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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00349 4 ' f DEVELOPMENT SERVICES DATE ISSUED: 6/13/03 ' II - 13125 SW Hall Blvd.. Tistard. OR 97223 (503) 639 -4171 PARCEL: 2S112CD-07800 SITE ADDRESS: 07595 SW ONNAF CT SUBDIVISION: FANNO CREEK TOWNHOMES ZONING: R -7 BLOCK: LOT : 001 JURISDICTION: TIG Project Description: Extend 220amp line to outside wall. 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: 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: MARK PLATT 7595 SW ONNAF CT. TIGARD, OR 97224 Phone: 292 -3259 - - Phone: 503 - 704 -0734 Reg #: FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/13/03 $46.85 [TAX] 8% State Tax 6/13/03 • $3.70 Rough -in Elect'I Final • Total $50.55 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 UNC at (503) 246 -6699 or 1- 800 - 332 -2344. Issued By: . ,10 . 4, e ,, e il i 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• ' DATE: LICENSE NO: d l,c1Yl 0) Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application FOR OFFICE USE ONLY Received Electrical ��11 DateBy/ /3 -03 7..)-1P Permit No. — 9 -005V? City of Ti and Planning Approval Sign g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: - Phone: 503- 639 -4171 Fax: 503 -598 -1960 taiar Post - Review Land Use �+�itr Date/By: No.: Internet: www.ci.tigard.or.us ■ eel I Contact Juris.: ® See Page 2 for ^ 24 -hour Inspection Request: 503- 639 -4175 "" Name/Method: 7 Supplemental Information. TYPE OF WORK PLAN REVIEW (Please check all that apply) . ❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility Addition/alteration/replacement I ❑ Other: commercial Service ❑ Hazardous ❑ over 320 amps - rating of ❑ Building Building over er 10 10,000 square feet, CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in 1 &.2- Family dwelling ❑ Commercial/Industrial 6 0 System over 600 volts nominal one structure ❑ Building over three stories ID Feeders, 400 amps or more Accessory Building ❑ Multi- Family El Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: JOB SITE INFORMATION and LO ATIQN Submit _ sets of plans with any of the above. / OR The above are not applicable to temporary construction service. Job site address: _ ,f" / {ON 0'A/ A 6 -/, FEE* SCHEDULE Suite #: ---- tt Bldg. /Apt. #: Number of inspections per permit allowed Project Name: ? Description I Qty Fee (ea.) Total Cross street/Directions job Slte' New residential single or multi - family per 6 f b GG �f 7� dwelling unit. Includes attached garage. Q tl,7�fj KJ t/ ' Service included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: I Lot #: Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling ION QF W C � , ` service and/or feeder 90.90 2 — fiyt.fL_. , yt { � J j /r � , � , � Vlr_i ces or feeders - Installation, 2-O v alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 - a rne: RTY OWNE J�NANT 601 amps to 1000 amps 240.60 2 , � j � Over 1000 amps or volts 454.65 2 aide: /' L ' Reconnect only 66.85 2 Address: 7,(Q �W 0 4-7:7" Temporary services or feeders - installation, City /State /Zip: OX 97 t' alteration, or relocation: e� x 200 amps or less 66.85 1 / Phone: so 7. Ned 07,�11Fax: ,13, 69V Ts Q� 201 amps to 400 amps 100.30 2 401 to APPLICANT ❑ CONTACT PERSON Branch 600 ch amps 133.75 2 circuits circuits -new, alteration, or Narne: -d J / �Q - "" Q I/• 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 service or feeder fee, first branch circuit / 46.85 2 Phone: I Fax: Each additional branch circuit I I 6.65 I 12 E -mail: Misc.(Service or feeder not included): CONTRACTOR Each pump or irrigation circle 53.40 2 1 Each sign or outline lighting 53.40 2 Job No: • ©(p) N1 Et , Signal circuit(s) or a limited energy panel, Business Name: alteration, or extension Page 2 2 Description: Address: Each additional inspection over the allowable in any of the above: City /State /Zip: Per inspection per hour (min. 1 hour) 62.50 Phone: Fax: Investigation fee: CCB Lic. #: Lic. #: Other: Electrical Permit Fees* Supervising electrician Subtotal $ '{(o -SS signature required: Plan Review (25% of Permit Fee) $ Print Name: I Lic. #: State Surcharge (8% of Permit Fee) $ 3./6 TOTAL PERMIT FEE $ A Jab Authorized �A ? /' Notice: This permit application expires if a permit is not obtained within Signature: v V /i ? Date: 6'LJ — V� 180 days after it has been accepted as complete. 1 /fie N- / A7r *Fee methodology set.by Tri- County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: Audio and Stereo Systems D Burglar Alarm ❑ Garage Door Opener Heating, Ventilation and Air Conditioning System ❑ Vacuum Systems El Other COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: Audio and Stereo Systems • D Boiler Controls El Clock Systems D Data Telecommunication Installation E l Fire Alarm Installation HVAC D Instrumentation O Intercom and Paging Systems ▪ Landscape Irrigation Control El Medical D Nurse Calls • Outdoor Landscape Lighting ▪ Protective Signaling O Other Number of Systems * No licenses are required. Licenses are required for all other installations i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business 'ne: (503) 639 - 4171 MST BUP Received Date Requested 6' / G'3 AM PM BUP Location T S9 1MC 4Tiite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC 2to3 -D o 3' Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes:. SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall «t F 44.4 Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Le-tie / ." 9‘. �l / 1—‘-.1 Other: Final PASS PART FAIL - PLUMBING G✓t' Post & Beam Under Slab Rough -In 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 P IL CTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm ina ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. tar, PART FAIL El Please call for rein . ection - • Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector i� Ext - tie Other: Final DO NOT REMOVE this inspection record from_ Jo b site. PASS PART FAIL