Permit r t� CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00901
DEVELOPMENT SERVICES DATE ISSUED: 11/17/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S134AD -02500
SITE ADDRESS: 11353 SW IRONWOOD LP ZONING: R - 4.5
SUBDIVISION: ENGLEWOOD LOT: 065 JURISDICTION: TIG
Project Description: (3) branch circuits for A/C & furnace.
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:
ARTHUR ASHBY GRF ELECTRIC
11353 SW IRONWOOD LP 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 579 - 8515 Phone: 503 - 829 - 4146
FEES Reg #: LIC 76751
Description Date Amount SUP 16555
ELE 3 -484C
[ELPRMT] ELC Permit 11/16/200`. $60.15
[TAX] 8% State Surcharge 11/16/200' $4.81 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: _l c;)tv
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 ` 'o FOR OFFICE USE ONLY
• Electrical Permit Appl:> izeee;ved ,�J Electrical r� G '* Date/By:// -11w5 l�.�j - Permit No.: vo 9u /
City o igard �� o� Planning Approval Sig[
°b �® Date/By: Permit No.:
13125 SW Hall Blvd• \� Plan Review Other
- . Tigard, Oregon 97223 • • W31 'i� Date/By: Permit No.:
' Phone: 503- 639 -4171 Fax: 503- 598- 1960C\GP Post-Review Land Use
•
Ni v• \NI` , 1 1 �jt' t o Date /By: Case No.:
G\
Internet: www.ci.tigard.ar.us G, O I
•,-,‘,.., �! r ... I'll Contact J�u .: ® See Page 2 for
.24 -hour Inspection Request: 503-63W44-75 ".-"-•" 'I ) rr Supplemental Information.
I •
:"• l`i: °: r �1y i . rl' "' .:4n, 'E 7►��ARKY „�:'� *.., ";, '- :: • W ( all thatapply)' .
r ::i , • _ , tr � ry4 '<r... , PL;A:N�REVIE Please ctieck
I New construction ' ❑ Demolition ❑ Sex over 225 amps- ❑ Health -care facility
' • di trOrJalteratwnlre • lacement Other: Oth commercial ❑ Hazardous location
„ l_. ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet.
�,
ala`:'J�, i k _ is .. d 1..14. tr a S•_; IJOT • ' ',': i' . ;r : , 1 & 2 family dwellings four or more residential units in
1M jtrl a�l�
i►jeli ttt4111r Commercial/Industrial ❑ System over 600 volts nominal one structure
In Accessory Building ■Multi- Faxnily ❑ Building over three stories E.1 Feeders, 400 amps or more
❑ Occupant load over 99 persons 0 Manufactured structures or RV park
• 11111 Master Builder IN Other: ❑ Egress/lighting plan 0 Other:
1 ?s' 1.:s. 1i.`� ttir ; „iL l4 a ...” nit OtATION ': -' :• '! •., , , • Submit sets of plans with any of the above.
y �:, .: • ary construction service. •1 i 3 3 5( .. -T--1-7)1,- 7 nf)at . The above are not applicable to temporary
Job site address: FEE�'SCHEDU ::`:;l? , ;
Suite #: /� , `
. Project Name: l'l 5 ` /9 :rescriatiou Qty Fee (ea.) Total
Cross street/Directions to job lte: New residential- slagle or multi- family per
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 1
Subdivision: I Lot it: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax Ilia • • arcel #: Each manufactured home or modular dwelling
_` � `' °, 4 : 4 : ,i ,':r6 u s iil4nyio 'WORK,,? : i .!: service and/or feeder 90.90 2
Ser•lees or feeders - installation,
alteration or relocation:
/ J? i4 w.- /1 C ' — 20 amps so l 0 s 80.30 2
f 1'F / � � 201 amps w 400 amps 106.85 2 dol • t ., it 401 amps to 600 amps 160.60 2
TI Ir t u l : a • +1 ,0. rr 'r.' f±i l Ir y: . Tf i.,%: ,,.::Ic - i. " „t
,' ,rat 601 amps to 1000 amps 240.60 2
t
:. Oves 1000 amps or volts 454.65 _ 2
Name / S as 0 ]reconnect only 66.85 2
Address: t 1 [.; 3 s( ., ) 2 ' i'OO L Temporary services or feeders - installation,
l/ A
alteration, 0 ms or le or ss 66.85 1
relocation:
City /State/Zip:
�� /� j Z3 200 amps or le
ph one: 5 s 6/ -- , `a 5 a Fax: 201 amps to 400 amps 100.30 , 2
;.E:INIT:T � ; pial - iVe-41. )1 ?'.CiR,NTlj C'1i. PERSOI ' , ; ° ;ti ,' 4 Branch nch circuit amps uit 133.75 , 2
' ^" "'' ' �"-� ^'" Branch circuits -new, alteration, or
Name: • extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
• City/State/Zip: B. Fee for branch circuits without purchase of 1 ` f •
service or feeder fee, first branch circuit ` 46.85 t • - k 5 2
Phone: . I Fax: Each additional branch circuit 6.65 i 3 as 2
E -mail: Misc.(Service or feeder not included): `
r : t , 1 • m. .- -,,ek !t, 1 F'ar a Each pump or irrigation circle 53.40 _ 2
,�: ;; F . '+ Y '" ^`- t? ;3G'f r ',( r ii 0 0' " '' Each sign or outline fighting 53.40 2
`� ;"J"`:!',l!'� .':rE ".. iii^,.. ...1,._ „. -. � ..� a:i "'%a' ��' . {�� '
Job No: Signal cacuit(s} or a limited energy panel,
Business Name: e,,,)-y- �,' ,
Description: or extension
D 2
� 1 Description: Page 2.
Address: 1 5` (p r S , P Kt, d .,-2 .r L , ' .
/� G + 7 ` Each additional inspection over the allowable in any_of the above:
City/State/Zip: Mfg I t
l,) (( C1 Per inspection per hour (min. 1 hour 62.50
Phone: 9) 3 . 00 t ! , +-(p Fax: 5b 3- 8 19 - S - 7 <4-7 Investigation fee:
,�-
CCB Lie. #: "7 b g Lic. #: 3 - y- G other: `i ,
: i:,.,L,; w..:,. .. .-- :...;IaletailtialiPet` halt :�Eees .. r,
, .:r, ;:..:
Supervising electrician. , /0 ;. Subtotal $ L7 t ! • signature required: �� J i �a S - Plan Review (25% of Permit Fee) $ L°
Print Nam A / ; ., _ _. Lie. #: .. State Surcharge (8% of Permit Fee) $ Mc 1
TOTAL PERMIT FEE $ -1 6,
Authorized Notice; This permit application expires if a permit is not obta Within
Signature: Date: 180 days after lt.has been accepted as complete.
*Fee methodology set by Tel - County Building Industry Service Board.
. 7 .1 • (Please print name) •
i :lDatslPe„i,it Por'nrs1E?lcPerrnitApp.doc 01/03
1, 'd - - LI7L9 - 6Z8 - 809 OI2:110312 d2i0 9 L . 1 L 90 9 L AON
. .4
CITY OF TIGARD . . , •
BUILDING DIVISION PERMIT #: ELC2005-00901
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/17/2005
Phone: (503) 639-4171 ,
il I
Inspection Requets (24 Hrs.): (503) 639-4175 Ja
INSPECTION WORKSHEET FOR DATE: 11/21/2005 TIME: 7:13AM PAGE: 61
SITE ADDRESS: 11353 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 065 TYPE OF USE:
PROJECT NAME: ASHBY
--.....,
DESCRIPTION: c I.,._ nit.,Circuits-i0E-ALLMUmace. 1
OWNER: ASHBY, ARTHUR PHONE #: 503-579-8515
CONTRACTOR: GRF ELECTRIC PHONE #: 503-829-4146
Inspection Request Scheduled For: Date: 11/21/2005 Pour Time:
Code # Inspection Description I, Confirm # Contact # Message
I
199 Electrical final
022015.01 503-319-5991 N
Corrections/Comments/Instructions:
c_ (
lq
A PASS 0 PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS
El FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: 4?Gt,Jid 6,--- i'' Date: Phdb Phone #: (503) 718-