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Permit • CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00192 DEVELOPMENT SERVICES DATE I SSUED : 4/1/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S133CA 00200 SITE ADDRESS: 11035 SW 135TH AVE ZONING: R -25 SUBDIVISION: MILLARD/VANCHUYVER TRACT LOT : 032 JURISDICTION: TIG Project Description: Alteration of existing 120 volt service. Job #TG1002. 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: 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: SHRADER, DALE G TRUSTEE DRYER ELECTRIC INC 310 3RD AVE NE #122 9409 NE COLFAX ST ISSAQUAH, WA 98027 PORTLAND, OR 97220 Phone: Phone: 503 - 771 -5667 FEES Reg #: ELE 26 -1142C Description Date Amount LIC 153466 SUP 28765 [ELPRMT] ELC Permit 4/1/2005 $80.30 [TAX] 8% State Surcharge 4/1/2005 $6.42 REQUIRED ITEMS AND REPORTS Total $86.72 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: �r 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. 03 - 30 -2005 14:06 FROM- T -933 P.043/043 F -594 uL /ui /Guuu lu.14 t'tata ..v..� ...... Electrical Permit Application MICE USE ONLY City of T igard �,�e eL - _ --9 L Permit No -: C os - a6 I "! 13123 SW 14s 1 BSvd., Tigard, QR 97223 Phil Review Phone: 503.6: 9.4171 Fax: 503.598.1960 %yea � p ; Other Permit: Inspection Lute: 503.639.4175 =? _ L • Ante RcadyBy: Sce Ya;ejl for \_-/ Internet: wwa'.ci.tigard,or.us Notif/M edetbod. Eil Sec information ,� r - T? r Z ' 1 . i2 I , l �. . ^ ' [ _, r ,t�.� J �' I Y�7 V f' i . d . ` i•?, , , �c,y .-, :: :..........7 _ - II t i I r . j1 , I.. 1 • 7,, ,, ,',7,7, ,.1 �k� 4 cr , e 1. 1 • t 1 %-MO J , 1 ! - !; I i : t . •.. r �G.10 1. ' h� •. i2w .. ' ..I 11.....�;:�..�._.. _.- i1..�_...:� 'd _,. II,,:._.a�_,...._...: ... � _., .: . .� . :iu:._ :._.s . Il. . . , ...bl:.'S.,S; .. c�... : iAD'd:h ts. Hu�itl kll:.4f - ,.. . ' ❑ New coils traction ❑ Addition /alteratiotlrcplaccrnent Please checic Ell th.: apply: ❑ Detnolittc n ❑ Other: ❑Sery a over 225 amps, cotnm'i ©Hazardous. location i N., ..�., _ ;_ ..1c. � - _ `• n +`� '_: '_ • ,1r _wl : .",� }y, q��-ry . L . � , _ , « . .- i ❑Service over 320 amps - rating ❑Btlildng o 10,000 sq. ft,, t r r L t t ' r �} 7 Wit; i,, ' J 7 tfiu& 1w� i�1� i lFti J7i ?I'.IH>� of I- and 2•farnily dwellings 4 or more ;newreside'ntial • ❑ 1- and 2 -i amity dwelling [f Commercial /industrial W 0 Accessory building ' ❑ item over 600 volts nominal units in one structure ❑Building over trace stories [Weeders, 4P0 amps or rwrc I it Multi •farx fly ❑ Master bWtlder [] Other ❑Occupsnt load Vt.= 99 persons . ❑Manufac:tired structures or J ,� •r r M .i1 t .., I . - ri •-� iii I:5 c 1 . , L 1 . . r , ' 1 ``J i ll 1 r :1. � e� ], 1.1 r �1 t 1 lC h t . ,i- - - ❑EgressAlha gnyPi= RV. pec i L� a t . ... ter ir '• I 412 ,_ , p1 t : �: y ,1 , 1 _:_, 1 I l 0 Job no.: Job site •dress a _• r ['Health -can facility ❑Oilier: _ _.. Submit 2 sets ofx l;uJ3 with any of the above. i °(( ' City /State /ZY tip , .Wil d ), The above are nor,rlplicable to temporary cons. - :< ";� ,,, ction service. 7: -fi;u t_ . i , , - ;i.- - :� Suite/bldg./alit. no.: P *jectname: -''i Ir :rl :l, , ; ir .. ., ' 's,t/1. : :1_ t ! " -..�,� /c Aoieciption Qty- riot. Cross street irections to job site: New residential single- or multifamily dwcU unit. iui(, uni Includes attached garage. 1,000 sq, ft. or lass - 1454 i 4 Subdivision: Lot no.: E.EL add'l 500 ;1.q ft. or portion 33.40 • 1 - -• Limited energy, residential 75.00 2 i Tax map /part el no.: Limited energy, no 2 75 A' 1 r: "_I' „ i,: 111. ,.i -1_ H� +, 1 . r trllri'..., r r 1. u I " ,: ; • . •; ; I.. ` Eachmnanufacure , 7r modular III . / , ,. � f.- _� I , � t dwelliig, service e and/or feeder 90.90 2 _ Sarvicey or feeders Installation, at ration, ant143 relocation �� `� i 200 amps or less _ ISM 80.30 1s9 2 r ,!or � ^� , t : 7 :;r' ,. = °; 201 104.85! 2 . r i , r 9 . 1�1 ,)il t 1 r . II � '...'..u: _ IrL 1 .U r ar;; r , , � . i .,;? y I -t ., _ _....- -' -_.. .. .. _._..._ _.�._ J.._ 14 L.. , i . . 401 amps to 600 amiss 1 60.601 2 *lama: c cessor601 amps to 1,000 amps - 240.601 t 2 A,ddreSS: Q� \'t 0 Over 1,000 amps or volts Eli 454.651 2 �.__., Reconnect only NM 66.83 2 City/State/ZIP: o\,�,/K__.- 5 W Tempor stlrvicei or feeders installation, alteration, and/or Phane ( ) Fax; ( ) relocation _ - 200 amps or less 66, 5 i Owner installation; This installation is being made on property that I own which is not 201 amps to 400 amps 1 100.301 ' 2 intended fort ale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps so 600 arrt S 133.751 2 Owner signature: Date'. Branch circuits - now, alteration, or extension, { per panel P ... . .: t. ' i ill 1 J t � c i 11 J .1 _ + ^ 1' 1. J . , i to-u'! 7 . ? x {11. . : a[. I, . Y + ^.L'i - ., ` A Fee for branch circuits with '0,1'.?:... ? i <. _ :Ire.,... _ _... ..... ._ . h...,_ _ service or feeder' fee, each 6.65; 2 • Business name: branch circuit --- s-- �-�- -- E. Fee for branch circuits Contact Hain:: without service o:• feeder fee, 46.85! 2 each branch. circuit t i Address: Each add'I branch c :rcuit 6.651 2 City /State/ZL ?: Miscetianeou :t (service or feeder Dot included) ' _ ^ --- Pump or irrigation circle 53.40 � ^ P3.0110: ( ) Fax•:: ( ) 53.40 Sign or outline lighting E-mail �.. Signal cirouit(;t)or rod- . v _ (. 1 r' x 1,7 , : , energy Panel. niteralion, or' r. (4 �1 t r , � L• I _..•... � . 141 71 r- too- ° r �. r ..__ ' extension, Describe: Page 2 Business 11AAte L i i .♦, . - / Each additional inspection over allowable in any of the above Address: 'L�l �i �` ! Ml ea ��� Per ins •ectiar: 1 1 62.50 I City/State/ZI?: / Investigation lea hour (t hr rain) 62.5E L- tduea'ial plaza pet' hour 73.7 I Phone: * _ / - _w 'A .--I 0 , ' f d., ..` i Y11 �1ry IA }iyf it 2):'!1,1 :+]drtltr1ME lak CCB Le.: Electrical laic.: I -- y - 1 Suprv. Lie.: ■ / / � subtotar 1��� Suprv Elects ician sign ■ re, required: / _ - Plan review (21% of permit fee) i -- ' State sitrcharge(8 % ofptwrnitfee) ., y , t _ .. .." name: _ �` j ' \-- � : f , ` /� 1 Date, / ` " l � � s S i� TOTA.T., ERra ' FEE . 4110 Authorized S:. gnature: Thie permit application expttee It a permit is ant ablpine7 vnrth,n I : . • I days ;diet' lthas bon accepted se complete Print name: l D ate: • Foo methodo.ogy a -e by Tai - County Building tndusuy1 Ccrvi;a Board - -• Number of in specriliris per permit allowed. lialtdinaTcrcnits %:- C- PcrmitApp,doc 1.7103 4eo_40.:T rwca/COMIWP9 CITY OF IGARD BUILDING DIVISION PERMIT #: ELC200I-00192 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/2005 Phone: (503) 639 -4171 an yl�l li Inspection Requests (24 Hrs.): (503) 639 -4175 :, W INSPECTION WORKSHEET FOR DATE: 4/8/2005 TIME: 7 :10AM PAGE: 12 SITE ADDRESS: 11035 SW 135TH AVE CLASS OF WORK: SUBDIVISION: MILLARD /VANGHUYVER TRACT LOT #: 032 TYPE OF USE: PROJECT NAME: COMCAST DESCRIPTION: Alteration of existing 120 volt service. Job #TG1002. OWNER: SHRADER, DALE G TRUSTEE, PHONE #: CONTRACTOR: DRYER ELECTRIC INC PHONE #: 503- 771 -5667 Inspection Request Scheduled For: Date: 4/8/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004118 -34 503- 516-3125 N Corrections /Comments /Instructions: ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` Date: 1'2_0 -01 Phone #: (503) 718-