PAGE: 106
SITE ADDRESS: 13720 SW 115TH AVE CLASS OF WORK:
SUBDIVISION: VIEWMOUNT LOT #: 045 TYPE OF USE:
PROJECT NAME: TAYLOR
DESCRIPTION: fkIC•, furnace if, exterior GA.
OWNER: TAYLOR, DANA PHONE #: 5Q3 -6134 -9205
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503-231 -1548
Inspection Request Scheduled For: Date: 11/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 A/C or heating unit circuit 021278 -01 503- 684 -9205 N
Corrections /Comments /Instructions:
(.;
INC\�(> --- d0s-%q - Ny) 5 2
1
1
nplvw yf) 7-1 iliMES 1J (- \A-
tfolcM' "/T) (I i (.1, .
..)SI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cii C Date: /!- /6 d< Phone #: (503) 718-
CITY, OF TIGARD :; �". -'_: 0
BUILDING DIVISION PERMIT #: ELC2005"00699
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005 •
Phone: (503) 639 -4171 i�1
Inspection Requests (24 Hrs.): (503) 639 -4175 - . E'-
INSPECTION WORKSHEET FOR DATE: 10/2012005 TIME: 7:09AM PAGE: 107
SITE ADDRESS: 13720 SW 115TH AVE CLASS OF WORK:
SUBDIVISION: VIEWMOUNT LOT #: 045 TYPE OF USE:
PROJECT NAME: TAYLOR
DESCRIPTION: A/C, furnace & exterior OH.
OWNER: TAYLOR, DANA PHONE #: 503 - 684 -9205
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503 - 231 -1548
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description ' Confirm # Contact # Message
14\ A/C or heating unit circuit 018755 -01 503.884 -9205 N
Corrections /Comments /Instructions: ' `r \
� tL a0(05---. y r
i ., R \AAA C._1 '--43 2 P. ( \ 0 1■) C IA' Niq PC To \ 5 i
. L }-a0L \--V a Co T'1, y \\\ S.f
,-,, IN k> \N \ )4 C -7- \\M l, Vi.,P(A.
".........1 l
T,,,m.___ ,,,,,,s , ,,_„.,,,, q o 1Y)) t 3 ‘-1 0 ),
1 I PASS (l PARTIAL APPROVAL F CANCEL I I NO ACCESS
s lli FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
,�
Inspector: �_,..-1, Date:1 e �'
6 Phone #: (503) 718 -
TRANSMISSION VERIFICATION REPORT
TIME : 11/09/2005 09:33
NAME : TIGARD BUILDING DEPT
FAX : 5036243681
TEL .
SER.# : BROD4J479592
DATE,TIME 11/09 09:32
FAX NO. /NAME 5038089108
DURATION 00:00:22
PAGE(S) 01
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CITY OF TIGARD , ' - ....
BUILDING DIVISION PERMIT #: EL C2005-00699
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2006
Phone: (503) 639 -4171 -Sa ve u 8'
Inspection Requests (24 Hrs.): (503) 639 -4175 A� '� .I,
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 107
SITE ADDRESS: 13720 SW 116TH AVE CLASS OF WORK:
SUBDIVISION: VIEIW/MOUNT LOT #: 046 TYPE OF USE:
PROJECT NAME: TAYLOR
DESCRIPTION: A/C, furnace & exterior CFI.
OWNER: TAYLOR, DANA PHONE #: 503. 684 -9205
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503- 231 -1548
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1.(<1 A/C or heating unit circuit 018755 -01 603- 684 -9206 N
Corrections /Comments /Instructions: /� 'e
t(._ X0(05 60 s
1; R t_A r..1- `)_43 A, 12 62 ,4P0(1\ o 1.1 CIAAN(cc, To 15 k i
1, t.- \-A 0 ■-, 0 h't L. C_ tn. y.--/ c ,K 0 i_,
z , 1 5 'Ne \4 b 'RP
21
PASS 1 1 PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Phone , _ #: (503) 718 -