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Permit . ; CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00706 440 141 t( DEVELOPMENT SERVICES DATE ISSUED: 11/3/2004 �' If 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134CA-00720 SITE ADDRESS: 11460 SW 115TH AVE SUBDIVISION: BURLWOOD NO.4 ZONING: R-4.5 BLOCK: LOT : 018 JURISDICTION: TIG Project Description: (1) branch circuit for new can lights in kitchen. Job No. 82758 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: WHITE, TOBY M + KIMBERLEY M OREGON ELECTRIC CONST /GROUP 11460SW115TH 1010 SE 11TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 244 -2403 Phone: 503 - 535 -2652 Reg #: LIC 203 SUP 4460S FEES ELE 26 -95C Description Date Amount Required Inspections [ELPRMT] ELC Permit 11/3/2004 $46.85 [TAX] 8% State Surcharge 11/3/2004 $3.75 Rough - Elect'I Final Total $50.60 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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) 2466699 0 : II • ' -234 • Issued =y: �� ■ i Permit 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: 7� S Call 639 -4175 by 7:00pm for an inspection the next business day NOV -01 -04 03:44PM FROM - Oregon Electric Estimating 5032313587 T -884 P.001 /002 F -895 Electrl Permit .Application ` . f Received Permit No.; f 7 4. City a Tigard QQ' Dater / i %v ex p 13125 SW Hall Blvd., Tigard, OR 3 1r Q Plan Review Odor Perna: . ;7'e,,, , r ' Date/liy: Phone: o Line: .4171 9 50 0 Q � �P � ,, • NI' "1;2/ ] ° 21 S ee P 2 for �,i _ 1 I Date ReadyBy, Inspection Line: 503.6 .or.uS \ \ � - j No hfied/M cth od ik . l Supplemental Information Internet: www.ci_tigard.or.w -. ( :(-\ rYP OF WORK KLAN REVIEW Please check all that apply: 0 New construction ® Addition /alterarion /replacement (Service over 225 amps, comm'I ['Hazardous location o Demolition ❑ Other: ❑Service over 320 amps - rating [1Bttildng over 10,000 sq. ft., • CAT18COR" OF CO■STRUCTION , . .,.: - :. of 1- and 2- family dwellings 4 or more new residential ❑system over 600 volts nominal units in one structure 1- and 2 family dwelling ❑Commercial /industrial 1=1 Accessory building ❑Building over three stones ❑Feeders, 400 amps or more 0 Multi - family 0 Master builder 0 Other: ❑Occupant load over 99 persons [Manufactured structures or . ' ' . • JOB SITE Tld'FORMATION:. AND' LOCA.2'►ON ['Egress/lighting /lighting plan RV park Other: []Health -care facility Job no.: 82758 1 Job site address: 11460 SW 115th Ave - Submit 2 sets of plans with any of the above. City / State/ZIP: Tigard, OR 97223 _ The above arc not applicable to temporary construction service. FEE* SCHEDULE Project name: Toby White " " Suite/bldg. /apt. no.: � Pro Y Description I Qty. � sere. � Total � . New residential single- or multi- family dwelling unit. Cross srrccVdirections to job site: includes attached garage. 1,000 sq. ft. or less 145.15 4 • 1 Lot no.: 2 a add'1500 sq. A_ or portion 33.40 l Subdivision: Limited energy, residential 75.00 2 Tax map /parcel no.; Limited energy, non - residential 75.00 2 j, DESCRIPTION.. OF WOI . Each manufactured or modular • dwelling, service and/or feeder 90.90. , 2 Install can lights in kitchen Services or feeders installation, alteration, and /or relocation 200 amps or less 80,30 2 I 201 snips to 400 amps 106 -85 2 [L 'PROPERTY OWNER': •1 1 - 401 amps to 600 amps 160.60 2 Name: Toby White _ 601 amps to 1,000 amps 240.60 2 - Over 1,000 amps or volts 454.65 2 Address: same as job site Reconnect only 66.85 2 City /State /ZIP' Temporary Services or feeders installation, alteration, and/or relocation Phone: (503)244-2403 LF ' ( ) , _ 200 amps or less 66.85 1 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 boo craps 133.75 2 Owner signature: ua - alteration, or extension, p nel DatC' Branch circuits new, alteration o per panel . . Q' CONTAtr.:;PERSON• A. Fee for branch circuits with Q AP1!IiICYiNT service or feeder fee, each 2 6.65 Business name: branch circuit ____- B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: . Each sdd'1 branch circuit _ 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53,40 _ 2 Phone: ( ) I Fax: : ( ) Sign or outline f fighting 53,40 2 E -mail: Signal circuits) or limited - •CONTRACUOR • , energy panel, alteration, or extension. Describe: Page 2 2 Business name: Oregon Electric Group y , - Each additional inspection over allowable In any of the above Address: 1010 SE 11th Ave Per inspection 62.50 City /State /ZIP: Portland, OR 97214 investigation per hour (1 hr min) 62.50 Phone (503) 535 -2652 (503 1 231 - 3587 Industrial plant per hour 73.75 (503) ELECTRICAL PERMIT FEES* CCB Lie.: 203 l Electrical • - • a pry. Lie.: 4460S Subtotal /j_ • Suprv. Electrician signature, Plan review (25% of permit fee) �, __ L State surcharge (8% of permit fee) , Print name: �lY/ , Aate� ` TOTAL PERMIT FEE � _ 6 el Authorized signature: ' it This permit application expires if a permit Is not obtained within 180 days after it has been accepted as complete + Date:// / a • Pee methodology setby Tri- County Building industry Service Board Print name: f , C •• Number of inapectio0s per permit allowed. , lauildine,xmluenLC- PcmIttpp.doc 12/03 440 461 3T(10/02/COWW211 CITY OF TIGARD 24 -Hour BUILDING Inspection Line:.(503) 639 -4175 INSPECTION DIVISION • Business Line: (503) 639 -4171 MST BUP Received Date Requgsted • 1 AM PM BUP Location l J'9 � Su) ) ) J Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR 1 BUILDING Tenant/Owner ELC t >1- ' 0 Y? ©h Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam G‘ (— Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL Serve Rough -In UG /Slab Low Voltage anw ire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL S Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date OA Inspector rAr _ EXt Other: Final DO NOT REMOVE this inspection record from the job Re. PASS PART FAIL