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Permit a/? /Ds 1 G 4 �"�' `��"C�4LECTRICAL PERMIT CIT PERMIT #: ELC2004 -00703 DEVELOPMENT SERVICES DATE ISSUED: 11/3/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104DA - 10600 SITE ADDRESS: 12865 SW BEAGLE CT SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5 BLOCK: LOT : 092 JURISDICTION: TIG Project Description: (2) branch circuits. 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: LYN PARROTT WEBER ELECTRIC INC 12865 SW BEAGLE ST PO BOX 231154 TIGARD, OR 97223 TIGARD, OR 97281 Phone: 503 - 804 -2084 Phone: 503 - 620 -1906 Reg #: LIC 44087 SUP 4028S FEES ELE 34 -442c Description Date Amount Required Inspections [ELPRMT] ELC Permit 11/3/2004 $53.50 [TAX] 8% State Surcharge 11/3/2004 $4.28 Rough -in Elect'I Final 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) 2:.699 or 1 -801 -. % -2344. ss . : y: /1 . / Permit 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 639 -4175 by 7:00pm for an inspection the next business day Electrical P 1 A l cation OR OFFICE USE ONLY a ' City of Tigard Wm 1 ,_ Received - 1 13125 SW Hall Blvd., Ti OR. 97223 Date/By: • --Q mw r+i I Plan Review t.® ; - g Phone: 503.639.4171 Fax: 503.598.196 B . �J 2005 /� r6� h . Date/By• Other Permit: Gt. f' e Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for t Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information r , ;� $ trxf a , . " PI AN RE8''IEWr; �� • .,�� - �'�� `x - Y- �, -.-�'- ': . .. • .z� 6Y.? °�'�s. � : '' ❑ New construction CI Addition/alteration /replacement Please check all that apply: ['Service over 225 amps, comm'l ❑ Hazardous location ❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., .; �_ „°i` =�C.`AT.Ft30R = ®Zs" CONST =RiI,GTION .,:: -` t, r of 1 and 2-family ii V: o -an-amwen �,_:'.`;:'w�" "� .,.> ' mat;. 3 � k' �t• t'.,i,.�:.'.g��;�°a��avr.. �. x.:, u�a... ea.,.-: r, ��. s:. x zsro a,.... r::', �:.:. � � ::.:"�.��ax:c'>s:;_ >�ri€::�,�s:; A..�.k^i Y dwellings 4 or more new residential g ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑Other: ❑Buildin over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons EManufactured structures or . " `t' I!,-4,-,, O ,SITEx I , OR1 4TION� - OCA ' TTON , ,, r : Egress/lighting plan RV park ❑Health -care facility ['Other: Job no.: 1 Job site address: /2865 SW (3e.0 51° l � Submit 2 sets of plans with any of the above. City/State /ZIP: 4 � � n Q 7 22'3 v The above are not applicable to temporary construction service. Suite/bldg. /apt. no J Project nam 1 .. `i I ,T' `'EE' SCHEDULE '.W . Description I Qty. Fee. 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 1 Tax map /parcel no.: Limited energy, residential 75.00 2 3 Limited energy, non- residential 75.00 2 ,`�.;; Tff r4 11)ES(R7PTIONOt WORK �" "� & l Mll`t , Each manufactured or modular i dwelling, service and /or feeder 90.90 2 SIg1n - over For perm:X * ELC. Zoo' - oc0703 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ti : ' - :' . ;. H1:41 a: t :, , acres N w: t = ;•. . r . x x 201 amps to 400 amps 106.85 2 z i P R O „ _ RT Y OW R,i iit,,I ik ( , t Vi. t TE1V °AkV,,,,t ii5 ,. tWi . 401 amps to 600 amps 160.60 2 Name: �. CA "01 (9 601 amps to 1,000 amps 240.60 2 Address: 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: ( ) I Fax: ( ) relocation 00 ams 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 3 1 . + x� r -t' ,it A. Fee for branch circuits with n,1 ,APP)IGANT >. _e ®CONTAGPERSO 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 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- energy panel, alteration, or r - .� { extension, Describe: Page 2 2 Business name: 1�le� ELeci / G 43 . Each additional inspection over allowable in any of the above Address: p ©2 ,. 3/ A--4 Per inspection 62.50 City /State /ZIP: 15 car A j , t o 9 72S/-/i5-4 Investigation per hour (1 hr nun) 62.50 t/ � Industrial plant per hour 73.75 Phone: ( 503 ,620^ /506 Fax: ( 505 620 62 I ? i : x �, Y. it *:, r_ � 'a °,�..a;n, mi . iELECTR7CAL PERM -v " T B .1l $ 7 I Electrical•. ic.:31 _ 9g 2 6+ Suprv. Lic.: 410 Z8 S Subtotal Suprv. ElecQiar si nature, required. O l d Plan review (25% of permit fee) Print name: "n /Aj h . Date: 5 State surcharge (8% of permit fee) Z ^ T � TOTAL PERMIT FEE Authorized signature: 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 * Number of inspections per pemvt allowed. i:\Building\Permits\ELC- PermitApp.doc 12/03 440- 46I5T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information Pf LIMITED ENERGY PERMIT FEES: RESIDENTTALWORKCQNLY� :.. n . Fee for all residential systems combined ... $75.00 Check Type of Work Involved: • ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ t Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: F , ® : l .J7, #0780WORKk® VLY 1,11 . . . Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls • ❑ Outdoor Landscape Lighting* ' ❑ Protective Signaling • t, ❑ Other ' ~ Total number of commercial systems: . *No licenses are required. Licenses are required for all other installations is\ Building \Permits\ELC- PermitApp.doc 04/03 • C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00703 4 11 DE VELOPMENT SERVICES DATE ISSUED: 11/3/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104DA 10600 SITE ADDRESS: 12865 SW BEAGLE CT SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5 • BLOCK: LOT : 092 JURISDICTION: TIG Project Description: (2) branch circuits. 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: LYN PARROTT OWNER 12865 SW BEAGLE ST TIGARD, OR 97223 Phone: 503 - 804 - 2084 Phone: Reg #: • FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 11/3/2004 $53.50 [TAX] 8% State Surcharge 11/3/2004 $4.28 Rough -in Elect'I Final 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 a - t rth -in OAR 952 - 001 -0010 'rough OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 99 or 1-800- 332 -2344 Iss d By: , I L' �-0,7 Permit Signatur �/ Q OW R INSTALLATION ONLY The installation is being made on propertown ,/ w, is not intended for sale, lease, or rent. l/ OWNER'S SIGNATURE: . f // /J DATE: `/ 0 CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7 :00pm for an inspection the next business day ego ' Z 0 Electrical Permit Application FOR OFFICE USE ON Received Wi Cif of Ti a A Permit o.. PitN 1312 im SW Hall Blvd., Tigard, OR 97223 Date/By( �� ( � ��� � �� g Plan Review Phone: 503.639.4171 Fax: 503.598.1960 1 ,r1 6 1 ,I Date/By: Other Permit: ,Inspection Line: 503.639.4175 � � Date Ready/By: Jn -i ' H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: / U Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction 0, Addition/alteration/replacement Please check'all that apply: ['Service over 225 amps, comm'l ❑Hazardous location ❑ Demolition El Other: ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories OFeeders, 400 amps or more El Multi family ❑ Master builder ❑ Other: ['Occupant load over 99 persons DManufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park Job no.: Job site address: 17 �5 Stu ❑Health - care facility ❑Other: 1— / . Submit 2 sets of plans with any of the above. City/State /ZIP: - -i i` \ 1 „ De Q' 7 ' T The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: ' � Project name: FEE* SCHEDULE I eI #y / � Description Qty. Fee. Total , Cross street/directions to job site: , " `� "1 / t C , r I (' u p I New residential single - or multi- family dwelling unit. V I ( � ' Includes attached garage. / 1,000 sq. ft. or less 145.15 4 Subdivision: C A A t, l I _ F 1 I p 0 J/ / Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 • Tax map /parcel no.: VV �/v/ Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 • DESCRIPTION OF WORK Each manufactured or modular 2. 2 1 � . tv (,��,( �iS ( O `}�,. ( a 1 O J 't•V(� 0 dwelling, service and/or feeder 90.90 2 U (_ / 1 Services or feeders installation, alteration, and /or relocation �% I i s 0 O w r nl I c to s -„-s I ( . 200 amps or less 80.30 2 '©— PROPERTY OWNER fj� El TENANT 201 amps to 400 amps 106.85 2 I � 401 amps to 600 amps 160.60 2 Name: l .-� ' � �� r 601 amps to 1,000 amps 240.60 2 Address: I `�' c ( - ems I, a- Over 1,000 amps or volts 454.65 2 ` � n a r 3 Reconnect y services 66.85 2 City/State /ZIP: ��••� �'�� � �i f____ Temorar services or feeders installation, alteration, and /or ( JL G� � (50 _ 7 200 ame n Phone: 1 F ax: t el 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, ore ange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 . 2 Owner signature: t Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT El CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: s "l branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, • Address: . each branch circuit ` 46.85 2 Each add'l branch circuit i 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal 75, Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) 4 7,2:3 V TOTAL PERMIT FEE 5-7- l7 Authorized signature: 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 ** Number of inspections per permit allowed. t: Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ., Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* Vacuum h Syste I ms* sl Other: rte` l 2 WG- - ∎ 1 (3Lt- X`-u-✓ � Q. k - tul o 3 - 1Z. A4- 0Je r C COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls Li Clock Systems ❑ Data Telecommunication Installation (l Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses'are required for all other installations i:\Building\Permits\ELC- PermitApp.doc 04/03