Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00536
6��1j DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
• PARCEL: 1S135CA-90150
SITE ADDRESS: 11150 SW GREENBURG RD 150 ZONING: R -12
SUBDIVISION: ASH CREEK PARK CONDO LOT : JURISDICTION: TIG
Project Description: Service panel change.
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:
WILHELM, FREDDIE R ELECTRO WIRE INC
11150 SW GREENBURG RD #150 18857 SE SUNNYSIDE RD
TIGARD, OR 97223 BORING, OR 97009 -9271
Phone: 503 - 639 -6194 Phone: 503 - 658 -8136
FEES • Reg #: ELE 26 -667C
LIC 67879
Description Date Amount
SUP 2717S
[ELPRMT] ELC Permit 7/28/2005 $80.30
[TAX] 8% State Surcharge 7/28/2005 $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: , A . d o Permittee Signature: j (R o 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.
FROM 'r: FAX NO. :5036431410 Jul. 26 2005 03:088PM P4
'Electrical Permit Aptil'icat O VE®
\ u ns.. 1ell:cirl'1; t.r:�t t ► \r.�
City of Tigard Received
Im . - 4 � Pt tn mit No. : . ° .�
13125 SW Hall Blvd., Tigard, OR 97223 J UL 2 6 2005 y. , . / ,g. ,
Phone: 503.639 Fax 503.598.1960 Review
inspection Line: 503.639.4175 Dine/By
Other Permit:
Internet: www.ci tigard,or.as Q /BFI . .
A" r
CITY OF G �� �• �r ` �� , t � B� r = eJS� 'P„�ara ; :
> S > +/ off( ,� d �ti; y "1 o n inn _ - ) Sapp/entente' ementd rormaticu
:-� ,„ t� , t;; t'' .;`l, k ! (" „4z i i; �A �` l f. sts+ ` s , • ,,s w ? s I> ci b 'TOP 4 ! g r u , , ;, }�v7. •.5 .<r my 1 1 � � pig to p,
. ' 'ti^ n ,,,„,„v...;-.6-.,..,;.,%,,,,,,,).4..4,1u S l M 1. i 0. p f 4 ` `+�' at:Y;�` k fi ike �I'� <`G i k ; S bw 1;k1k t w ' y
0
New construt;tion Y k d V 7s" a 1p 1 ,.Pa.e„v.r(1h.ad �'i� rl . E st . ^p x k ,s ,
� Addition /al tctatiotm/replaccment Please check all that apply:
❑ Demolition ❑ Other: EiScrviceover225am
y�� r--t amps, comm'E � ❑Hazerdou5 lomtion
; � ./ 1 f.k`� 1 '; VY ,f � l`�•r'(� vf `�`' ' . Q , ' t ' ' . ,`;;u �'. • • �, •, . DSe vice over 320 amps -- rating : ❑ Bullring over 10,000 s It.,
, • ;- r, e ` ,..,; ,.' .. • 4' . h ' ' %/.. f jri �;1, A: 1 r • , . �s , 'r 9
gZ., Z +•>G.>a ,o, •t.t .: of 1- and 2- f amily dwellings 4 or more new residential
❑ 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
lig Multi - family 0 Master builder ❑ Other: ❑Building ova three stories .. OPeeders, 400 amps or more
ds< f'. v� "`!}f�c'�tte; :'�.Y;`'��1�f• •�" �p�;�;` x• , f rid•. v, , �r.: . .r:.i' , 'r�1 , g` « ^' "� ^� ":,' %sHU:1:'�,tiiJfi, ['Occupant load over 99 persons ❑Manufactured structures or
'"e ....,.. , r 46 " r.`�' , � 1 �1>Qn�IS:' ,4 fF
+ f 1 :' ,.. a•x �JI;'�i::�:,� "i�!.�� ❑Egressllighting plan RV park
Job no.: Job site address: / ' ❑H care rao i l it y ❑ Other:
/ s i �-�' ' — •� • Submit j� sets of plans with any .of the a bove -
City /State/ZIP: �� 1
The above are not applicable to
b...4,2_ 1 •
temporary con ucdon Service.
Y M fYJY.?q:Yy,J Y1'P. A.,wiC'' „4 reF':.
SuiteJbldg / t no.. Project name: N' +`',� ' '°;"'
j I� l sA r:. <:,,. a
—
rksvlpibo Qty. Fee 'rota' ••
Cross street/directions to job site: • New residential single- or multi - family dwelling unit_ '
— Includes attached garage.
1,000 say- R or less 145:13 4
Subdivision: , Lot no.: Ea. add'i 500 sq. ft or portion . 33.40 1
Tax map/parcel no.' Limited energy. residential 75.00 • 2
�� ^.(1.� s i : g ;' ?;�, ; •,T.� , .,. x , Limited energy, non - residential 75.00 2
`; \ p i �$ . i rJ iM S a °, * ..:�! .Y ,,Jt ; i �;` .`.. :�r�y i� ;( >,tia -�' ,n i r 14., t y,
,,,., 1 ,,' y3.�" 1!,,�io;a' <.i.5, r,..zi�,l�"+.�".R,,,, _Y`,.. .. Li� >) r ,,s °)�.i, 1 \, Qt; �!1.`. i`�,7 ,"r., �.' "t,
is `� ,� 's ... ,...g?..,;:;'�,� 11` 1�t^'', ,;,,�:1 »�,wj,,;D;,.�J�F,�y'3as, Each manUfaCttllCd OF mOdU18r
dwelling, service and/or feeder. ,:..90.90 .: • 2
Servkea dr feeders installation, alterathili, an dhir•r elocation ,
200 amps or less • irm 80.30 - a r�
`: ?ra % ;k, ? l.. ^� "� ��p'�M ° w- •� i> �i 1,' �?'Q ;' •� �•' 80.30 M
um'
i .i• '; a : 0.0�F# J S b "; M .s� i ; t w :..d „ 2� 6 s,t • S :��1"'` ,.. , ° s'c:G 1 • 1 1 : f
r :Ze.<„ „,..'�;,;, ,.s. „,,,..,w, :4SN' .) ,S4'.4; Mg ta.> ti .
' . , 'a r, + b . , ' \ 'fir;' \ ' ,.)'.^!'. t:, "''''. ''''''''''''9'4''') �' ' ' ' sir t.
Name: f , Ale \ -9-' 1. J � \,. 4),\•___ , t u 1 t
r,/
Address: I Ova 1.000 amps or volts . �� 2
' Reconnect only
Cily/State/ZiP: Temporary services or feeders installation, altefpl5pp, and/or
Phone: (fa ) 639 - / 9 d'/ Fax: ( ) relocation
200 amps or less I 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1'00.30 2
intended for sale, lease, rent, or exchange, awarding to ORS 447.449, 670, and 701. 401 amps to 600 snips 133.75 2
Owner signature: Date:
e Branch circuits - new, alteration, iir•extenalon, per panel
.ti t` rty;, }7;? ii&�,A ' ; 4 , , 4 �y� Vii,; k ; � ' p `" *iii y, , .. n ,. ; :: Ufa;,..0 A. Fee for branch circuits with
.,fi .. .._. * '(' \; , ,., ,,.,
� yl :'r. ,,`� ,`�t.,f :i,
service or foods fee, cachi 6x
Business name: branch circuit 6.65 2
” • — B. Fee for branch circuits •
Contact name: without service or feeder fee. 46.85 2
Address: each branch circuit
City /Statc/ZIP: Miscellaneous (stroke or feeder not included) .
Phone: Pump or irrigation circle • • 53,40 • • • • 2
( ) Fax:: ( ) Sign or outline lightin 53.40 2
E -mail: Signal circuit(s)'or limited- ... •. . .
;}t t, i 2:' �' {` � ;W Yt' +: '_u ; :7I i 4 t• ,{,ttat . w ..,... `�"0' `kTVk� `��f_2(i, y '�r'�`i � f` ` �',^,`�ay��, °? '�` rrg+,..y.��'..• Jg.;: r,� ,•l enter el aeranO ...
;,c a1...,•aFt�`., ,; :�a >.'�^`.,1..... <n:�'r>�x,. .��'>.�� ^ ts*,r. 4 r��. y � , > i) aF.' t.•, ���ew .,:,;ad�.<. ^.7ry',r',.r.•T n,��.p1�s,.r,�, BY P� lt 4 or
�� ` e t ens i on. D Pagt.2. 2 • Business name : � 401/4
Address: / gci5 Each additional inspection over allowable hi any of the above
Per inspecion 6230
City /State/ZIP: 1 (!)4.4.1/ Investigation per hour (1 hr min) 62.50
Phone: ( s $ Fax f5 )3) GS $ 7 j
Industrial plant per hour 73 75 " •
CCI3 Lie.: ��S ] E lectr i cal L :2lo _ t'ofo S Lic.: i I .TE r ,� , `
9 7 u 7 Subtotal f5 D � ___..:
Suprv. Electrician signature, required : /-ti t._ „ 1/4. _ Plan review (25% of permit fee) . 4 '
State surcharge (8% of permit fee) / Z
Print name: A r V - f P-i NS OA) Da tet� ` (o ,
TOTAL PERMIT FEF,. 6'1 y 7
Authorized signa ic: Ins permit application expires if >♦ permit is not obtained within IRO
days after it lowborn accepted as complete
Print name: Date: • Fee methodology act by Tri-County Building Industry Santioe Board
• • Number of inspections per permit all owed
i:\ Building Wertnits\ELC- Ptrmitlapp.doe 1203 4 40. 4 615T(Iou2/COM VE9
•
CITY. ,OF TIGARD
BUILUIIVG DIVA PERMI #:
SON ELC2005- 00536
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7128/2005 (503) 639-4171
AI IPu�i,�y� '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9121 2005 TIME: 7 :03AM PAGE: 72
SITE ADDRESS: 11150 S1 GREENBURG RD 150 CLASS OF WORK:
SUBDIVISION: ASH CREEK PARK CONDO LOT #: TYPE OF USE:
PROJECT NAME: ASH CREEK PARK CONDO
DESCRIPTION: Service panel change.
OWNER: M, FREDDIE R, PHONE #:
WILHEL
CONTRACTOR: PHONE # 503 63!6184
ELECTROWIRE INC 503 - 658 -8136
Inspection Request Scheduled For: Date: 0121/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 - mica ..- - 01 = .. g ;, . 658.8136 Y
' orrections /Comments /Instructions: O\ 6g3
C -30VW0 c C f (4101 , 1 (1 G(1 4 3g7
r i
r r ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � .�c.4,,t�L,c/S — Date: 9` v Phone #: (503) 718 -