Permit „, CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00242
�d��6 DEVELOPMENT SERVICES DATE ISSUED: 4/7/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134AC-02656
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SITE ADDRESS: 4328 SW COTTONWOOD LN ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.3 LOT : 222 JURISDICTION: TIG
Project Description: Wire furnace, heat pump & exterior outlet. ADDRESS # ON RESIDENCE IS 11320 (SEE NOTES)
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: 2 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:
MULLEN, PATRICK M + PATRICIA WEST SIDE ELECTRIC CO INC
6990 SW HEATH PL 1834 SE 8TH AVE
BEAVERTON, OR 97008 PORTLAND, OR 97214
Phone: Phone: 503 - 231 - 1548
FEES Reg #: LIC 13306
Description Date Amount SUP 4654S
ELE 26 -13-13
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[TAX] 8% State Surcharge 4/7/2005 $4.81
[ELPRMT] ELC Permit 4/7/2005 $60.15 REQUIRED ITEMS AND REPORTS
Total $64.96
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: Permittee Signature: 1'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'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.
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• Ele�ctfical Permit Application FOR OFFICE USE ONLY
City of Tigard • R E C E V E 0A Dato/ vea `� _ 7 G �� � v l �- G� GZ) U9a��
Ds ceive Pero t Na
13125 SW .Hall Blvd., Tigard, OR 97221
Phone: 503.639.4171 Fax: 503.598.1960 /,,.t; Flan Review
n � 14' t� �__ . Y: Other Permit:
Inspection Line: 503.639.4175 , ', , ii-\R 2 9 2005,44- T'��, Date ReadyBy: Adis: Vf Sec Page 2 for
Internet: www.ci.tigard.or.us Notificd/Mtdrod: SupptemeThd I n (ormativn
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TYPr 1„4.,,,,, tj l
PLAN REVIEW
❑ New construction V Ad. itto alterahon/replaccmcnt Please check all that apply:
El Demolition ❑ Other:
r � ❑Service over 225 amps, comrn'l ❑Hazardous location
l over 320 amps - rating ❑ttuildng over 10,000 sq. 0.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
C6-1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
ID (vlulti ❑ Master builder Other; ❑Building over three stories ❑Feeders, 400 amps or more
YOB SITE INFORMATION ANI) • LOCATION ❑Occupant laud over 99 persons ❑Man ark t structures or
❑Egress/lighting plan park
^ j OHcalth -care facility ❑Other:
Job no.:3 2. 3 /S ? Job Site address: t 32 5(J C0 ( �,..,.,i .� L N —
Submit 2 sets of plans with any of the above.
City / State/ZIP: k (� ,_ ("1 l 2 Z Tbc above are not applicable to temporary construction service,
F EE* SCHEDULE
Suite/bldg. /apt. no.: t n Project name: / 4 l P 7( . . - c am lam- •,
L „� 7 n o una Qt
I Rue. I Toi.t I
Cross street /directions to job site: New residential single- or multi- family dwelling unit.
includes attached garage.
�„ _ ,•,� I ,000 sq. ft. or less 1.45,15 4
Subdivision: Lot no.: _ Ea. add'i 500 sq. 11, or portion 33.40 1
• Limited energy, residential 75.00 2
Tax map/parcel no.: --
-._. Limited energy, non - residential _ 75.00 2
DESCRIPTION OF WORK �� Each manufactured or modular
r 1 dwelling servic and /or feede 90.90 2
✓ ! d� "t wt 4 . _ �'! '� X _, Services or feeders installation, alteration, and/or relocation
, K .s i - � ; ._r- 1/47 `A ( t 1 T ^ T 200 amps o
❑ 7' r less 80.30 2
PROPERTY OWNER TENANT-- 201 amps to 400 amps
^ , - ._._ 106.85 2
Name:
t ---- 401 amps to 61)0 amps 160.60
-
2
' A
�,C• ” \G 'r l 1 L3 L....1 601 amps to 1,000 amps 240.60 2
Address: ` Over 1,000 amps or volts 454.65 2
Reconneel only 66.85 2
City/State/ZIP: —
_ _T Temporary services or feeders installation, alteration, and/or
Li Fax: ( —
Phone: ' >) 41 c - z l 11 relocation
( 5 5
_ _ w..
200 amps or Icss 66.85 I
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: _• __ •• - • •• _• w Date: Branch circuits- new, alteration, or extension, per panel
❑ APPLICANT ❑ 'CONTACF:I'ERSON ' A. Fee for branch circuits with - M
.� ".- .._...,. -
service or feeder fee, each
Business name: branch circuit 6; 65 2
- _. a. Pee for branch circuits •
Contact name: _ i `J '
without service or feeder fee,
_each branch circuit 46'85 ,> S 2
Address: _ •
Racb add't branch circuit �1 6.65 I , , o 2
. City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) - — ( Fax' ( )
-- _ .� l Pump or irrigation igation circle 53;40 Z ^
..,_ ,.._ 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: WEST SIDE ELECTRIC CO.
Address: 1834 SE 8T" AVE. -' )Patch additional inspection over allowable in any of the above
.- Per inspection ' 62.50
City / State/ZIP: PORTLAND, OR 97214 — Investigation per hour (I ltr min) - 62:50 ----„
Phone: (503) 231 -1548 Fax: (503) 736 -0677 Industrial plant per hour __ _ 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 13306 Electrical L- - 26-135C Suprv. Lic,: J S Subtotal GI j
Suprv. Electrician signature, required: � ,� J �7,L� Plan rcvicw (25% ofp_erntit fee)
Print name: rn a<K� I � 1„ r , h � A Date: ? 2 / State surcharge (R %, of permit fee) 9 t , 7 j
,.--c ltl tC:-N '� X 711 , j - /
TOTAL PERMIT' FEE: 611 , r b
Authorized signature:
This permit appttcation expires it a permit is not chromed within 180
. days after it has been accepted as complete
Print name: Date:
• Fee mcdadolobry ant by Tri- county Building Industry S flUL*,)
—" " Number Of ucspeetiuns per permit allowed.
i:'. Duitding \Permirs\F_I.C- PerTltA,p,duc 12/01 440.461Sr( r o/02/COtaW S
2 ' d LL9O- 9EL (EOS) •L•3 oT-12.0aI3 0 p T S zsapi eO.17 t T I SO 62 -+eI4
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC2005-00242
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/7/2005
Phone: (503) 639 -4171 /4"8. �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 52
/2 ( 5-r_ 5,, i„roo
SITE ADDRESS: 11328 SW COTTONWOOD IN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 222 TYPE OF USE:
PROJECT NAME: MULLEN
DESCRIPTION: Wire furnace, heat pump & exterior outlet, ADDRESS # ON RESIDENCE IS 11320 (SEE NOTES)
OWNER: MULLEN, PATRICK M & PATRICIA PHONE #:
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503 -231 -1548
Inspection Request Scheduled For: Date: 1119/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 020818 -01 603 -231- 1548 N
Corr ct Pgik)631,- -- s-0-4,P
Correct
Insstructions:
k /(i..__ 0 A l i M - 30 m
___
PASS V ' ARTIAL APPROVAL ❑ CANCEL I 1 NO ACCESS
❑ FAIL /AL'I. FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�.. r
Inspector: Date: /I r ° S Phone #: (503) 718 -
ND
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