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Permit CITY OF F TIGARD GAR ELECTRICAL PERMIT PERMIT #: ELC2005 -00535 c. DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA 05800 SITE ADDRESS: 15148 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT : 035 JURISDICTION: TIG Project Description: (2) circuits, A/C & outlet. 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: 1 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: LI, MICHAEL GRF ELECTRIC 15148 SW GREENFIELD DR 15460 SE PARADISE LN TIGARD, OR 97224 MULINO, OR 97042 Phone: 503 - 601 -01790 Phone: 503 - 829 -4146 FEES Reg #: LIC 76751 Description Date Amount SUP 1655S ELE 3 -484C [ELPRMT] ELC Permit 7/28/2005 $53.50 [TAX] 8% State Surcharge 7/28/2005 $4.28 REQUIRED ITEMS AND REPORTS Total $57.78 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: 7 , j 5L Permittee Signature: Ss2,e, 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. • c. 1^ Electrical Permit Application - FO .. FFIC USE ONLY Date/By: -! iL.tL Electrical C�Ol _,,,1 J ) • aielBy: Per mit No. J // City of Tigard ; Planning Approval Sign g ���� Date/By: Permit No.: `. 13125•'SW Hall Blvd. Plan Review Other . Tigard., Oregon 97223 • 'JUL 26 20f1f Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use q A � {'I Contac Case No.: Internet: www.C1,Ligard.oLus �l dlf= e� Contact • Ju s.: ® See Page 2 for ,24 -hour Inspection Request: 503 r1tY3 -6 175�IG DIVISI ©SIO � Name /Method: �� Supplemental Information. • r'�B�1h1G . , •l;'1 tFiiw� n M a -' f 10 F ) .. ` :PLAN-REVIEW. Pleasecbeek• :all'that aPpI')` { �; �� `�!• � :..�:...,•;-�t�i �T�PE�QF�' � 'YUI2K'. : :-��+t.;;' ;., ;. >�,_, ,;• ... ,. �. �, . �'� `::':; =' .: ( ■ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location 0 - .dition/alteration/replacement R- Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, P ., •.•, rtir:.4t : OkWEa?A? ;Q ,,' 1KSTRYJCTIQIV ` "' . "' ": "" = � ••:' .`! & , 1 2 family dwellings four or more residential units in 1 & 2- Family dwelling 0 ] Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more Ili Accessory Building CD Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ■ Master Builder '❑ Other: ❑ Egress/lighting plan ❑ Other: :�: �^ : . • Submit sets of plans with any of the above. • rr 15 ' 1�����. , ., }, ",�, � y.I,.,, „ SAN :'Anti •LQGIATYON` : � :.' : . :. The above are not applicable to temporary construction service. Job site address: • ! 1 1 f - k` S c,t_7 6 v --e e.0.-Fi t:7.{ eL- .. .r:FEE *:SCHEDULE?r•`:"; :•: ..:.:.• Suite #: I Bldg. /Apt. #: b Number of inspections per permit allowed • Project Name: t _ t :3aeriptioi, t Qty Fee (ca.) Total 1 New residential- single or multi - family per Cross street/Directions to job site: , 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 #: L imited energy, non residential 75.00 2 Tax Ina arcel #: Each manufactured home or modular dwelling p�.^� • • C. 1rm,�!Y,n1� ■T W K t :'•, :.. r• : = .:4 ,, ; t... service and/or feeder 90.90 -,, 2 a +�1: (IY�MY ��S'fnN�•M- '�f�'IYT"��Fi,T R •'011 " .. I t -.: .. I.. .. �. 1� ,.', 1.� /' - Se rvices or feeders - installation, ' 9 ' 6-4%:: e.. {-<., - /�'l C 4-71- alteration or relocation: 200 amps or less 80.30 2 t 201 amps to 400 amps 106.85 • 2 [�• L . 401 amps to 600 amps 160.60 2 ?`* L� l ' '. '. t, IIIME AINV' ^r "' y ,�,,,,,y z + M1 S!' t',MS,'i' 601 amps t0 1000 arnpS 240.60 2 . ., . :.. ,.. `;r,t.," h:1 Ovec 1000 amps or volts 454.65 2 . Name: p. lf! - 66.85 2 / �• - � 2 , Reconnect only Address: . / L5) k*cc 3 ( 0 6 r e.. e.� -/ C'�j C ,( 1,9 Temporary services or feeders - installation, T alteration, or relocation: 66.85 1 City /State/Zip: 9 I , (, ,( `7 -) t- , 200 amps or less 100.30 2 Phone: (p � . 201 amps to 400 amp U 1 1 y t F es' , A �,,,, ;t , A � ,. 401 to 600 amps 133.75 2 _ �F,',{' �,, lit Mi "'+i14S. C r y., y� Y IF. n y$QI�FnF]'tl ` '.1.i.,� >t.,.; ® CfJk�IT�CTi ''l' :''; Branch circuits - new, alteration, or Name: • C ` 1 extension per panel: • � I t � " V' ` � "l /) A. Fee for branch circuits with purchase of ' Address: ` ' � .}-' s /t Or C' -(• . -� e-/• _ service or feeder fee, each branch circuit 6.65 2 � t .-, Clty/.State/Zll): 1 i / /� C 1 7 Z' 2 .L f t ✓ 1 � r B. Fee for branch circuits without purchase of 46.85 c 1,, •.� �i 2 service or feeder fee, first branch circuit Phone: / Q l - j '� (9 Fax: Each additional branch circuit l 6.65 L. E -mail: Misc.(Service or feeder not included): : , r; ; y 1 16 Each pump or irrigation circle 53.40 2 1 ut' .t!' y ..d`.•x.3 ?':a!:• 'R..,.''''�' ?1' I!' :�.F�. i o ` �' Each sign or outline lighting 53.40 2 Job No: • Signal circuit(s) or a limited energy panel, • alteration, or extension Page 2 • 2 Business Name: S P e j (. Description: Address: 15 - b9 o S. F. rz, rL - r • C1ty�StateJZlp' I 7 s- /� - f - 0 L + Each add inspection over the allowable in anrof the above: (" ' , t 1 • -1 i Per inspection per hour (min. 1 hour) 62.50 Phone: ciy3 '- ca ..,61 . C / t' Fax: 6b3 8 zi - c - 7'1•,7 Investigation fee: _ _ Other; • CCB Lic. #: r Lic. #: 3 - 4 '� � - :,' �,, :;! -„t ; :! .. ElectrieahPcruiit`Fee's :. + ' . : :�' 1 xi'..'•'': .. Supervising electrician �� �4 �- Subtotal $ • <0 j signature required: 1 I Plan Review (25% of Permit Fee) $ Print Name: w r / l i At.,,,, � I Lic. #: � L .� S • -� State Surcharge (8% of Permit Fee) $ -- .4'y TOTAL PERMIT FEE 1 7 K Authorized Notice: This permit application expires if a permit is not obtains within Signature: Date: 180 days after it.has been accepted as complete. •Fee methodology set by Trl -County Building Industry Service Board. • • (Please print name) ' ' is \Dsts\Permit For sWlcPermitApp.doc 01/03 . 1'd Lt'LS828E0S 0 T - 1 10a13 ANS d2S :TO So ea tnC CITY OF TIGARD 4+ BUILDING DIVISION PERMIT #: ELC2005 -00535 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005 Phone: (503) 639 -4171 l 'I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/12/2005 TIME: 7 :06AM PAGE: 54 SITE ADDRESS: 15148 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 035 TYPE OF USE: PROJECT NAME: LI DESCRIPTION: (2) circuits, NC & outlet. OWNER: LI, MICHAEL, PHONE #: 503 - 501 -01790 CONTRACTOR: GRF ELECTRIC • PHONE #: 503 -829 -4145 Inspection Request Scheduled For: Date: 8/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 013452 -01 503- 557 -2220 N Corrections /Comments /Instructions: • • • • • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1\V 68 t Date: 15 I C 1 -1 0 6 -1 Phone #: (503) 718- 2.0 L