Permit • CITY Y OI TIGARD ELECTRICAL PERMIT
(� K PERMIT #: ELC2005 -00298
DEVELOPMENT SERVICES DATE ISSUED: 5/3/2005
X 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL:
2S111 CB -01306
SITE ADDRESS: 10410 SW DEL MONTE DR ZONING: R -3.5
SUBDIVISION: DEL MONTE SUBDIVISION NO.2 LOT : 013 JURISDICTION: TIG
Project Description: (1) branch circuit.
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: 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:
BISBEE, ROBERT L /BARBARA A GRF ELECTRIC
10410 SW DEL MONTE DRIVE 15460 SE PARADISE LN ,
TIGARD, OR 97223 MULINO, OR 97042
Phone: Phone: 503 - 829 - 4146
FEES Reg #: LTC 76751
Description Date Amount SUP 1655S
ELE 3 -484C
[ELPRMT] ELC Permit 5/3/2005 $46.85
[TAX] 8% State Surcharge 5/3/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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: ' T Permittee Signature: ,5,12.7e...,
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.
May,. 02 05 03:25p GRF Electric 5038295747 p -1
i. ' � �' ' FOR OFFICE USE ONLY
Electrical Permit Ap Ii 'ern Reeeived O Electrical p
Date/By, j ..f U. 4 Permit No.: O'd�gD
Cl of , Tl and Planning Approval Sign
\ �J t� Date/B Permit NO.:
"" 13125''SW Hall Blvd. p A 2. 2005 Plan Review Other
®
Tigard, Oregon 97223 tlkI Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598- 9 • 1 �� p�a9 Post - Review Land Use
y •o t i' II Contact Juris.: Case No.:
Internet: www.ci.tigard.or.us cV S ` eV I I .:
„�,� p�V� � E ! See Page 2 for
24 -hour Inspection Request: 5( vutJ 5 Name/Method: 1"/ V ' Supplemental Information.
,'h :: '>:''' .: l ..r "';TYPEiQ WORK` i-` , ., ,. : PLANREVIEW (Please check alf tliat iPPly) 4 ' • . - '
Ii New construction • Demolition 0 Service over 225 amps- ' ❑ Health -care facility
commercial ❑ Hazardous location
• ddition/alteration/re • lacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
r ° ''i' 1 ' :' •i °sill•; : ' ;i1tY' Lt $ RY'::� F CONSTR CTION I & 2 family dwellings four or more residential units in
111t 1 -7 2 -Famll = : • Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
r � • ACCeSSO Buildin: Multi -Famil ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
1111 Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
Migigt7Z SIBS', _ .IN p ' • TIONaadsLOCATION' .: ' . ' Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: 0 0 S • a > v 1 _ _ I . ,''''' - , - FEE! SCHEDULE', • = ""
Suite #: Bld_. /A•t. #: Number of inspections per permit allowed
Pro'ect Name: AnMgEIIIIIIIIIIIIIMIIIIIIIIII Scscriation _ 1 Qty Fee (ca.) Total
Cross street/Directions to job site: New residential-single ginclude attached t a c ed f ga r a yper j
,j dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft or portion thereof 33.40 l
Limited energy, residential 75.00 2
Subdivision:
Lot #: Limited energy, non residential 75.00 2
Tax ma • / • arcel #: • Each manufactured home or modular dwelling
, `6a 0, `i. 1 ,. • -, i „ : ._... ,,,,. .. , ,;, service and/or feeder 90.90 2
Services or feeders - installation,
alteration or relocation:
� ��� 200 amps or less 80.30 2
!%_� s �� 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
601 amps to 1000 amps 240.60 2
wr . ' O„ P!.;- G d�h Over 1000 amps orvoits 454.65 2
.— Reconnect only 66.85 2
Li- Address: 5 t as " '1C 4 ` i Temporary services or feeders - installation,
EmEEE INNomm alteration, or relocation:
• 200 amps or less 66.85 1
Phone: ei., g Fax: 201 amps to 400 amps 100.30 2
y , ; . 401 to 600 amps 133.75 2
t� '7 „ I tP * '141.--:',:,:1-' i i'
p���{�- wz'! €,t "= '` `- �' . A : Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
Cl /State/Zi • : B. Fee for branch circuits without purchase of .
service or feeder fee, first branch circuit ( 46 85 Lf(f5. —2
Phone: Fax: Each additional branch circuit -4f=. 6.65 .j"°
E -mail: Misc,(Service or feeder not included):
. Each pump or irrigation circle 53.40 2
��++,�..
r. f. • ++'a�' ,.I.:.•� Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
Business Name: e 0 - - * Description:
or extension Page 2 2
_ a Description:
Address: Z / • S
Each additional inspection over the allowable in any of the above:
ES
Per inspection per hour (min, 1 hour) 62.50 ,
Phone: ji . - : - , Fax: 6D3- 3 - H Investigation fee: .
CCB Lic. #: " o ther -
' : :i': ' : : :]Electitie '
s* ',.' ,° ;
Supervising electricians` Subtotal $ 5 c�
Si: • ture r" • uired: `^ \ t ] Plan Review (25% of Permit Fee) Si `. r
m
PrintNae: A , , ,, ,, , State Surcharge (8% of Permit Fee) $ 1
TOTAL PERMIT FEE $
Authorized Notice: This permit application expires if a permit is not obtained withi a
Signature: Date:_ 180 days after it has been accepted as complete. s o, j U
*Fee methodology set.by Tri -County Building Industry Service Board.
(Please print name)
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��UUUU K�U ` DIVISION ^ ELC2005'O0298
~~~~....~"�0�� .~n�.~°.~~"° PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005
Phone: (503)630'4171 a'
Inspection Requests (24 Hrs.): (503) 639-4175
"K�-
INSPECTION WORKSHEET FOR DATE: 5/6/2005 TIME: 7:10AM PAGE: 81
''
SITE ADDRESS: 10410 SW DEL MONTE DR ' CLASS OF WORK:
SUBDIVISION: DEL MONTE SUBDIVISION NO.2 LOT #: 013 TYPE OF USE:
PROJECT NAME: BISBEE
DESCRIPTION: (1) branch circuit.
OWNER: B|SBEE. ROBERT L8BARBARAA. PHONE #:
CONTRACTOR: GRF ELECTRIC PHONE #: 503-829-4146
Inspection Request Scheduled For: Date: 6/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 006243-01 603-567'3220 V ���
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Corrections/Comments/Instructions:
(11": _ _____ , ,
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.
k ASS II PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
pi FAIL B� ' ALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
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Inspector: �� Date: - Phone #: (5O3)718'
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