Permit CITY OF TIGARD ELECTRICAL PERMIT
. PERMIT #: ELC2005-00195
DEVELOPMENT SERVI�:ES DATE ISSUED: 4/1/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S 110AB -04600
SITE ADDRESS: 11430 SW GAARDE ST ZONING: R -4.5
SUBDIVISION: PP1996 -069 LOT : 001 JURISDICTION: TIG
Project Description: Alteration of existing 120 volt service. Job #TG15C2.
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 HMI 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:
DUNLAP, KELLY JANE DRYER ELECTRIC INC
11430 SW GAARDE ST 9409 NE COLFAX ST
PORTLAND, OR 97224 PORTLAND, OR 97220
Phone: Phone: 503 - 771 -5667
FEES Reg #: ELE 26-1142C
Description Date Amount L1C 153466
SUP 2876S
[ELPRMT] ELC Permit 4/1/2005 $80.30
[TAX] 8% State Surcharge 4/1/2005 $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. 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:
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.
03 13:50 FROM- T-933 P.025/043 F-594
2 1/20 0.5 15 : 12 FAX 503.5981960 k...; ii'l: ur 1 1 univu
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Electrical Permit Application 01
1 i L !1st: ON tl.Y
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DeldaY1 3 -- ,7g dr
'i125 SW klal 1 B ivc1., Ttgertl, OB. 97223 --- -- -
'FL= 'Review
:ne: 503.61 9.071 Fax $03.598.1960 S
pectin Luu, c 2 tor
; ko:A,,, A. 1 A Other Perrrdt: I
\ ---4Soino: 5.d39. . ii , ..,,,,j i DateBy;
,:- '-;!!!...,„, Date Ru dy/B y. *—.--
luris: " — L. - S2I e Page:
I,
:aternct wv.no.,: 03 4175
li tigard.or.as - Netilledilvieditot Sup pimento! Information _ .1
•-••- ,-----
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bt .. ' I. ..12.. .1 .. . ., -.: .., ..,--,....4.:5 ...,..... • , .
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7 New eens truction 0 &Mita • alteration/replacornent PleaSe check all lia_ afrply:
Other
iti 0 : OService oy it rnm
ez 22:- airil., co'l 01342ardo t::: location
-J Derrioltti
....,,,„.- ... L . c .-, ...,,,, ,..... ,. .. • n . ..... L . ,. -.,...... „,„.-,,,..„....,.....,.........,.. .,.,,..„,,.....,, , , . . .„.. - . , , _ 0 Service over 32 '‘., amps - rating OBI.al dog ol 10,000 ;;;•,. fr.,
'
,.' .1 ....... 11. :,- .'.. .._ '` ::, -:.,-', 7 ‘,..,... . 1,...-:,' '1' .:',..,fr,,, A4615.0170 7 . 1 .,, , , ,7 9,,, r,.7
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:;i'l-,',-Id:-.2-:::-::.::•..;:l:19:!:-;:;;...'''''Y'.5.1.4LI9111-e'll.Niliguif.1!. Ot L- ar,s12.P.tin9) dwellings 4 or :tore 'new resider.tial
3 i.- and 211'arr ily dwelling 711 Cornraercial/industrial D cesaory building
,..., Ac ElSystem aver 6011 vOILS nominal uni:s 1.1 one struerase
: MUlt -fatilly - 1 Master builder D Otter OBinloing o) n, duce o tor•OFeeders, 400 amps or r.lore
. . • DOcaxpant Lae c,o.rc 99.persons OM structures or
7: :q....."::: —.7 ' ....,.,,ryr,:7...7.7.77,-: . 7.-':'.t-,:v .
''IP 'r... , , ',, ' : ' :,. ':-'1:`.1.;:':..',1.!.i...!..1'..:?...1 .:17
.1':':..,:.:.' ..: - -.'',..1..!;;;....:::::: E]gresilligh:i311;P+u RV. park
Job site : . dress: Wil r 61 1 [01;1=1th-care fa:,•il..,tv [30ther: ,
1 ) 'it y/StateiZT.? '` .6 • 1 1 , ---. dillriallW a II!Al 17 Th a se te ll n cl o i t P a l" ;: i p l l i b th ie all tXm f p servtce.
'.. 4itefbidgial It, ao.:
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....,_ .....
.rase streett ire ctions to job site: P si"t11E4='; - il f- 41 !9M 1 -1,. .
J.:1..:Z.L::::.!-IZ'llitligg.7,7ZITITO...'a.:.it.',:i'f:•7:: ':::1'.•':.:
Description !Qty. no. ; Toot 1
■
New relidential single- v r Meld...Mealy dwellimi unit
Includes attattc.d Llat age. _
1,000 sq. ft, ot leis 145.151 I 4
... .....-
Abclivision: Lot no.: Ea. add 500 sq. ft. or *portion 33.4C1 — 771
..---
---, Linitcd energy, tesidential 75.0C; 2
Limited energy, non-residential 75,0e IIIIIII 2
i
!it .., • ..;:, „I ::,L1'. ••••;/....,- ," ■.!,.1'1;'': I : .- :1: ..1.,.': '::':: Each roanufacAnld .x. ir,odular
All ' troVireWiliranVIIIIIMI dwellit3, setvi.ne ast'or tbada 90.90;
Servicea or foci:Lars installation, air ration, anoilw relocatIon 2
. A . ,%.-11MNii2idirAVL.;111. 200 ampsor less __.. MR 80.301 'lit= 4
, , - ,....:,!.. 2m.., -, ..---...r.,...;:, t , 7, : r ; :' '' .," 'r -~ ''.'" ,i -..,..7r:' -,........ - : - .;-.°; , :;: - . 7 :7.7:'.1.!; , 7'2 - i- - .....r.':''.'1:[;.:r .. . ) .':''''..r:':t : 201 amps to etaarnr,to . 106.851 2
!.:c, •• '. ; ii..-;:.,-. - :,;'.', . ,';,::. -.. . , • - 4 :, • :. :.,. .-- • •-• •-• ;.._...: .-!. ,•;+.:. , tf .•.1':( .
160.601 2
'uric c , as i . 601 amps to 1,000 amps MIN 240.60! • • 2
-
4 " . -am-
. . Over 1,000 an.ps or volts 454.65, OM 2
"---eiclress! ...
---------- - 'Reconnect aril f 66.85 MI 2
_
1:7/State/ZIP: _ ----....... Temporary strviool or feeders inAtallstien, alteNtion, and/or
_.__ -------
, ' rein catiOn
F ax: ( ) ------
200 attps or less 6s. a51 I
, _______ ......_._
rwner ilaStallliou; This institlation is being made on property that I own which is UPI 101 amps to 400 arr9(1- tQO.30 I 2 ,
ittended for alo, lease, rent, or exchange, according to OR 447, 449, 670, and 701. .
401 arripS to 500 arops 133,75 2 '
i
--__ 1
Anna si .--.....
gnaturii: Date: Broach circuits.- new, alteration, or extenolon, panel
)..,,i..., ,..,. . . ,Ej.. • . :,..,-,.":;: .:: 1.-- - 'F ..'. '.. i'7.:17 . .' , 1'.`,; . .:7 . 7 ..7.7 : 7 7 k .-..:::?!.. Fee for brarZ11ilc wfth 1
• :!.....:•-• ...,: '.:-,. , . , E - .•...::...:, - ...' . ... . . -....-......._......,,..-.!..:, .,,..... .'.4.`=;3:;-.,',':1"-:,:',...zL:,' service or fueder t'et., each 6.65: 1 2
usitteSS mauls: branch Circuit ' 1
-----
-. B. rco for braficl. eh Gaits
ontaCt num; without sonde.: a fvedcr fee,
.,_„..... .. _ 46.85! 2
each branch. droll il, .
-ddress: • .
, Each sdd'I bra nc ti ercoit 6.65! _ 4-
ity/State/ZI.:?: Miscellaneous (ser or feeder poc included) .
-- ---..
?Limp OT irrigaticn circle 53.40 . 2
olione: ( ) Fax: : ( )
Sign or olctinc lighti.,i; _ 53.4(11 IJI1
mail: Signal eirouit,(Tor 1:rolted-
. ..:.xfe,..-.:*• , ' . ••• '. BEIME. ' ' r.'■'''' I'47.7.!!..,I;;;I:T,T!'.;--..':::::,iff, energy pan el, „1
extension. Deombe: Page 21 2
LISinees 'Mintz: 10
..1 ,s. L
• —.-.
,.ddrass: 'Lfite, Itidliltal.:;..IPWW a cf,_.. Each additional lnction over allowable in amy of the above
-- Per inscecor. 1 ! 6T.Te .
ity/State/ZI?: . MIL 111,011111ngl enrs Mb i per holzr 0 hr min) I ti2.5C i
...... _
.Mtnuatrial -ion tr a no K 13.7f
. 1-j'ael ) Air F4X' - " w -iie -4 ,4 " -- (0 1-1 a — r.::i....
Electrical /,,Ic. - f _... q ,i Suprv. Lin .a73 Subtotal , •ori. j gib
46 I F 4 I
Aprv. Electr loi an ;Znartre, required: -.....--_,-.. Plan rc /icy/ (25% of pcttnit fee)
Date: _Sone sitrcherge (8% of p fee)
I c 4 %•I TOTAL PERMIT FEE
- TWo permit app expires If 3 permit Ls ad e oldezine • within 1'
""'"--- 1 days at:er It has been :Incepted as complete
- -7int name: I Date: • Fee meth:sae toEy *: t I y Tri-Couray 13u.ildiug Incit+stry:St.r Buc
----- L...........■ . - Number pf ;R.51)1,04011:: yer permit allowed.
.41siimi 1. Pertnia\V.C. PwraitAfp.doc MU
44C.4 6 i .77(10/01/COM/WEE,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00195
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/2005
Phone: (503) 639 -4171 kaa hgn9A����
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/7 /2005 TIME: 7:17AM PAGE: 43
SITE ADDRESS: 11430 SW GAARDE ST CLASS OF WORK:
SUBDIVISION: PP1996 -069 LOT #: 001 TYPE OF USE:
PROJECT NAME: COMCAST
DESCRIPTION: Alteration of existing 120 volt service. Job #TG15C2.
OWNER: DUNLAP, KELLY JANE, PHONE #:
CONTRACTOR: DRYER ELECTRIC INC PHONE #: 503- 771 -5667
Inspection Request Scheduled For: Date: 6/7 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 008636-01 503-771 -5667 N
Correq ions /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL (l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r Date: _ °� Phone #: (503) 718-