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Permit A. t. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00089 DEVELOPMENT SERVICES DATE ISSUED: 2/24/03 WP 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 109AA -02000 SITE ADDRESS: 14450 SW 130TH AVE SUBDIVISION: WOODFORD ESTATES ° ZONING: R - BLOCK: A u � J LOT : 008 JURISDICTION: TIG Project Description:8144A C. OE M Chu- ( �� � � � 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: 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: CARY & TRACEY PANGARES OWNER 14450 SW 130TH TIGARD, OR 97224 Phone: 503 - 693 - 3747 Phone: Reg #: FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 2/24/03 $100.25 [TAX] 8% State Tax 2/24/03 $8.02 Rough -in Elect'I Service Total $108.27 Elect'I Final 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. Th.se 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 (5I. S� : -6699 or 1- 800 - 332 -2344. / Issued By: 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:U DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application Received FOR OFFICE USE ONLY , 9, ,4 Electrical r e1 DateBy: -- i)3 —03 ' • Permit No.: LZ0 �D 0 $ 9 City Of Tigard Planning Approval Sign Y b Date/By: Permit No.: 13125 SW Hall Blvd. • Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Awadl Post - Review Land Use +' it\ Contact Case No.: Internet: www.ci.tigard.or.us a (� 11 01� Contact Juris.: ® See Page 2 for `^ 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information. ` ^�.' �.�,2F�. i—w. ,ems' ,�.. ,^, .. `e`=. ::;: �`�� ".€�:�t.�*,.,: ,� ', ; �"`,� °. :. .,.�. fir' - � - " °�;:-^ �' ; ^s'- srs�°°� „ ,�. , ,.....� , .ta-w _ . a �. .i;. TI'PE�OF WORK,.V,,S0 - �1--.� �;. .M ,L.z °:., PLAN*EVIEW (Please check all;;that ilVijr v �' *: �� =v ❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location ❑ Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet, r ';` CATEGORY OF3CQNSTIVO ION ' ' a MV 1 & 2 family dwellings four or more residential units in ❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more ❑ Accessory Building ❑ Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: El gr ss g n plan ❑ Other: E e /li hti g p r ” ,rt := i= J„ O.B INFO ION,a dLOCATION „'� �' " RMAT " ` Submit sets of plans with any of the above. _;: The above are not applicable to temporary construction service. Job site address: 1 ( l) 1 0i" Au'e . Titer- I 62 , z .s0 "."t" , l$ fi FEE *rSCI3EDULE "'" 3's'. = • t Suite #: Bldg. /Apt. #: Number of inspections per permit allowed Project Name: Description Qty Fee (ea.) Total Cross street/Directions to job site: New residential - single or multi - family per i dwelling unit. Includes attached garage. Z m c . — Q.4,„X- ay. G „.p- t .Q4* on Service included: t 1000 sq. ft. or less 145.15 4 l tJ� e6j , V+k OWE ( 301'" • Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: J Lot #: Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling x, _ g . ,,,:,"'; ice 90.90 2 P W®RIC r'" ::;� °. Services sery or and/or feeders feeder - installation, alteration or relocation: 200 amps or less C80.30 40 2 201 amps to 400 amps f06 785 2 401 amps to 600 amps 160.60 2 itig1PR:OPERIV O WN ER " 4q0111 It. TENT w ; ,. " , - 601 amps to 1000 amps 240.60 2 � x .teems.. .e., Over 1000 amps or volts 454.65 2 Name: Cat L .-k -- ic cu n,� a tie S Reconnect only 66.85 2 Address: I L{ q SO Su/ t No • Temporary services or feeders - installation, City /State /Zip: ` • 9 pt 0e . q, N alteration, or relocation: 200 amps or less 66.85 1 Phone:_s03 > c -3 Fax: 201 amps to 400 amps 100.30 2 . T ,, 401 to 600 amps 133.75 2 u ` ' APPLCANT . �„„I N� €, CONrget ERSON ; ; " . x Branch circuits - new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of 3 (� �� Address: service or feeder fee, each branch circuit 6.65. 2 City /State /Zip: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit 46.85 2 Phone: Fax: Each additional branch circuit 6.65 2 E -mail: Misc.(Service or feeder not included): ,; , ;; s . -„ E , = .; c Each pump or irrigation circle 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, Business Name: no EX_ Descri ti n r extension Page 2 2 Description: Address: L M C5,,,) ern' Nf. • City /State /Zip: — p O i- . a, '\ Each additional inspection over the allowable in any of the above: Per inspecction on per hour our (min. 1 hour) 62.50 Phone: Fax: Investigation fee: Other: CCB Lic. #: Lic. #: „� •. N � 3v - _ii,� ., ;, �A �El ectrtcal`P�ermttlFe es *. a �e. t'��"r�a,�s�. AAA Supervising electrician Subtotal $ /00 • 25. signature required: Plan Review (25% of Permit Fee) $ Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ 1 .0 TOTAL PERMIT FEE $ /d V .02 Authorized • Notice: This permit application expires if a permit is not obtained within Signature: & ' •_., . gm , ti Date:o7 8°' 180 days after it has been accepted as complete. *Fee methodology set.by Tri- County Building Industry Service Board. `Facr,t L _ illflad.feS (Please prif t name) is \Dsts\Permit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: El Audio and Stereo Systems n Burglar Alarm Garage Door Opener n Heating, Ventilation and Air Conditioning System n Vacuum Systems Other COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: E Audio and Stereo Systems n . Boiler Controls • F Clock Systems F - 7 Data Telecommunication Installation n Fire Alarm Installation n FIVAC n Instrumentation E Intercom and Paging Systems n Landscape Irrigation Control n Medical ri Nurse Calls 1 - 7 Outdoor Landscape Lighting ri Protective Signaling n Other • • Number of Systems * No• licenses are required. Licenses are required for all other installations i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03 CITY OF TI!GARD 24 -Hour . BUILDING 0 Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested .3- / a AM PM ' BUP c 1 Location / ( 4(5) /3 D Suite MEC � � ' Contact Person j)� -1�fi1 � Ph ( ) 7 7 ' - • PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 3 Ada ' Y7 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation ,� .r .9 ► ' ♦ f Drywall Nailing ► �tr�� i �I !1 I� i4 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In • 417 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 ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm is SS PART FAIL E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE El Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA --1? " Approach /Sidewalk Date Q p 3. Ins ector7a-- < <A Ext Other: / d Final DO NOT REMOVE this inspection recd from th job site. PASS PART FAIL /)