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Permit . C ITY OF T ELECTRICAL PERMIT PERMIT #: ELC2004 -00159 DE VELO PM EN T SER DATE ISSUED: 3/29/04 Avite ,fi. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BA -05500 SITE ADDRESS: 09970 SW KENT CT SUBDIVISION: PICKS LANDING NO.2 ZONING: R-4.5 BLOCK: LOT : 085 JURISDICTION: TIG Project Description: Install 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: 5 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: GLORIA CRAIG L & K ELECTRIC 9970 SW KENT COURT 3540 SE KELLY STREET TIGARD, OR 97224 PORTLAND, OR 97202 Phone: 503 - 516 -2524 Phone: 971- 506 -8351 Reg #: LIC 157326 ELE 26 -1180C FEES SUP 4975S Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/29/04 $80.10 [TAX] 8% State Surcharge 3/29/04 $6.41 Rough -in Elect'I Final Total $86.51 • 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: - - ^ Q Permit 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: G i d �%j DATE: - - Z 9 - OY ■ LICENSE NO: 4 /975S Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Applr E I VE r. R City of Tigard eceived DateB Permit No.: i5" MAR 13125 SW Hall Blvd., Tigard, OR 97223 M / � p Plan Review - — ��-- �� �Gt �. Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 " M''� Date/By: Line: 503.639.4175 CITY . -. L = Date Ready/By: funs: 13 See Page 2 for Internet: www.ci.tigard.or.us OF T IG ' Notified/Method: Supplemental Information ❑ New construction XAddition/alteration/replacement Please check all that apply: . ❑ Demolition I=1 Other: ['Service over 225 amps, comm'! ['Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., of 1 - and - residential 2 fa dwellings 4 or more new resider rtul dwelh - x 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building El System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑ Other: ❑ Building over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons ❑Manufactured structures or V :::: ::::::�r��:::�r . •: >~ri��r.l > ice: >:: � . RV park ❑ Egress/lighting lan P P ., ................................................................................... ...... ....: ............................... Other: Jobno.: ••••. Jobsiteaddress: ••....•.. .�. •.••� •.• ❑ Health -care facility 99 Submit 2 sets of plans with any of the above. City /State/ZIP: ^, 0 . The above are not applicable to temporary construction service. Suite/bldg. /apt. no Project name: ' ' " "'......:. ":. .'.`.:•:.': Description Qty. ( Fee. I Total " 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.: Ea. add'! 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 ::>::<::<: ::::::2: >::::: >:::::::::` ::i :::< r:: i::<::::::::?::: E: E: ::....................................................................................... ............................... Each manufactured or modular dwelling, service and/or feeder - 90.90 - -' 2 L� .J Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 201 am s to 40 am 10 0 s 6.85 2 P P : : :::::::: :: :::::: ::: :::: :::: . • • •: ::::: • :::::::::::::::::::::::::::::: 401 amps to 600 amps 160.60 2 . Name: _ to P , L.I 601 amps to 1,000 amps 240.60 2 Address: • rAIIIIMIIIIIII Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City / State/ZIP: e Temporary services or feeders - installation, alteration, and/or Phone: 603 ) Fax: ( ) relocation • 200 amps or less 66.85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 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 : T? Y aG 1 y `[: ::::::::::E >:: >`::::: .. `: `: .it.`ix. !: >Y?) lt..+EX !> ::' :> :: >3«; A Fee for branch circuits with r/ service or feeder fee, each Business name: L i F-- • , branch circuit 6.65 2 Contact name: �1 B. Fee for branch circuits ay. , 1: 5r N without service or feeder fee, Address: each branch circuit 1 46.85 4 2 Each add'I branch circuit 5 6.65 33, ' 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: L. ft`• /- .. uilo c Co Signal circuit(s) or limited _• _ . , - , 1 alteration, or ener s�i gY P ane extension. Describe: Page 2 2 Business name: t .. Address: �� Each additional inspection over allowable in any of the above • Per inspection 62.50 City / State/ZIP: r ._' 0. ' •'7 20 Investigation per hour (1 hr min) 62.50 Fax: Industrial plant per hour 73.75 Phone: ( 5 0 3 ) ` . 3,4 20 ( CO3 ) 33 - . ((R :::: :<: > :::: > ...:.,..::•::.. ....:.: >':: • > > :... . .. ...::..:.:.. ,.:..:.....:.:::::>::::::: : >:: >:::: > :::::: >::::: ::: > ........ ..........: ^:: it s: 1:'• � �' �?:;: �?. �+.:.. �. y..' �..*:::>::: :>::: >:: >:: >:::: >'s:: >::. >. ;:< ::::> : CCB Lic.: /573 _ Electrical Lic.: , `t1 b'oc Suprv. Lic.: (,my ? s-- Subtotal g© 0 Suprv. Electrician signature, required: �W� _ Plan review (25% of permit fee) / Print name: ( V' �� Dale: Z O State surcharge (8% of permit fee)_ _ (A . TOTAL PERMIT FEE �'4 „5-1 ' Authorized signature: £a- ' ' a � This permit application expires if a permit is not obtained within 180 days at'ter it has been accepted as complete Print name: / A. � Dat e: 3 — . _p * Fee methodology set by Tri- County Building In dustry Service Board wa Number of inspections per permit allowed. i : \Buildumg\Pernits \ELC- PernitA. •.doc 12/03 440- 4615T(10 /02/COM/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST `/_ BUP Received Date Requested 7 �� AM PM BUP Location / / w `ems d 1 Suite MEC Contact Person Ph ( ) PLM ontra Ph ( 71631 35 SWR BUILDING Te t/! ELC / 2 O / Footing r i 7 6e_e__"-e...)- ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors � _ Ext Sheath /Shear r " _ — - - - -- Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In \ 3 0 L3 Water Service ` Sanitary Sewer . Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL - ELECTRICAL Service Rough -In UG /Slab Low Voltage • farm Tarr ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line FDA -- i Approach /Sidewalk Date — inspector 4 -./ i Exit Other: Final DO NOT REMOVE this inspection record from t Job site. PASS PART FAIL