Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00480
DEVELOPMENT SERVICES DATE ISSUED: 8/28/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103BC - 03300
SITE ADDRESS: 12300 SW ALBERTA AVE ZONING: R - 4.5
SUBDIVISION: CANOGA PARK LOT : 007 JURISDICTION: TIG
Project Description: 3 branch circuits. Furnace and WH.
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: 2 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:
OLIVER, CHARLES A/BETH M SUNSET HEATING & COOLING
12300 SW ALBERTA ST 0607 SE IDAHO
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: 503 - 590 -7095 Contact #: FAX 503 - 234 -0439
PRI 503- 234 -0611
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 8/28/2006 $60.15 LIC 161085
[TAX] 8% State Surcharge 8/28/2006 $4.81 SUP 4638S
Total $64.96 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. / I
Issued By: . 1
Permittee Signature: a et ��,( C j
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.
Aug 25 06 01:3Op
.^ p.2
7
E Permit A ir 4slll e FOR Or1.I('t: t .1. 0 \I.1
Received r. O �O 6 , Permit No. �. • V
_ City of Tigard 5 1-�� Date/3 Ora al
13125 SW Hall Blvd., Tigard, OR 97223 NUc) ' 010 / ,.,r Plan Review Other Permit •
Phone: 503.639.4171 Fax: 503.598.196 QF 10,„-\13 \s , � ! * 1 J t
Inspection Line: 503.639.4175 Ready/By: ® See Page 2 for
igard.o -a+i y y
C \ � O \ N(j Q Notified/Method: � Supplemental Information
Internet www.ct.t tgard.r.us L
7774 .a ,wV*... -. ° •.:.c . n. -:5741 r .^.7 -7 , 7K.i ^.H t iii; F, k . ' .,.47 f` 7 s , x,:gii , L :.1,.
err � + - * ,° -e 7'tR . 8 -. y 4 � . ,r� `. . ;', ° h :sc•L
,... sy' x 'i ;* (: '� s'''...; 5•n •R .-.�, ,, ''' ,''"- .n .'4,,' T ^-taN''
- -` g 4 Please check all that apply:
❑ New construction ® Addition /alteration replacement ❑Service over 225 amps, comm'I ❑Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps- rating DBuildng over 10,000 sq. ft.,
z f rx rr fl rT R: T ,�r 3 r+ t ° ti . 3 �'r y .4 r x i. of I- and 2- family dwellings 4 or more new residential
..P:c:. _:?z::.�igth _';.E 'P..Li �:�.: .
%....:4,,s , *'� *, .1.k ., , + °:'-�,.W. .t, fit;. ,, ::.
❑ units in one structure
System over 600 volts nominal
Q;1- and 2 family dwelling 0 Commercial /industrial D Accessory building ❑Building over three stories ❑Feeders, 400 amps or more
• ❑ Multi family 0 Master builder 0 Other • DOccupant load over 99 persons ❑Manufactured structures or
12t ar r� a''"' k �a1` " YJ •, '.
:i16 + i ', •- �.. x•r. � .
r 4 ff i cri kk' i t RV park
� i : Us t °i , i u t �F .s 8 �•• ,l s �..,, . • - C'' - T.,- ' tE -1: r �l.a . .Sli 11s; :Ru� z ❑Egress/lighting plan
h cam'� e "' ,`. " '" . :t z F s • ^ f ❑Health-care facility DOther:
Job no.: r:_7 i - 7.' f Job site address: 1 .) 7; c . j v , (31 'rL l 4--/;‘,.-- Submit 2 sets of plans with any of the above.
City/State/ZIP: -
ity/State /ZIP: 'f Z , -) The above are not applicable to temporary construction service.
Suite/bldg./apt. no 1 Project name: 6_' { 1\/t .)i' Description ...q j Fee. I Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
x •'," ', % Y
'' , I.N . . S' n r'. ;.?.:, :;,!';', r . ' t'..,.".i „:.4, M . try , ;" ,,, ., '),edi"' hit :cs.7�.�.i •,�£A . :` ` > h ti 1 Each manufactured or modular
t .1 r ... ,� . «� .. �v dwelling, service and /or feeder 90.90 2
•� r ..
j:C`i 4,71 C t ,e',b 1 ' 1 Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
:1 - Sti
;: 201 amps to 400 amps 106.85 2
7474-"s7 1 � w -t.m ,., s»,, . ws -a+ao :Iola". +3 "��:a{ ;&„�r�. '` ;t., 5 °. `"�,' 's ,, '' r-'' ?� w <s x �'� -IL . t :. x a Rs� 4-'"` a 160.60 2
�� .^�. :1'. ����' 401 amps to 600 amps
'Name: t 1' d . 1 • • . 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: ,: ;1 ti, u s =; 1�f- R'1`r_ Reconnect only 66.85 2
City/State /ZIP: --1 ,',( (1" ,? ?, Temporary services or feeders installation, alteration, and /or
., relocation
Phone: (S, .� ) `�; [- �j. - ��•; e-...., I Fax: ( ) 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 1 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: Date: Branch circuits- new, alteration, or extension, per panel
` ",•. . 9 . ..: 11 < r ' _ , , :"=4 ' °-;0' A. Fee for branch circuits with �.� .., •.., r
" Y12 ' nfp,a s =e 4 f. a.s..
.. . , ,, : ` ., M ` •kt. ,. " ; at r s d Q:aa'... , P PF a service or feeder fee, each
6.65 S 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 'l 46.85 Li ,5" 2
Address: Each add'I branch circuit : .yt 6.65 I'•> 5. _ 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 -
ia � li: s �, y 04 t r:�Y .r � '�, `s � , � ci x 7 1 a. r energy panel, alteration, or
extension. Describe: Page 2 2
n , `�i,
Business name: Sunset Heating and Cooling
Each additional inspection over allowable in any of the above
Address: 0607 SE Idaho Per inspection 62.50
City/State/ZIP: Portland, OR 97239 Investigation per hour (I hr min) 62.50
Phone: (503) 234 Fax: (503) 234-0439 Industrial plant per hour �� 73.75
CCB Lie.: 161085 I Electrical Lie.: C117 Suprv. Lie.: 4638S Subtotal Lit..) . 1
Suprv. Electrician signature, required: Plan review (25% of permit fee)
:
l ,, 1 State surcharge (8% of permit fee) 44 Print name: ESS J Date: `e ∎ , . Y; i - TOTAL PERMIT FEE / . Li G :,
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 45 1 l t . j j b i 6%.... Date: 2'12.S (t„:e • F. methodology o per f by . untallowed. ng Indust Service Board
• • N umber o i ns
ilBuilding \Permits2ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM/WEB
CITY OF TIGARD . -
1 BUILDING DIVISION PERMIT #: ELC2006-00,180
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/28/2006
Phone: (503) 639 -4171 44 4411\
Inspection Requests (24 Hrs.): (503) 639 -4175 11.
INSPECTION WORKSHEET FOR DATE: 9/20/2006 TIME: 7 PAGE: 64
SITE ADDRESS: 12300 SW ALBERTA AVE CLASS OF WORK:
SUBDIVISION: CANOGA PARK LOT #: Q07 TYPE OF USE:
PROJECT NAME: OLIVER
DESCRIPTION: 3 branch circuits. Furnace and WH.
OWNER: OLIVER, CHARLES A/BETH M, PHONE #: 503.59(17095
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503 -23.4 -0611
Inspection Request Scheduled For: Date: 9/2012008 Pour Time: ,
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 036630 -01 503-234-0611 N
Corrections/Comments/Instructions:
ilk. OM 11 0 ,i-ixiF-
/ - e___ NIZ_ . AiPip .
AMR'
MIAMI"
ro PASS 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C441P Date: - Z D • d Phone #: (503) 718- 2 -6 y1-1