Permit C ITY OF TIGARD ELECTRICAL, PERMIT
PERMIT #: ELC2005 -00916
DEVELOPMENT SERVICES DATE ISSUED: 11/23/2005
3 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103CA -00209
SITE ADDRESS: 13050 SW HOWARD DR ZONING: R -4.5
SUBDIVISION: WOODCREST NO.2 LOT : 027 JURISDICTION: TIG
Project Description: (11) branch circuits.
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: 10 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:
JOANN KISH ELECTRICAL CONTRACTORS & DESIG
13050 SW HOWARD DR 150 NE VICTORY SUITE A
TIGARD, OR 97223 GRESHAM, OR 97070
Phone: 503 - 524 -2034 Phone: 503 - 666 -9358
FEES Reg #: L1C 47712
ELE 26 -466C
Description Date Amount
SUP 1882S
[ELPRMT] ELC Permit 11/23/200` $113.35
[TAX] 8% State Surcharge 11/23/200` $9.07 REQUIRED ITEMS AND REPORTS
Total $122.42
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 ``` Permittee Signature: � � n1/4,
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.
Nov 23 2005 5:OGPM_ tct l9t11 Contractors & 503 - 667 -7365 p.2
Electrical Permit Application t� FOR OFFICE. IISE. t)NLV'
City of Tigard NOV 23 2Ub5 ... J !' PecmitNo.:
Date/13 : / (/ ‘26 /l(j
13125 SW Hall Blvd., Tigard, OR 97223 -:: ` : ^rrvl . Plan Review
Ph. h 503.639.4171 Fax: �-
y jr� �` ? ra
; tJg ; Other Permit:
r� y pF Ti(,,,' Tl ' Amy„ Inspection Line: 503.639.4-175
503.598.1960 � I Date Ready/By: is See Page Z for
Internet: www.ci.tigard.or.us a LDING D v ' N d/M Pp
ot Supplemental
.
1 $. '{a p _ 6 C 'n".. 3 . % .a °a ,' l';';',11 _ i " }. 41 - . .x s c., . d: .. s' •r . : I s�iYk ; ty
_ I Ya y x m . $ X < a'�k k +t a r m y :,7 n hre. a � �'ds�e �e � � r � . � r r 'rdt a1 .
i
� _- ;,; r. _ a - -- � i ,
El New construction ® Addition /alteration/replacement Please check all that apply:
[3 Demolition El Other: ❑Service over 225 amps, comm'I ['Hazardous location
��� = , *, r ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
s , yifl x v � F i ,1 1 ° r 4 w . x . r < k 'a` " `" � tt of 1- and 2- family dwellings 4 or more new residential
»�at� �i�., ....w, ,. __. ... ....... �.: .�.�"?xr:,.st- wg ._. .. .tti�. . 31
�;..:.,<,ax o , .�5st...,a�- ....,.
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
[3 Multi - family ❑Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
nsh , mot t g y1 , , f r Q 1 a x- .0 l 4N Y ��� �{ 1i ['Occupant load over 99 persons ['Manufactured structures or
4 3.z , �t� e- us e zsa +# ro t il £, es RV ark
�. l.*_.��°'_ � y �._�.� *C:� .F St.r�rc n� as •�� _.._.__._.. n,. .�.: ��� ��� ❑ !3r sllighting plan P
❑Health -care facility DOther:
Job no.: Job site address: 13050 SW Howard Dr Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard. OR 97223 The above are not applicable to temporary construction service.
3... �.d1 t Y r E n fl l: i d !! l a: 1 - ti . : s: 9 i X31 rLt i I' -r- TI r}
Suite/bldg. /apt. no.: Project name: Kish cw�lYtt }iI d a�
Peeeripdon Qty. Fee. Tote "
Cross street/directions to job site: New residential single -or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: 7 Ea. add'! 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no
Limited 4nergy, non - residential 75.00 2
r liNibi;43,, ? ! k %,' , :': ' ,:3. :';, ate? .:3.11 e : 4 Y :e :•i :t , ;:6.a,' n,. ,.:ri', t i',. :'ir a`
t 1 ` i * ```
$ Each manufactured or modular
Bathroom Remodel dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
Bedroom Addition 200 amps or less 80.30 2
' rte-- r mss^ _ rs - 7T e 5 c. 201 amps to 400 amps 106.85 2
t .._ `r_' ,r*x. ..:.. .. _.: a`lr -• . - :- •im: a ::; 4t Ella .r :� i. ;: 1 4ir3 ...,
401 amps to 600 amps 160.60 2
Name: JoAnne Kish 601 amps to 1,000 amps 240.60 2
Address: Same as Job Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)524 -2034 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 1 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: Date: Branch circuits- new, alteration, or extension, per panel
xk;° R M zl �.
Y °fi r.�'�S 4s _ i., m i x. r . 5' '1 7iti"S'r C fE` , ii 9 v s , ia. 3 I RGIei r71Y 1�
t r is A Fee for branch circuits with
"� x ` °"" service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit I 46.85 46,8c 2
Each add'! branch circuit ID 6.65 64 ..cx) 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ; ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
' «» i ' g - 7 3 , p'"l 1 F } fe-r , ^ m r e a _ 'r z - .. ks t o r,�, Wiz..
£:"° � :. .,.rrs r u_ w r . _ t ".:;i ,t, ..: 4 - _ o...., . »_t.. .: ...::: { . ° it 141,.. er a energ,�� panel, altCIatlOn, O[
.
extension. Describe: Page 2 2
Business name: Electrical Contractors & Design, Inc.
Address: 150 NE Victory, Suite A . Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Gresham, OR 97030 Investigation per hour (1 hr min) 62.50
Phone: (503) 666 -9358 Fax: (503) 667 -7965 Industrial plant per hour 73.75
,__. -;=- ...?.:.._318I .:. %e_Yak.5.3'c.x isle on, `3 'E',..FF.'U ' s .. ._... . t . r
CCB Lic.: 47712 Electrical Lic.: 26 -466C Suprv. Lie.: 1882S Subtotal 1 i 3, 35
Suprv. Electrician signature, required: - ' Plan review (25 %ofpermitfee) .. - -
Print name: Ern_ State surcharge (8% of permit fee) G( , 0 - 7
a Date: 11/18J05
TOTAL PERMIT FEE , e2_2_, 142_
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i. BuildingtPerrnitatEL6permitApp .doe 12/03 _ 440- 4615TO0/02COMJWEB
ITS' ,O F D
C TIGAR
BUILDING DIVISION PERMIT #: E C da5 _ 4 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171�'u�lp @� /1/2 3/ 7,00 u C
Inspection Requests (24 Hrs.): (503) 639 -4175 =�!�
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: J ewe, r" )0f ' CLASS OF WORK:
SUBDIVISION: ' /i/U LOT #: 7 TYPE OF USE:
PROJECT NAME: K
• S h
DESCRIPTION:
Cec)Vciurv, ? 3c,. 5 dc/ 'i'o - ,
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
!�q C-4I P: . 0,0Z 9 0 -) -G1 s03 - 66.6 -- 'i35?
Corrections /Comments /Instructions:
' - I PLINK
`W / .
i
I PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
I FAIL CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector,: l ', �� a=> Date: CS `X Phone #: (503) 718 - Z--
� 5 Cr---
CITY bF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00916
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/23/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11128/2005 TIME: 7:05AM PAGE: 1
SITE ADDRESS: 13050 SW HOWARD DR CLASS OF WORK:
SUBDIVISION: WOODCREST NO.2 LOT #: 027 TYPE OF USE:
PROJECT NAME: KISH
DESCRIPTION: (11) branch circuits.
OWNER: KISH, JOANN PHONE #: 503-5242034
CONTRACTOR: ELECTRICAL CONTRACTORS & DESIG PHONE #: 503-666-9358
Inspection Request Scheduled For: Date: 11/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 'Electrical rough -in 022484 -01 503-666-9358 N
Corrections /Comments /Instructions:
PAct'l I L : 15Z N Oiav Nom' b01)
Olc
Ci •
PASS ►■ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: f6 Date: WI 11 1 73 Phone #: (503) 718- IN � —�