Permit ,
it,v CITY OF 'TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -10048
VIP DEVELOPMENT SERVICES DATE ISSUED: 3/15/2006
..v 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S111 CA - 13600
SITE ADDRESS: 09645 SW SATTLER ST ZONING: R - 3.5
SUBDIVISION: DARMEL LOT : 013 JURISDICTION: TIG
Project Description: Replace service mast. Job No. R - 06 - 330
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:
BRYAN HANSON ABC ELECTRIC
9645 SW SATTLER 135 NE 9TH AVE
TIGARD, OR 97224 PORTLAND, OR 97232
Phone: 503 - 639 - 1609 Contact #: PRI 503 233 - 7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: ELE 161501
[ELPRMT] ELC Permit 4/4/2006 $80.30 LIC 26-1226C
[TAX] 8% State Surcharge 4/4/2006 $6.42 SUP 5096S
Total $86,72 REQUIRED ITEMS AND REPORTS
This Permit isissued 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:
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.
- ENV ED
ElectripalVerlmit Apo b :tr1,1
City of Tigard Received ,: 3 S -o Permit No PO I< 70d 0S
13125 SW Hall Blvd., Tigard, OR 97223 MAR 15 201., Plan Review
�,,;, n Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 � ^�iF�
C �Ji Date/By:
Inspection Line: 503.639.4175 7 ITY OF 1 a Date Ready/By ? ' /fr ® Sec Pegc 2 for 1 Nif d/ M hd S Information
Internet:
' PLA R E V IE W
❑ New construction Addition/aIteration/replacement Please check all that apply:
❑ Demolition 0 Other ❑Service over 225 amps, comm•I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
'' ' ' . -..... ' CATEGORY OF .CONSTRUCT ION of I- and 2- family dwellings 4 or more new residential
in••1 and 2- family dwelling ❑ Commercial/industrial I=1 Accessory building ❑System over 600 volts nominal units is one structure
Other: ❑Building over three stories :Weeders, 400 amps or more
❑ Multi - family 0 Master builder
DOccupant load over 99 persons ❑Manufactured structures or
' • JOB •SITE INFORMATION. AND LOCATION ❑Egress/lighting plan RV park
Job site address: ❑Health -care facility ❑Other
Job no.:
(t 3 501 9L0 �/5 � (, J r a � ' Submit a sets of plans with any of the above.
City/ State/ZIP: T: and O q 7 a s y The above are not applicable to temporary construction service.
Suite/bldg./apt no.: Project name ' = . ' ': ''F Et SCIEDIILI a :: ; _:'r.; :• ji , '' .
,
n.SCrti -, Description 1 Qty. I Fee. [ Total I
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'1500 sq. It or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
`' :: • DESCRIPTION OF'.WORK
, .. .. ■ . _
. : Each manufactured or modular
dwelling, service and/or feeder 90.90 2
ed 1 Q s S f l CL /)'lr %J Services or feeders Installation, alteration, and/or relocation
200 amps or less j 80.30 n. 30 2
- :: -. -;• _ ; 'g.PROit.ERT1�',OW,NBR . • . .., .- .. ❑ 7'ENA.NT 201 amps to 400 amps 106.85 2
. . -
401 amps to 600 amps 160.60 2
f j
Name: s r' / ( ., B A 601 amps to 1,000 amps 240.60 2 -
q
Address: I ( 0 r y S-- -- LS i'A � Q.aVarcl eekr. ` 7L Over 1,000 amps or volts 454.65 2
` Reconnect only 66.85 2
�
City/State/ZIP: / / ‘ Al j d ce 4 7,a ...../ Temporary services or feeders Installation, alteration, and/or
Phone: ( ) (0 J % +- / lX 0 9 Fax: ( ) relocation
200 amps or less 66.85 1
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
' ; : , A. Fee for branch circuits with
�r= . ; - I�. : i\PP L 1L`ATIJ'• �; : .. : '.•. � .. CONTACT PERSON p `
� b � ` � c ' ' ( ` branch or feeder fee, each
Business name: h c ircuit 6.65 2
es blanch c
Contact name: (2 C/ ( , (� B. Fete for branch circuits
A 1 ,7�� without service or feeder fee,
46.85 2
Address: each branch circuit
Ea
l 01JJ Each add'I branch circuit 6.65 _ 2
City/ State/ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) I Fax : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limite d-
0 - CONTRACTOR :. energy panel, alteration, or
Business name: r- 1 ; extension. Describe: Page 2 2
C, ., c r c-.
Address: Each additional inspection over allowable In any of the above
I ` ` ��� t• -.L Per inspection 62.50
City/ State/ZIP: - ?mc ` „,_nc% c '70 Investigation per hour (I hr min) 62.50 •
Phone: ( a 5 � ` ' Fax: f Industrial plant der hour 73.75
/ 7 �� ELECTRICAL PERMIT, FEES ,'
CCB Lic.: )(p / SO ) 1 Electrical Lic.949 ./ I Suprv. Lic.)Q G S Subtotal g® ,„3 /�
Suprv. Electrician signature, required: permit Plan review (25% of pmit fee) �/
State surcharge (8% of permit fee) . L/ e-
Print name 17d (4 ) A 1 T) / el /-) Dater / � !„
/ S / 1► TOTAL PERMIT FEE (p W
Authorized signature. T6ts permit application expires If a permit is not obtained within 180
days after It has been accepted as complete
Print name: v tt_n Ni n I Date: j/ c /( • Fee methodology set by Tn -County Building Industry Service Board
/ ** Number of inspections per permit allowed.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #:F1 C -201)6 / o O4-g,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I I
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
•
SITE ADDRESS: [ f 6q[" Scj- - a. _ , 5+ CLASS OF WORK:
SUBDIVISION: l 7 6� �� " LOT #: TYPE OF USE:
PROJECT NAME: ,, 1
DESCRIPTION: /GQ M .S,"f r /RGLu /
OWNER: A PHONE #: 57,3 --.7-33— 75
CONTRACTOR: vt PHONE #:
Inspection Request Scheduled For: Date: 3-21- Pour Time:
Code # Inspection Descri tion Confirm # Contact # Message
/ 1 , (j7-t__ . .
Corrections /Comments/ Instructions:
x PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3 P1 0 co Phone #: (503) 718-