Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00303
DEVELOPMENT SERVICES DATE ISSUED: 5/26/2006
"f I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S134DA -03000
SITE ADDRESS: 10600 SW NORTH DAKOTA ST ZONING: R -2
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (2) 200 amp services. Job # 958.
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: 2 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+ ampNolt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KENNETH PATECKY BOONES FERRY ELECTRIC INC
10600 SW NORTH DAKOTA ST PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 - 682 - 4936
FAX 503- 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
[ELPRMT] ELC Permit 5/26/2006 $160.60 LIC 88482
[TAX] 8% State Surcharge 5/26/2006 $12.84 SUP 4918S
Total $173,44 REQUIRED ITEMS AND REPORTS
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: sQ{� c1(,
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.
iIMay.26. 20069:57A BOONES FERRY ELECTRIC No. 1654 P. 1
1 �,C�tlUa
•• ' City of Tigard
, 43125 SW Hall Blvd., Tigard, OR 97223_ ��R OF! if F' j'SF UNL \'
Phone: 503.639.4171 ECEIV D ee . ,
!n Pax; 503 ,598.1 Dew j��
Inspection line: 503.639.4173 ba vie � ` 1 ` `I l _ I
a
.,: - ►carnet: www ct.tigard onus ' .l ._ ?j,.. I: -- 0,4 " r, 2UUr Date Read /B : Other Pertain
�'r I rho
❑ New co r r . r' `, 4' i { I s , N o I th to Seepage I for
❑ Ne construction A• •1171 Ir i_ ,u ,,, .. , ,I ' `iV'!', , ' � ;.,.� :' ,, --:,•,-
' ( f -. 7 '!,. '., . Supplemental Information
Demolition Ot. 1u �, ent < ,, „ p�: n i r i h•
„ T er I Please check all that apply:
I ' T - r ` t 1r '� : ^` ` '• '
I� c ,� � . t � ,, � I":1,'-'.''' i ` .. � ° k , vice over 225 u
• 1 - and�_f• ' ,r l 31 , .I , I , U , {! . + � ., r 9, „ amps, comm.! ❑F(QZaidOnS location atnrfy dwelling °: ❑ Cor'''atier•ctal/ladua ' " ? ' /1 I' I, , t 'l ❑ 1- aer 32
(] Multt fanitly �� ❑ Accessory Se o over amps - rating 1- and er 3 2 y OBuildng over 10,000 sq, ft.,
I In Master builder n' building • !
❑Srst over volts nominal units 1 dwellings 4 or morn new residential
❑Ot 600 " vas structure
J. I
! c Y { ❑B uilding over three stories m
Job no.: 1 ,, ! ; u u li i ! i ' I , , ['feeders, a
9 S • r ❑Oc teagni load over 99 �� 400 amps or more + g Iob, site address: /p 64 S yr No r `' Li Occupant load
lei 9 persons ❑ Manufactured structures
City /Statel2lP .fit g p RV park c4ares or
�r . p.. 0 VA° fa L 121 ❑Health. facility ❑Other:
SlritelbldgJapt. no.: I submit nets of plans with any of the above.
Project name:
The above ere not applicable t
e o
Cross street/directions to ' P� �` 1c.
I temporary construction sere`
L , " '' : ' t . t � a service.
fo site: : 1 , I' 1 . , I ,5','7‘:',.7:-Tr f ,{ 77,C4`71,-5;,7`.7
Detstiptlon i ' ,nix . . r;:x -��
New residential ' � • -•
�
•
Subdivision: Includes attached or multi - family dwelling unit. c
ttached garag
Tax nip/parcel 1,000 sq. it: or less
I r no L ot :. no.
• Ea add'1500 sq. ft, or portion
®` 4
' ,! 7. - I 1 ' , It , ,,� , r u Limited energy, residential 3340 1
SC�~1Ce� C�a : y ' - ; A [ :I; ' S1rl ,'.' < r. ` :'v • , 1 'i \, ,f t,i;.f. Ea anuf _ 75.00 Z
c _ �� `d. Cr' I '.1 ;,;Y r, [ energy, 75.00
f-0 . � Ea ch manufactured or modular 2
y f�c) s -� r • II dwelli service and/or feeder 90.90 2
! ; • j
Services or feeders i •
, { Ser installation, alteration an
Name: I' ` ! ' r I it ;' "I, ` j ' Tr! , , . ar►Sps 01 1eSg door relation
• ` 201anrpeto400amps ® Ili 80.30 Mill 2
ldre I "` 401 amps to 106. _
_ 6 , 0a m ps 2
City /State/ZIP: 601 amps to 1,000 amps = 160.60 ME 2
Over 1,000 amps or volts 240.60 2
Phone: ( ) Reconnect only 2 •
Owner Installation: This ins is hei 1. Temporary services or feeders Installation, 2
attended
relocation
stailatioa, alteration
owner d far sale, lease, rent, or exchange according oo ' OR. S 44 that I own which is ht 200 amps or less 201 amps to 400 a • s 100.30 � ' and/or
Mature 8 to ORS 447, 44 9.670. and 7th.
1 . ., , , , 401 a.
l , I Date •s to 600 amps MOM 2
Business name. ,ti? i , ; ti I , si r ; ; *"` �. ; � e: } � L a ;4t ,' t ii'��I: Branch is - new, alteration, °r extension, per panel
ame: i
servce or feeder fee, each
• Address: branch circuit .
B. Fee for branch circuits 2
C ity/State/ZIP;
/gyp
• without service or feeder
• • each branch c' fee,
Phone: (
Each add'l circuit 46.85
i (service o branch circuit 2
E 6.65
rY Pump or irrigation on r4 r feeder not inUUded) 2
rrcle
: Y , ; ,; :;i ,, 1( (, , I a ■ Sign or outline l• 53.40
Business name: E �I'i� ti + t, l f lighting _ 53.40 2
err Brier al circuit(s) or limited- 2
BOO es I' + :,1 r L `:Ui I ' i;l 'f,:
�ddre6s: P.O. t?C C extension.
0 ' OX ' 2 8 extensio. D l; alteratioh, or
•
qty /State2 Describe:
Each a Page 2
�' W ilson#rilie OR 9 7070 dditloaalInspection 2 •
Phone: (g 3) I over allowable i a an of the above
68 -4 I
Per on
Fax: (503) lnvesd
CCB Lic.: 8 8482 6 8 2 —7 9 i s��in Per hour (t >s teie 62 MN
4 6 � { Industrial plant � � 62.5
e, rPiy. Bloc r - Pant erhour _
Electrician signature, n4Wted: ,rr� ' X 11 ' -- 31 �� �� 1 l ie,' - i , r -
'_`r name: �� =.vii -.' � J ' i' fi fr - , ,,_!!
ti:.l �; �! FRC ;t
•
Su total 60 0
Authorized signature: H EI R E O A Da I Flan review (25% of
�� Permit fee)
l State surcharge (8% of
•
I:�a„tu Date: Title permit a TOTAL PERMIT FEE . / 7 S . y
•
d � C -P° PD.doo t • Fie ream d y t cabs expired t beef a p s e+mit is not obtained within 180
•. F1,ue6er °dotogy sat bY'IaR -Comev a ed at complete
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006.00303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/26/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 :tale ..
INSPECTION WORKSHEET FOR DATE: 6/8/2006 TIME: 7:03AM PAGE: 77
SITE ADDRESS: 10600 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PATECKY
DESCRIPTION: ( 200 amp services. Job # 958.
OWNER: PATECKY, KENNETH PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503 -6132 -4936
Inspection Request Scheduled For: Date: 6/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 031369 -01 503 -682 -4936 Y
— t aF 2. S>;`RVtc , 0(41.0 < Iy5 1 63
Corrections /Comments /Instructions:
--
I bF 2 .vi Cz .
h PASS A ALA VAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I v e L-- Date: 6' 8.06 Phone #: (503) 718- 21446'