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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00611 DEVELOPMENT SERVICES DATE ISSUED: 8/22/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DD -BV023 SITE ADDRESS: 12675 SW DA VINCI LN ZONING: R -7 SUBDIVISION: BELLA VISTA LOT : 023 JURISDICTION: TIG Project Description: (8) 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: 7 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: RIVERSIDE HOMES, INC BEAR ELECTRIC 1925 NW AMBERGLEN PKWY #200 P.O. BOX 389 BEAVERTON, OR 97006 DONALD, OR 97020 Phone: 503 - 645 -0986 Phone: 503 - 678 -1355 FEES Reg #: LIC 20919 ELE 24 -107C Description Date Amount SUP 4902S [ELPRMT] ELC Permit 8/22/2005 $93.40 [TAX] 8% State Surcharge 8/22/2005 $7.47 REQUIRED ITEMS AND REPORTS Total $100.87 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: , , -'27 1 1 - 14 . 6 ... ,6P 4-- 1 ^ _ Permittee Signature: „P 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. 1. Electricai Permit A ED FOR OFFICE USE ONI:X ��^� / ) City of Tigard Dat e - . Permit No -: CU�, // 13125 SW Hall Blvd., Tigard, OR 97223 AUG i u 2005 Plan Review CI OutcrPernut' Phone: 503.639.4171 Fax 503,598 1960 i � " ei \ J7ateB f; i• ' Date Ready/Br, l21 See Page 2 for Inspection Line: 503.639.4175 CITY OF TIGA - =" Notified/Method; Supplemental Jnformat on Internet: www.ci.tigard.ar.us N � , = r. t ^ �' is .�,, ,fl. "iF5* .'P�i'. 4kFtl'• �.1i.` � ;i; IIII '2ij ".C=h�Ipbi.;;th�`nrin , ;p . : �..` 1 , ••s ° +r . • Z qW ,;,r„ '9 s , ' h. -` 1 ; 6, lx , rc �l;ljl=,'� - ;:m a,Ybw .r': '•: •, y ., i ,�r4r:.::e• "41y,' ...... - -' -. �, ry :., ( ��,� I ' � ,Y ,t. ? ,3ae::,.1�r. - d6 „ . , I r� f ,t,.l iM�l � „i.��„ =�' � :I . ,: a.l•C +P. ; +},Iw ;,� _ . �'::... ��•', - i %'«Ir 1 ; ���:' ! ; ill "�'• , r � vi? G � " ;�'��0� '�� ,'13 i -., Id: �:.,: � ;' Di: .,,. •. ..r_ �Y'rtl:,f��', �' ,7. /I'; r.. :t:e: fF �Irt ill � �':JrpiW.`S�h1Y,1.� lIr .J,. �k 7�IS:/t, �p ;J. ,7 -, Please check all that apply- . , . ❑New construction Addition/alteration/replacement ❑Service over 225 amps, comml ❑Hazardous location ❑ Demolition ❑ Other: ❑Service over 320 amps - rating ❑Putldn over 10,000 sq. ft., .�, : .: �' „„ ,., • - ;i r,s v, -,,,. y�. ,,. ;'r,r �t,t!` d;: dwellings a or more new residential ,/�' -:.t ll:� yy.. / `��r�r•�'y1�,vyly� /�y� i V,, ; M {,,�!, 3. , 111: of 1- and 2-family g Ill, ,• .f�h.f , _� .• k .. Y�'� ; • 1'I { - ��'r V �iF+ „ lY,l!"`��:�NC, � � r.�,�„�� ;r4�y ;' „ lu' �H ;.:,1 \'`. ;ill y s �s; 1' M a fti �S n i���y"ifl'�` Ire lk9,� �1 .w., =�.� s .- .„ .r, "_. - ❑System over 600 volts nominal units in one structure [ 1- and 2-family dwelling ❑ Cornlxlerciallindustrial ❑Accessory building ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder 0 Other: ❑occupant load over 99 persons ❑Manufactured structures or n<, : p j .CJ4 1:F r It I J /' d , .'w,r . :. "c 5 F V papark rr.r' ?s;l « g s'� ,L ` f ialc. `i 1 4 g _ ,t:t ( d�1�. ; :; � .hfj ,�.: ;<`.•1 ,( 1- ❑Egress/lighringplan ;, I; , i;''< � �lr ? � 1 a,0It1VA , ? , , o t.. l'IiS:, ; ;a:• ❑ Other• , ,:. „',;� .. '-- � '•,,, ❑>;Iealth -care facility Job no.: Job site address: /26 5r.,› iiiqr5W-/ 1i Submit 2 sets of plans with any of the above - The above are not applicable to temporary construction service. City / State/ZIP: -t, GAi41Q ,1 . . t�C - ' ti::7A`i'; . ;:, { •` +' :` =li,;� t,,SPIXTiYJ) `�'':' i�4i ' . , .- - - 5uite%bldglapt, no.: -• • - • • . Prod cci starve: . 64 f r A d t s 7,0 Acscrtption I Qry Frt. I total J `' Cross street/directions to job site: New residential single - or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less id5.15 4 Lot no.: E a dd'I 500 s ft, or p ortion 33.40 , 1 Subdivision: - Limited energy, residential 75 00 2 Tax map/parcel no.: Limited energy, non - residential 75.00 2 _ •,twa ":w't'itl;sta` nF a, ; v'x -A %d i ,' �,-. ;',n"i;" §:tga,'e`'ib ""�4.: u! e4.�i�i� " I�fi '' Each manufactured or modular t ++ I" ,w:t�i)S'�1! "Ilf� , .r�:1't 7 i 7r R ] fONFlr,4�i, I �C.1 adwfy ;.. 0 dwellin:, service and /or feeder 9 0.90 2 Services or feeders Installation, alteration, and /or relocatio 200 amps or less 80.30 2 - � ro '•r 201 amps to 400 amps 106,$5 ? ''ry• n_, ` "'s , 41, rr. .,E,h` ^'' � f, if ai'�° S �M •MM1 1 5 11 �' i ' N � l' , I l r i ,$f" i ,,, p 2, CV Pi „,P.p . ,, ..7..k ti tIE ! 1rt 4.- Ph.' -''1. ° `'Ili ' . - :.i tiri _Jil s f ldi n l ''l " '� {a. lk; 401 atXaps to 600 amps 160.60 J 601 amps l0 1,000 amps 240,60 2 Name: t 0 . ■ D1" c' 454.65 2 Over 1,000 amps or volts Address: / �- y� 66,85 2 lC,�, j / /[� ,4 Py9A/ i �R 1 `f R onl City /State/ZIP: /WA-Az, 4/47 Temporary services or feeders installation, alteration, and /or 'relocation Phone: (5v.5) G - Fax: ( 3rs3) 490 - .A. 4 °.�' 200 amps or less 66.55 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 ., r s,l Fr' 3 i �'i i " i `' , y x•I` 0 14 r ' ' `tl "0 A, Fee for branch circuits with y�1'� l� f� � /�� ®f�'`. ,., � ` F. �'1��4a� fy ; ".'1:1~�iiii�e�' ��4� ;{��I� .lRre'ii• -.I�„ r �., l.,x�. ,�,:•.i service or f fee, each 6.65 2 �; isu -, ,, Business name: branch circuit _ - B, Fee for branch circuits Contact name: without service or feeder fee, i 46,85 r76 ." 2 each branch circuit Address: _ Each add`l branch circuit — 7 6.65 ,c/4" ,y) 2 City / State/ZIP: Miscellaneous (service or feeder not incLuded) _ Pump or irrigation circle 53.40 2 Phone: ( ) ,Fax: ( ) Sign or outline lighting 5 3.40 2 Signal circuit(s) or limited- E r t a r 'p 3 "' Uf ;; I, energy p anel , alteration, or ;c 1 .. 1;iP yl 'I 4 i4 l ” <> , r, , t ONga r°' s.,m E f �' r'�4�r i ' 4 'ldl ;rs.�tOY',`i.i)��li.lj.r . 2 'r: Ll' :=., ;� jXi4, ',�fdZ "''1 ' .Ft =' I �;w':�.' ;Rr'PL; ©R l„ 1 iti•�'sl4r :ts,.! '� �v,- Y...a:i�'la: -.'� b Page 2 gr4 t W � Y,.i65..7«'.. ,�'� 1iGi,: , .: ), o ri ail =a• �� 'i v; u,' - extension • Descri Business name: l Q e q 4 jr le t e j ��° . E ac h additio inspection over allowable in any of the above - Address: go, > ?Y 3 5. 9' Per inspection 62,50 City /State /ZIP: h / di , �,1 er;(,,,,v b �40 Investigation per hour (1 hr null) 62.50 Industrial plant per hour 73 - 75 Fax: �) `7 f/ ' O t r 't� i y: '• ' ; �fr.11*•�i'Y:tI`r: ='n. Phone: (6 - 0, � ) 6 7g /3 6 ,5 _ ( `rJ - : ;�'..�F ,1 3 i ;1 �, G� RL ` ' / iJ fi 1 CCB Lic.:,,p 97 9 Electrical Li . : 24_ / ,c I Suprv. Lic.:, 'ifb Subtotal 7 qq • / Plan review (25% of permit fee) Suprv, Electrician signature, required: C� State surcharge (8% of hermit fee) 7/4Z Print name: rd _' ' ) . , 5 s Date: g^ s ea _ S TOTAL PERMIT Flip Authorized signature: 4 1. ,,, -01 1/0----9;44-4-----.4 This permit application expires it a permit is not obtain el within 180 days after it has been accepted as co mplete Print name: Date: • Fee methodology set by Tr,- County Building industry Service Board 1 I "+ Number of inspections per permit allowed_ ) 40 .. i \neadt. 0 \12 rrmteo,o- P�itnpp,e0, 17/03 440- 46lSf(Io 021001 f/t'7E r-- — CITY OF ��m w n n�'m TIGARD BUILDING DIVISION pERM|T#: ELC�0�[�611 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/22/2005 Phone: (503) 639 : 40\ Inspection Requests (24 Hrs.): (503) 639-4175 ~ ,.:471 INSPECTION !NGPECT|ONVVORKSHEETFOR DATE: 12/19/2006 TIME: 7:01AK4 PAGE: 25 SITE ADDRESS: 12675 SW DA VINCI LN CLASS OF WORK: SUBDIVISION: BELLA VISTA LOT #: 023 TYPE OF USE: PROJECT NAME: BELLA VISTA DESCRIPTION: (8) branch circuits. OWNER: RIVERSIDE HOMES, /NC.. PHONE #: 503-645-0986 CONTRACTOR: BEAR ELECTRIC PHONE #: 503-678-1355 Inspection Request Scheduled For: Date: 12y15/2086 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 023593-01 60'3-678'1355 N Corrections/Comments/Instructions: 66‘ 6#144144 . n PASS 4 I A P^ r AL APPROVAL El CANCEL III NO ACCESS | | FAIL . CA FOR INSPECTION D ADDITIONAL FEES ASSESSED . ' �^� ��� Inspector: -- ----bate: / (-^� �'qrPhona #: (603) 718- Y OF TIGARD BUILDING DIVISION - PERMIT #: ELC2005 -00611 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/22/2005 Phone: (503) 639 -4171 4,0411111 iii Inspection Requests (24 Hrs.): (503) 639 -4175 'G___- INSPECTION WORKSHEET FOR DATE: 8/2/2006 TIME: 7:07AM PAGE: 41 SITE ADDRESS: 12675 SW DA VINCI LW CLASS OF WORK: SUBDIVISION: BELLA VISTA LOT #: 023 TYPE OF USE: PROJECT NAME: BELLA VISTA DESCRIPTION: (8) branch circuits. OWNER: RIVERSIDE HOMES, INC., PHONE #: 503- 645`8886 CONTRACTOR: BEAR ELECTRIC PHONE #: 503-678-1355 Inspection Request Scheduled For: Date: 9/2/2005 Pour Time: Code # Inspection Description Confirm • Contact # Message 125 Wall cover 0148 -01 503- 678 -1366 V Corrections /Comments /Instructions: S '72�4'?a8 ,,--) _ \-1..:e �t i L Ci C Q68• 7 PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G . N33 V e Date: C I - 2 Phone #: (503) 718- Zy •