Permit •
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -10072
DEVELOPMENT SERVICES DATE ISSUED: 3/24/2006
° 1 1 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 DD -01500
SITE ADDRESS: 08815 SW AVON CT ZONING: R -4.5
SUBDIVISION: STRATFORD LOT : 043 JURISDICTION: TIG
Project Description: (1) 200 amp service.
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:
MARK MINATO WILSONVILLE ELECTRIC INC
8815 SW AVON CT PO BOX 845
TIGARD, OR 97224 WILSONVILLE, OR 97070
Phone: 503 - 860 -4590 Contact #: PRI 503 - 638 -5353
FEES
Description Date Amount Reg #: ELE 3 -307C
[ELPRMT] ELC Permit 4/5/2006 $80.30 LIC 75752
[TAX] 8% State Surcharge 4/5/2006 $6.42 SUP 3854S
Total $86,72 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.
Issued By: 127,. � Permittee Signature: ri 'C;V2
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.
Mar 24. 06 12:21p Wilsonville Electric 5036388804 p.2
r
Electrical Permit � FOR OFFICE USE ONLY
City of Tigard ft 006 Received
DateB 6 — / y ' "L Permit No �� 14 7 56 7
1 3125 SW Hall Blvd., Tigard, OR. 972 ? t-k. Plan Review
Al one:' 503.639.4171 Fax: 503.598.19 0 R� �ti^ n l D a t e /B y: Other Permit:
Inspect Line: 503.639.4175 \\ 3 --- "• f Date Ready /By: i s v ®See Page 2 for
Internet www.ci.tigard.or.us C \S� 0 \v \S \Q '� Notified/Method: / 0 Supplemental Information
t 6 r,. PLAIN-REVIEW RZ. E
EP 4F ! ' it,OT py '' "ry'c'l � W
❑ New construction 'Addition/alteration /replacement Please check all that apply:
❑ Demolition 1=1 Other: ❑Service over 225 amps, comm'l ❑Hazardous location
r x .,. ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.
:' ,t0'6� ";� i `1 r 1 C�T : ,..,..,-,.:,: ; Y• ' ' , i;; � : ; J; : : i of 1 -and 2- family dwellings 4 or more new residential
p t _1,- and 2- family dwelling rnercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi-family El Master builder ❑ Other: ❑Building over three stories EFeeders, 400 amps or more
L , w „ • _ ❑Occupant load over 99 pet ❑Manufactured structures of
. . JOB r);':]NFiOt2MATIO19','p4, ; M, DEgress/lighting plan RV park
❑Health -care facility ❑Other:
Job no.: Job site address: � 5 S A VG J (, •T Submit 2 sets of plans with any of the above.
T he above are not applicable to temporary construction service.
City/State/ZIP: T : �1 ,� op L�, , 2 ;f Ppy '
� 'iyn Pc Y • ll l 4" g '�!� ��,..,., r:,- �1 :.�n _ .
Suite /bldg. /apt. no.: Project name: ` - . .--:''7 .
�^ Description «'.: . r I Qty. I Fee. J 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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non - residential 75.00 2
• ' .D
r IE PT O, :.,0 t,� K. '' '' :.,
� }� '�,'t;,� %;';'; `r=:•' Each manufactured or modular
,C f arot �! A dwelling, service and /or feeder 90.90 2
v
/ t.) J t_•-.V„ it 1 L-;- 1 L' t721..., Services or feeders installation, alteration, and /or relocation
200 amps or less i 80.30 ; 2
' +,a k; it s "'"' " '
"""t`" ° "' :: ` ,. 201 amps to 400 amps 106,85 2
'PROPIrRTV . .... Ri: ` , l: :' v •,
'; �L�3 . . AT `.:
' "'''� 401 amps to 600 amps 160.60 2
Name: %Yt /3 e Ai i AL P 601 amps to 1,000 amps 240.60 2
Address: I ` , J` � Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
iei Fa ( ) relocation
Phone: (.3-V—) f4- • > ✓ y J 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT ; lFti, COW ,C ' :541 SeW " ; A. Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: • Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuits) or limited-
... ' ... 7 . ..10 . 1'I ?t? G' ip14. : :: ;;i; - :: :'`' »1; `• energy panel, alteration, or
'' extension. Describe: Page 2 2
Business name: It L s C if !2. i iJY , -
Y „! Jam
Address: �� Each additional inspection over allowable in any of the above
' .. . Per inspection 62.50
City/State /ZIP: r /I ' Investigation per hour (I hr min) 62.50
mi l. -•s k -'14 i �r I.... 'I c .• i
Phone: (61, <,,) ♦ 3 ,e � „� 7 ,. J , F. ( l �' . ) - �� _- � " v ' / Industrial plant per hour 73.75
• zit .
CCB Lie.: - Electric. Li 3 i . S rv. L' .: . (—
..5-11 S Subtotal f
Suprv. Electrician signature,. require - / Plan review (25% of permit fee)
( / State surcharge (8% of permitfec) / .5/
Print name: , D e: %� _ /
' 'L i a ' `� /�e TOTAL PERMIT FEE •7 9.... Authorized signature: '
g This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
" Nwnber of inspections per permit allowed.
,•\ OU ,ldincipemi,siCLC- ramatit,,adoe 12/03 440- 4 (iI5T(IO /02 /COM /WER
CITY OF TIGARD
BUILDING DIVISIQN, PERMIT #. 9-0C16 /Dv 7 2.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 !plm ", '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: • PAGE:
SITE ADDRESS: FSfSl5 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #Cs7,13) &30 3
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: — 3 D ° Pour Time:
Code # Inspection Des iption Confirm # Contact # Message
q 1\
IA keg- cev‘e )-°- 4 45- 7 41"
Corrections /Comments Instructions: (:>(I-GL o.�, ma c+..) �`‘' 2
e_o v ► cam �� 's _ 2-
( - , / -lac
12 PASS II 'TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL • L OR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: _
. 11.1w Date: � � Phone #: (503) 718- —`i