Permit A . CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES
PERMIT ISSUED: E 8/2005 00389
DATE ISSUED: 6/8/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103AD -00407
SITE ADDRESS: 10940 SW ERROL ST ZONING: R -4.5
SUBDIVISION: ECHO HEIGHTS LOT : 012 JURISDICTION: TIG
Project Description: Replace service mast and meter base. Job No. J24224
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:
MICHAEL CHAMBERS WEST SIDE ELECTRIC CO INC
10940 SW ERROL ST 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 292 -6309 Phone: 503 - 231 -1548
FEES Reg #: LIC 13306
SUP 4654S
Description Date Amount ELE 26 - 135c
[ELPRMT] ELC Permit 6/8/2005 $80.30
[TAX] 8% State Surcharge 6/8/2005 $6.42 REQUIRED ITEMS AND REPORTS
Total $86.72
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable laws.
All work wi • - 'one .• ordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspen. -d for more than 18.4 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a - set forth in OAR 95240 - 011 hrough OAR 9 2- 001 -0100. You may obtain copies of a: • direct questions • OUNC at
503 -2 ., 6 -6699 1- 800 -332 -2 4.
Issue. By: _ / Q Permittee Si. • - - • _ _ l 1 i (c)—"-
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'NL / DATE:
LICENSE NO: '
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
fl j L.11VIt�11, ,, •
.. Electrical cal remit Ap lica 2005
City of Tigard CI ► Y OF TIGARD Received � � ,, ott rr oFar Iclr use ONLY
13125 SW Hall Blvd_, Tigard, OR 97223 BUILDING DIVISi Dater; ; UP 7/� f(4 1 PcrtnirtJo. �� z»�$�
Phone: 503,639.4171 Fax: 503.598,1960 titt rr.xi i1I ti Plan Review
ti'712.1.• Dato Other Permit
Inspection Line; 503.639,4175
.a<" _ l l Dale Reedy /5y: J 91 Sr peter 2 roe --
interne; www.ci,ti 1`tolifwd/Mot oa:
Cupplementel I rl Inrme tin.,
TYPE OF WORK PLAN .REVIEW
0 New construction Addition /alteration /replacement Please check all that apply:
❑Scrvicc over 225 amps, cootm'I (]I lazardous location
CI Demolition 0 Other:
CATEGORY Oh CONSTRUCTION • ❑Scrvicc over 320 amps - rating ❑Iiuiidng over 10,000 sq_ R,,
of 1- and 2- family dwellings 4 or more new residemiul
I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
• Multi- family ❑ Master builder ❑ Other; ❑uuilding over three stories [Weeders, 400 amps or more
JOB SITE INFORMATION AND LOCATION . ❑Occupant loud over 99 persons ❑Manu('acturet] structures or
0 ligress/lighting plan RV puck
Job na. �l l �,Z Job Site add ❑Health•care facility ❑Other:
_I _ i f$ei�(7 c l r-J 6 ✓,ream I ci, - -
City /State /ZIP; ' — Submit Z sots of plans with tiny or the about.,
, t-� 6 N Tr ' `
C / - l `7 z :2_3_, The above are not applicable to temporary construction service,
Project name; 1.1
/ FEE* SSCHEDULE Suite/bl /apt. no,; I
u k..i l'e / (i/Le�S (f," —fit = jJ _ ota<APtlon I ct(y nen. 1 Tnmt (
n •�
Cro strcct/di to job site: ti`1t „New residential single or multi - family dwelling un;t.
-' - Includes attached garage,
- -. —. _ 1,000 so. Il. or less 145.15 4
Subdivision; t 500 s Ea. add'I 50 ft. or portion -. Lot no.: sq. 33.40 1 p -
Tax reap /parcel no.: Limited energy, residential 75.00 2
-
DRSCRII"II OF WORK - Limited enew, non-residential 75,00 2
Each manufactured or modular
, e ma-t�j f r- 0. dwelling, service and /or feeder _ 90.90
`
1 \ II/ C 4 r C vv C A -6 V C (0; Servic or feeders installation, alteration, and/or relocation 2
200 amps or less 80.30 Jo 2
0 PROPERTY OWNER I CI TENANT - 201 - 401 amps to 600 amps 160.60 z
amps to 400 amps - 106.85 2
Nagle: ! 1 t 1 ( 1 1 X r
AA ' t �•'LG l l he n .n lr t, 601 amps to 1,000 amps 240.60 2
+ Address; Ct Over 1,000 amps or volts 454,.65 —' 2
City /State/ZIP: — Reconnect only 66.85 2
Temporary services or feeders installntton, alteration, and/or
Phone: (; 1 ) 2_C( - C 30ri Fax: ( ) relocation
W
Owner installation: This installation is being made on property that I own which is not 20 amps or less 0. I
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701,
4 amps to 400 amps 100 ,10 2
Owner signature: 401 amps to 600 amps 133.75 2
- Date: _ Branch circuits - new, alteration, or extension, per panel • 0 A]<'PLICANT � ❑ 'COili ACT ' A. Fee 1 'or branch circuits wilt
Business name: -- service or feeder fee, each
_ branch circuit 6:65 2
Contact name: 13. FCC for branch Circuits
without service or feeder fee, 46,85 2
Address: such branch circuit
-
Each add'1 branch circuit _ 6.65 2
City/State/ZIP: r _Miscellaneous (service or Feeder not included)
Phone: ( ) P ax:: ( ) Pump or irrigation circle 53:40 - 2
E-mail; - - Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
Business name: WEST SIDE ELECTRIC CO - ex[cnsion. Describe; Page 2 2
Address: 1834 SE 8 AVE. _ Each additional inspection over Allowable in any of the above
City /State/ZlP: PORTLAND, OR 97214 Per inspection 62.'50
investigation per hour (I la olio) EMI 62.50
Phone: (503) 231_1548 Fax: (503) 736 -0677 Industrial plant per hour 1.111 73.75
CCB Lie.; 13306 Electrical L' 26 -135C • Suprv. Lic.: / L ELECTRICAL. PERMIT FEES*
r - �Q 7 l tiubtotnl
Suprv, Electrician signature, required; i .�/ r �r� -
Y '1
D•P - , Plan review ( 25% of permit fee) J 1 , 7 v
Print name: L am^ , A ( p___ Dat /� State surcharge (8e/. of permit fcc); 6 ,(4 2. W
Authorized signature: TOTAL PE)<tMIT E j7
This permit application expire° it a permit Is not ubtnined within 180
Print name;
Dote; un
days after it has been accepted as complete
-_ • Fee methodology ant by Tri- Coty Building industry Service Board
iaauildev� rermittlEIX- PermItA ' Number OI•inq>ectiuns per pcmlil allowed.
PD du' 12/ti,� 440- 4512T(10/a2/CUM/wp_ti
2'd /../..90- 9EL(EOS) '03 Ot..lzoa13 aP'S zsaM d8Et21 SO LO unr
1 -
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: ELC2005-003B9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .6.02005
Phone: (503) 639-4171 ,,,y tit
Inspection Requests (24 Hrs.): (503) 639-4175 d
1 INSPECTION WORKSHEET FOR DATE: 7/1212006 TIME: 7 : 05 AM PAGE: 30
SITE ADDRESS: 10940 SW ERROL ST CLASS OF WORK:
SUBDIVISION: ECHO HEIGHTS LOT #: 012 TYPE OF USE:
PROJECT NAME: CHAMBERS
DESCRIPTION: Replace service mast and meter base. Job No. J24224
OWNER: CHAMBERS, MICHAEL PHONE #: 503-2916309
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503
Inspection Request Scheduled For: Date: 7/1212006 Pour Time:
-::::.. • Inspection Description Confirm # Contact # Message
199 Electrical final 032975-01 503-231-1548 N
Corrections/Comments/Instructions:
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--- 7\ 4
X PASS n PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Wg 8 L._, -
Date: 1 I 6 Phone #: (503) 718- 24
. _