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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00544 DEVELOPMENT SERVICES DATE ISSUED: 8/1/2005 rc1 �I ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 CA -05400 SITE ADDRESS: 09460 SW LAKE SIDE DR ZONING: R -7 SUBDIVISION: SUMMERFIELD NO.12 LOT : 674 JURISDICTION: TIG Project Description: Panel change. Job No. 1456 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: 1 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: JACK HAMILTON KELSO ELECTRIC INC 9460 SW LAKE SIDE DR 545 SE 3RD TIGARD, OR 97224 HILLSBORO, OR 97123 Phone: 503 - 689 -8905 Phone: 503 - 648 -6360 FEES Reg #: LIC 116254 SUP 4270s Description Date Amount ELE 34 -43-43 3c [ELPRMT] ELC Permit 8/1/2005 $80.30 [TAX] 8% State Surcharge 8/1/2005 $6.42 REQUIRED ITEMS AND REPORTS . Total $86.72 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 suspend: i or mor- • .n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules a - set forth in OAR 152- 001 -.e: 0 thr• -• h 9AR 952 - 001 -0100. You may obtain copies of these ru s or direct questions to OUNC at 503-216-6699 o 1 -800 -3 2 2344. Or Issue By: ' , +6 - - , - d . A,i Permittee Signatur 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' %• iii' ' 6-t- DATE: LICENSE NO: •g70 _ _ _ _ _ ___ ___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. FROM : KELSO ELECTRIC INC FAX NO. 5036488211 Jul. 29 2005 d1:05PM P1 .r r' —. Iec -, p5 t r� Ca� P� tit Ali u at.o'It �p t►ic011ll'Ii;.�rsi.: < >.��.�• City of Tigar Test IY OF I - O N Piu m A,provsl , ! 3 lin tN Go�,�S' I3125 SW Hall Blvd. Fortin I ∎I Dude . • xr ft N..: Tigard, Oregon 97223 gU1LD Plea RsviCw •they liPirrffe ?bone: 503- 639.4171 Faye 503. may pafmltNo.: f 598.1960 PooRsview Lind Um 1 !Homer www.ei.tigtrd•ar.us . t ! , oeraray: ;Ho ono,: 24 -;hour Irspectiou Request: 503 - 639 -4175 �` ' I •'�� NOiuR 7u • .: 0 s.e Per - . • - tmcat•i Inlartus�ioa, i - :::, ..:.. "- 7. I! ■ Nacz construction 1rD o i� :,`:r; *' ;`ill: ;t..;`> ' ?'' .r'ii�alFI3t.�1i• ! •,I #flach�ck'A111tkati;i i li De>aOlttion • Scrrrtop ova 23.5snips- ■ califs- tare fYcflity Adcit -lacement IN Other: °0r aitssr • Hazardous In:skin q '`.:r = + . s.•R}c: I CON a a > ❑3etvico ova' 3;0utm -rating of i Buildfn • �, f r •r: ' U ' ' 1 ;411 1 do 2 > ltttil +el , 8 0` er 10,000 squat i cct or V k • I & 2•Fami] dwelli-r ! • Commercial/Industrial system cver dvi four a nyl�nrirl ur;� to trill Y 60p roles ran one arrucrurc i ii ACLC3SOZ V )31ti1t1SA = L Building ever three atoricc U ponders, 400 11111L or more (r Multi -Fami1 ?r1E5tei Builder Oceupa,u load over 99 persona mtt ufactiired aeucturar tv RV 1� Othe 0 Efrcu/Iiihtingpion ➢" -k 'JOB . Cl Otttor; . RMAZZOK °'' ;I! +;, Submit Antiofpiruswith artyattbeabort. Job sire address: . ; Thc above a hot (( r pp tiie � ss bletotom y 4 r conrtn+ezion .ervicr. Suite n: � .. \ _ • I. .y, .R... :. .:"!? 1,; C r {': B1dg.JApr, #: _ A>TLNr'; a :. Proj eerNarne: j-71 f�,�o�} � :lots Kumbsr oCinr•tetioa� cr•prtnit Cross Set! job Now ta i tai - limit or tours r umay per Qty Fu Oa.) Tani t/DLTectlons to o b S + T dwaliiaQ unit- Intiuda 'aided grtrsQe. `S) 3wlu iasiadads 1.02 .. tt or 143,17 • t* 4 0•4 . St:;;d- i<'is1On: L ot : i trn # e q tram, warn • �� o ��E� Tax e/ creel #i: LimRiSt rtti�. rerl6�nri�J 75 .00 } � Lich mtallfs tad Inn or modal" dv ellin >PT'O�EnF WOR�E's =``t i " {•t.•F: ureiceand/Or feeder g 9 .90 2 semi oomxfeodars- imntllarioa attsrgtba or Nastiest 1•r — • �`•w ..� 7 - 200arn• caress 30_30 ‘• � 2 i0 i • •�'`i�I'EF2T ! • ,� 401 am. ro600 4 a loC�13 �© 6®TE3y t1TtN,. tF .-: �, , ,i — U ;`ia,7te: / • er70 or valb � �� 16060 ivA i Address; RC0040•ctonY 66,65 TCmDariry act'vicca or frxdon - Inr#allatio a, GI /S1 atWZ? • : attention or telacution; ;CO MD* or tote 66.83 1111 ` Phone: 1-- ``l Fax: 2.1 ar+r. • .. ors., , i•,rx'::isx:i; ;, ®iO0,N•'.T.,A T.1-p. t,Si7NA! r.'t. 422 to600 loa3a ;V3Q1G: B nadB cltcrritr. stew, aitertttes or astsasiaa per was r Address: A Fee for bmtit circuits with lourrhssa of 1 Ci tv!Staie /2i ip Ylee or focder fcq vac) br+netr circwir .. 6.65 1 r D. Far for branch circuits without purchase of Phone: Fax: :a s , .J, r.. yr, * Miaat 5arvioa or revise not 1;144 6.63 111/.1.14 •--- ' - _ ' 'r .: �= ' `. CC6iTRACTORr. : , _ - :r : Psch . ..' ., . •t: >:::; ... -.;. .or frrf • nett+de Job „o: s?.ao N. Eaoita 6rovl, t i ., r , 53.0 Business Name. i _C d /,t l � ,: I Address: �4 `?i�-D . -- zs,•� 2 Ci /Staze/Zi.: i. trap G � 1 tacit aiellltional tes•salon over the at{ewabit io arthe also , ..s: Phone: , - .,... {��►� 1, / , t 'NT Ipahour -rein. 1 hour) � ' r 30 CCB Lie. #: �� _ _ - Liu. #: _ � ..L _ J� �1co Supervising electricia>1 . 3t� ',�!� 1,:�',;;3`;�': F t si y` 4<i' �. �:y i:•ctiic�i to * s ::; :N:� ; • •rule re.uir Su -to * s1 s • Print Name: a , _ _ '3 L. 04: 3 r-uriorizid TOTAL PF.RMTI• FEE �y - - -- -- — siyaan.Ke: tam . . t7 ACoticx Thia-patrak applicatiotre.npirisilf a perralt is oat obtal acd wuhia In days sitar It has been aowptatl as complete. (Plsus print ma* 'Foe tartbodm alo set by f'rl- County nulidlag industry 84 goerd. • • ribrv.l r r Jr, Y T T.. 9 11 11111Y OF TIGARD &- BUILDING DIVISION PERMIT #: EL:2005 00544 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1 /7.005 Phone: (503) 639 -4171 i _01j�iig l 6llIIII- Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/4/2005 TIME: 7 :08AM PAGE: 87 SITE ADDRESS 0 460 SW LAKE SIDE DR CLASS OF WORK: SUBDIVISION: MMERFIELIJ NO.12 LOT #: 674 TYPE OF USE: • PROJECT NAME: HAMILTON DESCRIPTION: Panel ch tInge. Job No. 1456 ' ��,� l ci'3.32 /"O V OWNER: HAMILTON, J . K PHONE #: 503 - 688.8906 CONTRACTOR: KELSO ELECTRI NC PHONE #: 503 -648 -6360 Inspection Request Scheduled For: Date: 8/4/2005 Pour Time: Code # Inspection Description ' onfirm • Contact # Message 115 Electrical service 0 ' 7T 11 503 - 648 -6360 N 1 °1 F • Corrections /Comments n structions: 'P Mkt L P b; 0 " .ci -yn.`V ill c rL >A"CT t1/4\ ` "N I S ; (), (),e P kt o -PASS ❑- PARTIAL-APPROVAL 0- CANCEL ❑_ -NO- ACCESS El FAIL ❑ C OR INSPECT ri ❑ ADDITIONAL FEES ASSESSED a7 Inspector: / Date: r , 6 Phone #: (503) 718- 2A 4 6