Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00509
���11 DEVELOPMENT SERVICES DATE ISSUED: 7/18/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1S125DC - 03600
SITE ADDRESS: 07059 SW BARBARA LN ZONING: R -4.5
SUBDIVISION: THE RAZBERRY PATCH LOT : 029 JURISDICTION: TIG
Project Description: A/C and furnace installation.
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: 1 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:
RICHARD TURNER HILLSBORO ELECTRIC
7059 SW BARBARA LN 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 449 - 6260 Phone: 503 - 439 - 9666
FEES Reg #: ELE 34 -4399C
Description Date Amount LIP 134481
SUP 4941S
[ELPRMT] ELC Permit 7/18/2005 $53.50
[TAX] 8% State Surcharge 7/18/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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: 7,6 5" Permittee Signature: _ 7.4 2 . Q�p c
OWNER INSTALLATION ONLY V
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.
From:HILLSBORO ELECTRIC LLC. 5036013680 07/18/2005 09:43 #113 P.004
Electrical trical Permit A ticat 1 �,E FOR O.�c>r 1IS&()N1N .
City of Tigard ( V R eceived 7 _ /1
Date/Dv: l j v � r✓ Permit No,; /f `` L `r-`.
13125 SW Wall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503,598,1960 JUL 1 8 2130, �,, ' {i t ` DotefB : Other Pexmit:
inspection Line: 503,639.4175 w 1 r?A L Date Ready /fly; Jurie: (� 13 See Page 2 for
I wu.Ci,tis�*ai'd.O[,US + TIGARD Notified /Method: 1 -- / Supplemcntel tnformntion
. , .. T 1 ; 's `�1r R tVIS1 • . PLAN REviEw ,
D New construction la' Addition /alteration/replaccmcnt Please check all that apply:
{] Demolition ❑ Other: DService over 225 amps, comm'I Hazardous location .
❑Service over 320 amps — rating ❑Suildng over 10,000 sq. ft.,
• 'CATEGORY OF CONSTRUCTION of I I. and 2- family dwellings 4 or more new residential
1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building USystem over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
01 Multi - family ❑Master builder ❑Other:
JOB SiTE INFORMATION AND LOCATION Occupant load river 99 persons ❑RVnufacturcd structures or
❑Egress/iighting plan park
Job no.: oh site address: r`�� I ❑Health -care facility ['Other
r '' ✓ a nI . eA .4k k ' Submit 2 sets of plans with any of the above, • . A.
'P The above are not applicable to temporary construction service.
Suite/bldg✓alot, no i •
SC Q U LE ; . i .: I • "• �•• •
D es cr iption Qty. Fee. Total
Cross street/directions to, job site: New residential single- or multl- family dwelling unit.
Includes attached garage
1,000 sq. ft. or less • 145,15 4
Subdivision: Lot n0.: Ea. add'1 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
. DESCRIPTION OF WORK °.� ::: _,,,::::: '.;,`:; . . ,:'. .
• :.:.,...• � Each manu or mo
.� f� 1 dwelling. service and/or feeder __ __ — 90.90 2
Services or feeders installation, alteration, and /or relocation
• • 200 amps or less 80.30 • 2
..PROPERTY OWNER '' :'; : • 4 9 : .,:, :" :: 2 amps to 400 amps 106,85 2
• .... ' TENANT: , , , • r. ,:
4 01 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240,60 2
A ddress: "AAA. i' / A .,, ! • 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
Phone: ( Fax: ( ) relocation
200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 20i 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
;i;; ;.:,. ❑ APPLICANT .,: ... : ❑..CONTACT PERSON" %: ':i„ * : A Fee for w r branch circuits ,ih
'service or feeder fee, each 6,65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, { � {
each branch circuit r 46.85 • D' 2
Address: Each add'! branch circuit 6.55 _ 0 , l 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 circuit(s) or limited-
I..' • ' .. ., :; -..... ;• •!:•• CONTRACTOR :............. •• energy paneL alteration, or
extension. Describe: Page 2 2
Business name:g±11sboro Electric L L C.
Address: 21185 NW Ever. reen PKWY S - Each additional inspection over allowable in any of the above
Per inspection 62,50
City/State/ZIP: Hillsboro, OR . 97124 Investigation per hour (I hr min) 62.50
Fax ( Industrial plant per hour 73.75
Phone: (503) 439 966.6 (503 )601 — 680 _ , • ELECTRICAL, PERMIT FEES' •
ccs L;c. :1 3 4 4 81 Electrical Lic.:3 4— 4 9 9 C 5ttprv. Lic.: 4941 S Subtotal
Suprv. Electrician signature, required: ! . ArAPPill. Plan review (25% of permit fcc) `
Print name: Joey Vitacco / Date: \.3, State surcharge (8':6 of permit fee) ,
TOTAL PERMIT FEE 5 , 1
• Authorized signature: This permit application expires ire permit is net o1,tuined within ISO
dnya afloe it boa becn e eeapted us c9a+plete
Print nume: Date: . Fee methodology act by Tri- County Building Industry Service Board
" Number of inspections per permit allowed.
\ i:\n wilding \Parmns1ELC- 1.ermitApp.dac 1:/03 44it„Ib1STIIII/02/COM/W50
•
t ,
CITY OF TIGARD L,_
BUILDING DIVISION PERMIT #: ELC2005 -00509
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/16/2005
Phone: (503) 639 -4171 /b 11 016iigl iil'l\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/29/2005 TIME: 7 :07AM PAGE: 113
1 /
SITE ADDRESS: 07059 SW BARBARA LN CLASS OF WORK:
SUBDIVISION: THE RAZBERRY PATCH LOT #: Q29 TYPE OF USE:
PROJECT NAME: TURNER
DESCRIPTION: A/C and furnace installation. Job #3300.
OWNER: TURNER, RICHARD PHONE #: 503-449-6260
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439-9666
Inspection Request Scheduled For: Date: 7/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012366-02 503.539 -2953 Y
Corrections /Comments /Instructions: i4 I 19 c)-2,G
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Al uN ii- Pain(t t'IAI< 0Al`'tF
b 1S 3O ketir Tv Se s)
doo F..
j N PASS 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL 2 C' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ S ---- Ins ector , ∎ —� Date: �� Phone #: (503) 718 -
mr-