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Permit CITY TIGARD ELECTRICAL PERMIT s PERMIT #: ELC2005 - 00224 DEVELOPMENT SERVICES DATE ISSUED: 4/1/2005 r�l♦ I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133CD-03000 SITE ADDRESS: 13665 SW ASHBURY LN ZONING: R - • SUBDIVISION: COTSWALD MEADOWS LOT : 028 JURISDICTION: TIG Project Description: Alteration of existing 120 volt service. Job # TGO9C2. 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: HAMILTON, JOHN B DRYER ELECTRIC INC 13655 SW ASHBURY LN 9409 NE COLFAX ST TIGARD, OR 97223 PORTLAND, OR 97220 Phone: Phone: 503 - 771 - 5667 FEES Reg #: ELE 26 -I 142C Description Date Amount L1C 153466 SUP 2876S [ELPRMT] ELC Permit 4/1/2005 $80.30 [TAX] S% State Surcharge 4/1/2005 $6.42 REQUIRED ITEMS AND REPORTS Total $86 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: �7 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 14:02 FROM- T -933 P.039/043 F -594 u /O1 /2005 15:12 FAX 5O 59b1Utiu '.111 or J.,_uz 1'► Elec &mkt Application vp,d11 a E ilsF. r.o.:11.1' City of Tigird : eceived • l N o . : 2 ` 225 SW Hull Blvd, I igard, CM 97223 plan Review Odisr Petaut � � l cr_ ane: 503.6:9 - Fax: 503.596.1960 /' , " ' Ir '� . 'c DLtJ : N .�rspection Lino; .503.639.4175 rr I . AAte Readylay: RI 5cc Pa for 'aitCrnet ww�+':C'1 rig rd•Or.us No[ir.ed/Mathed: --"• 1 1 Supptculent Information .... 7 ., . s ; r .. .,, s'w-,,, 1.•r j'FT Y� 1 ' I , l �ti°i t - 4,,F ;l • IYf ' r1 s . : ..a ` , .7 1 . �•` t2. ; 't 4i..�... :1.._ :_. I J � .. �; - ��l_.SL�L' :.IYIk}l' •. 7 New CO 1 128 teu0tion (] Additio. alteration/replacoment Please check all iha apply: D Dcmolititn 0 Other: v : _ s ©Buildng o /er 10,000 sq. f!. • °Serviceo c 2 srtlpa conun'1 t I 71 - 7 r , -, ,,c' e t , ; .. ❑Service ovec 32" amps rein I a` ,: i , 1 % i r,: :.I t �i w 11 .. n i � f .1",!= G fil or i - ar,d 2• fat :aly swellings 4 or rrore 'new residential 1- and 2.1iar ily dwelling r Comxuercial /industrial Q Accessory building ElSystcm aver 600 volts nominal units in Ole Struct= lvlulti- fatx,il ❑ Muster bgilder o - tacos . ci Stnlcttlr S cr �Buildi fig of cr tt on stories Feeders, 4i)C amps or _ ore i - d Qtltior r �- : :;.�; :�;•- ., :-- �;•��, sn,e p anu . •,I „ , 1 ❑Egre ss/ligh�!att' ,p sr7 9 9. RV. pa 1�r G [� acn {re' - lG lob no.: Job site : + dress: ► , Ql$CIIlt13-cart factl;t;• []Oche:' I �.__ , , .. N Submit 2 set: ofpl'un with any of the above. : /State /21': 1 y Th: above are not a,plicable to temporary cons. ctior. service. :,:ii r . �� �� .il I t_1 . II . A!i;f ��.5s 1"-.1.•--:'. .E. . � I.1 eis,':i ":I :r..' . :. : te/bldg. /alt. ' . no.: 1' • j pct name: poacript[on d QIy 8;o, I z h Total .loss street/eire ctiorrs to job site: 1 Ycw residential singfi�. or multi-family dw wait r �� _ Includes attached l;a age. - 1,000 oq, ft or i 145.15 4 ubdivision — I Lot no.: Ea. add'l 500 ;:y. S. or portion 33.4ci • I l - -, Limited energ;r, tcsidc;llial 75.Q _ 2 4 1 ax map/parcel eon.: rl Limited enerr/, non residential 75.00 I .ek I ,,, 1 -- y : — : 41.0 Eachmanufac'a:red .)8 modular 40 y r� ,�,wr ' , � , j _ � Serv , ces O r ado err ir'ar feeder 90i 2 / / Se fel:TS Installation, alt ratio and s, l�ir reloeuGo • • 2 0o amps or iesa _.__ a. ri 2 .. Y . , it .., .� _ . . .- ! _ K,. , „ 201 amps to 400 axn 1 06.85; 2 401 amps [0 6f)0 amps 160.601 2 `amp: ec /' ,,, ��� 1 _- ^ _� 601 amps to 1,00J Lang 240.6d 2 • Over 1,000 ao p or volts 454.65 NM 2 - (ildxes 1 • .,•. - _. �--- Reconnect only 66.85 2 ity/State/ZE': Temporary sa:rv or feeders Installation, alto erica, and/or hone: - — relocation — Fax: ( -- --- - _"_`1,'1 ( ) 200 amps or l ess 66.85, i )wner in &Cafationr This installation is being made on property that I own which is not 201 amps to 400 asr s t laud •wended for a a1':, lasso, rent, or exchange, according to ORS 441, 449, 670, and 701. 401 �rnFS ,0 6u0 am;�s 1 f 13 IIIIIIIIIg )tee• sigastaril• Date: Branch circuits -now, alteration, or extension, ,per anel ,1 ,,.. ,, s I' I t ^ "' 4. Fee forbraz.sh chCmts with ": ; , ..' _.I .._ service or it :ec or r:ce, each 6.65 2 F.1usioess nano: branch circuit J -,- S. Fee for brar,c circuits .cored name:: without sen ic: a:.Tecdcr fee, 46.85. • 2 1 - '- each brario1. circuit _ _ 3dress: Each a dd'I branch :roan 6.65: 2 •i ty /State/ZL ?_ - - MisceUaneou :: (; :ei'ice or foe let pot included) - ?Wrap ar irrigation cite le 53.40 � 2 ''hone: ( ) I Fax:: ( ) Sign or outlinc:light :n �� 53.40 ? .:_mail• Signal oircuit(:r orFrn1tc :" - 77... - . .‘'7 ' i - , , - . [ r 7 ',I�• energy panel, .tlterra1 or I extension, De:erbe: I Page 2 i 2 i USiDOQ5 11anta: Al i• ,/ 'I t* . r :.ddress: v �grAr t _ o is r, Each additional ir, ptettoa over allowable to arty of the above inspection 1 625C. inspection 1 ity /State(2I ?: ,/_ _ Investigation per Hour (t N n) I i 62.5d i i v 7adu &tCial )sriiper l :u)u: -13 I ' I . non: ) -'�(p Pax! L�r r L� (('� r r :u _.._ 1 : " .,:. : ,. 3 , . - , d }mesa 51 :, ill :=i +,o';;.f : : ::!...a•taR l[t�J :.;. PMr 1 ' - Ll1' IP �i3 Lic.: 1 Electrical T.ic 6 Suprv_ Lic.: Z. Subtotal 6 ' .iprv. Electrician sign re, required I ._ '` rtan review (25% of permit fee) / _ /�` a ,• Stale surcharge (8 /0 o:Fpemut . °ce) a / e - _ • \� :"irtt Dame; Date: I - TOTAL PERMIT FEE 4LOr 1.uthOXiZCd 6: gtlaturn; This permit spplica loo expires Ira permit i9 not obthtne.w[thli _ - - — -- -- doya Bite :. lobos been accepted as complete int name: Date: • Fee orethudategy, s•:. rl• y T: i- County }:uiidillsfxd , suyI Service 3oard — •• Number ofipso :eli:to per permit allowed. .JtdinsV ta:C.tertdrApp,doc 12193 44O-46 isr(ro/o /COI EB , CITY OF TIGARD BUILDING DIVISION PERMIT #: EL_C2005`00224 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/1/2005 Phone: (503) 639 -4171 ia ,, l, �p� �1, Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/8/2005 TIME: 7 :10AM PAGE: 15 SITE ADDRESS: 13665 SW ASHBURY LN CLASS OF WORK: SUBDIVISION: COTSWALD MEADOWS LOT #: 028 TYPE OF USE: PROJECT NAME: COMCAST DESCRIPTION: Alteration of existing 120 volt service. Job #TGO9C2. OWNER: HAMILTON, JOHN B, PHONE #: CONTRACTOR: DRYER ELECTRIC INC PHONE #: 503-771-5667 Inspection Request Scheduled For: Date: 402005 . Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004118 -31 503-516-3125 N Corrections /Comments /Instructions: ■►Il PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: (f — ) , ( – 0 J Phone #: (503) 718-