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Permit -- . 4 CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00625 � I� DEVELOPMENT SERVICES DATE ISSUED: 9/29/2004 _Al. �--" 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112CB -08800 SITE ADDRESS: 15118 SW KENTON DR SUBDIVISION: ASHFORD OAKS NO. 2 ZONING: R -7 BLOCK: LOT : 102 JURISDICTION: TIG Project Description: (2) branch circuits for a/c & furnace. Job No. 06 -3386 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: HOOVER, BJ EVERGREEN ELECTRICAL CONTRACTOR 15118 SW KENTON DR 23861 SE 442ND TIGARD, OR 97224 SANDY, OR 97055 Phone: 503 - 620 -8730 Phone: 503 - 668 4608 Reg #: LIC 136311 ELE 3 -472C FEES SUP 4581S Description Date Amount Required Inspections [ELPRMT] ELC Permit 9/29/2004 $53.50 [TAX] 8% State Surcharge 9/29/2004 $4.28 Rough - Elect I Final 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 o I ©R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6 9 or 1 -800 -332 - / / Issu d By: ,Q Permit Signatur.�! ,A. y ! � /t��' 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 I STALL , TION ONLY SIGNATURE OF SUPR. ELEC' . 1 .- _ �� %� �7L4! ' d DATE: LICENSE NO: 5 • I Call 639 -4175 by 7:00pm for an inspection the next business day Ii lectrical Permit : - i i " C gt �°t FOR OFFICE. ONLY CItys6f'i gard A '104 - DDE'E 9 A-9 417 Permit No.: 6 p 13125 SW Hall Blvd., Tigard, OR 97 `•11 T V L P �`� ~DO Phone: 503.639.4171 Fax: 503.598: .1 4 t-7 ,4 :11;01' Date/By. Other Permit: Inspection Line: 503.639.4175 v - r1G AF}p 11.!. D a te ReadyBy: ®See Page 2 for _ Internet: www.ci.tigard.or.us GVVY 11 n`v 1 5►10(J Notified/Method: 'T ( / Q • Supplemental Information r `r.:54 „ �.- ` , # a - e.;: : , si . era ` i 41,44 8 , .- _ rg:, -- ;� f , �.✓. 5 ;,, .,.. -. ..r T �, . ' ,�, 4 - ” o �. .. ';_:�' . � # � .d- ;a:s?5., ^s+ ,,'�- C- ;.�fifi�C �.. ��"a•*s•.:.P."r.'i- "�'35,:�4x. , ..•.,s.�`, _� _. . -.. -m_ . 7 _ ... ,`¢-, _. -. • - ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location a . � _ sA _ v ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., "".' sue 0 - 8 , 0 iwtf - .+.. - Aref ;V ,x,, "'•s , �� 4. ' g* ,: ,; i . i' v of 1- and 2- family dwellings 4 or more new residential and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi- family ❑Master builder ❑Other: OBuilding over three stories OFeeders, 400 amps or more ❑Occupant load over 99 persons ['Manufactured structures or 1 ¢ < .0 i - . ' ' - T I - "!.... , � . aIi _ : ' - , , � , Iw t .a ' . .� w,, . ❑ ` Egress /lighting RV park Job noon -/ � /) I Job site address: 15 I [ 0 S� 2 �1 ❑Health -care facility ❑Other: t� Submit 2 sets of plans with any of the above. City /State /ZIP: The above are not applicable to temporary construction service. a r , *Y ,sz=: ' k its ±YN_: ' . Suite/bldg. /apt. no.: I Project name: :...E3>P - _:' Description J Qty. Fee. Total l ,. 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: I Lot no.: Ea. add'l 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 ,. � c 1 ' -„ , P ` ��_ t.; ; 4# Each manufactured or modular � j dwelling, service and/or feeder 90.90 2 1 l /► 1 \l�Cl Q a— V�� l ] uCJl1 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 , i i +w ,X 1a 201 amps to 400 amps 106.85 2 401 amps to 600 amps _ 160.60 2 Name: bve:C' 601 amps to 1,000 amps 240.60 2 Address: 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 Phone: ) (j— c`i 1 `C I 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 ` w> 5 ;"` j A. Fee for branch circuits with ,X- zy.F . J9 P Y 1 `� '� "- # a '`` "`�'' serv or feeder fee, each Business name: branch circuit 6.65 2 B. Fee for branch circuits Contact name: without service or feeder fee, i each branch circuit 1 46.85 1 + ,0 2 5. 2 Address: Each add'l branch circuit 'i 6.65 &os 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- t::::::-I,•-f. t , ?IV" s 3 . f , 4 energy panel, alteration, or . - extension. Describe: Page 2 2 Business name: F r'P!P.J'� F e 1L� . Address: 0 ` ) - 1 A_, Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Ce_._ GilbSS Investigation per hour (1 hr min) 62.50 Phone: ( 4) apt- 6 Fax: ,) e %- C.);Og, Industrial plant per hour 73.75 2/ CCB Lic.: I - 3 1 ( Electrical Lic.: --41jC, Suprv. Lic.: L jgt s Subtotal SI ,O Suprv. Electrician signature, required: - Plan review (25% of permit fee) Print name: n • 1 �Datt. _(1 , .. State surcharge (8% of permit -fee) � 1 TOTAL PERMIT FEE ..-- . Authorized signa P ( `3` ► This permit application expires if a permit is not obtained within 180 i � t days after it has been'accepted as complete Print name: 01.;+11%` Date * Fee methodology set by Tri- County Building Industry Service Board " Number of inspections per permit allowed. i:\ Building \Permits\ELC- PennitApp.doc 12/03 440 461 5f(10 /07JCOM/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: ( ' 3) 639 -4175 INSPECTION DIVISION Business Line: • 03) 639 -4171 MST BUP Received Date Requested l — Z Z AM PM BUP Location 1 ( T Suite MEC o 90 C — Z) {e Contact Person Ph ) PLM Contractor Pr' ( ) SWR BUILDING Tenant/ wne' ELC e2 CI" 6 0 �aS� Footing — F73 ELC Foundation �, Ftg Drain Access: `' 4 / t"��55 � Lf — " � ELR Crawl Drain l 7 �: ,' /_ . t _ Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear A �� �� a • 1341< g -- ) Framing �J Dry ation .L,�®� U ) �I � C i) T A/ VI P/3 /TV / 1 Drywall Nailing Firewall Fire Sprinkler Fire Alarm -® "istE Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING, Post & Beam Under Slab Rough -In Water Service Sanitary Sewer • Rain Drains Catch Basin / Manhole Storm Drain CT 417" Shower Pan Other: • Final PASS PART FAIL MECHANICAL. Post & Beam Rough -In Gas Line Smoke Dampers (11 1 V - 0 0 *ART FAIL ECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm PASS ART FAIL D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date G 20* - ® Inspector / l Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL