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Permit
` CITY OF TICARD ELECTRICAL PERMIT ae PERMIT #: ELC2005 -00864 i� DEVELOPMEN SERVICES DATE ISSUED: 11/3/2005 '�J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133AD-14200 SITE ADDRESS: 12767 SW SORREL DOCK CT ZONING:. R -7 SUBDIVISION: SUMMER LAKE LOT : 023 JURISDICTION: TIG Project Description: Replace main breaker. Job No. 88553 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: • GREG HERRLING OREGON ELECTRIC GROUP 12767 SW SORREL DOCK CT 1010 SE 11TH AVE PORTLAND, OR 97223 PORTLAND, OR 97214 Phone: 503 - 860 -3111 Phone: 503 - 234 -9900 FEES Reg #: LIC 203 SUP 4460S Description Date Amount ELE 26 - 95C [ELPRMT] ELC Permit 11/3/2005 $80.30 [TAX] 8% State Surcharge 11/3/2005 $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 suspende• - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules a set forth in O' - •52- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of the,seerules or direct questions to.OUNC at 503 -24. 6699 or 1-800-332-; • • . . Issue' By: ` � _� .r! II _ I - - Permittee Signa j ____ -- ! f eb--e--- 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 I SIGNATURE OF SUPR. EL ) % 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. NOV -02 -2005 03:13PM FROM -tl,i� Q f�� ' �' R' Fy�yin �r 5035352763 T -440 P.001 /002 F -007 / L' he al Al 6111116 r '�1,. sr1 11 L. D c ' Cl of Tigard Received 13125 SW Hall Blvd., Tigard, OR 9722 L Plan Review Phone: 503.639.4171 Fax 503.598.1960 u" 1 •+ I �, Date/By: Other Permit; Impaction Line: 503.639.4175 CITY OF TIGARD ► - T 4 � '' I- D ate ReadyBy; h� El See Pam Z f or Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/method: le 3,. Supplementallnformation TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition/alteration/replacement Please cheek all that apply: ❑ Demolition ©Other: ['Service over 225 amps, comm'l ❑Hazardous location ID Service over 320 amps — rating ❑Btnidng over 10,000 sq. R, CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ® 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure ❑ Multi family [] Master builder ❑Other ['Building over three stories ❑Feeders, 400 amps or more UOccupant loud over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV pork Job no.: 88553 Job site address: 12767 SW SORREL DOCK CT. ❑Health - care facility ❑Oth Submit 2 sets of phui$ with any of the above. City /State/ZIP: TIGARD, OR 97223 The above arc not applicable to temporary construction service. Suite/bldgJapt no.: Project name: GREG HEMMING FEE" SCHEDULE _ DvrvipUun j Q. I Fur. I Tate! I .. Cross street/directions to job site: SOUTH OF SW SCROLLS FERRY RD., OFF OF New residential single- or multi-family dwelling unit. - - Includes attached garage. SW SUMMER LAKE DRIVE 1,000 sq. R or leas 145.15 4 Subdivision: Lot no.: Eu. add'! 500 sq. ft or portion 33.40 1 limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular REPLACE MAIN BREAKF,R dwelling, service and/or feeder 90.90 2 _ - Serv'Ices or feeders installation, altcnitlun, and /or relocation 200 amps or Ices j 80,30 80 3p 2 ® PROPERTY OWNER f ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: GREG kHERRLING 601 amps to 1,000 amps 240.60 2 Address: 12767 SW SORREL DOCK CT. Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State/ZIP: TIGARD, OR 97223 Temporary services or feeders Installation, alteration, and/or Phone: (503)860.3111 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 anips 10030 2 intended for sale, Ilese, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Brunch circuits — new, alteration, or extension, per panel ❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with • service or feeder file, each 6.65 2 Business name: branch circuit 13. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46,85 2 Address: Each add'I branch circus 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax : ( ) Pump or irrigation circle 53.40 2 _ Sign or outline lighting 53.40 2 E - mail: Signal circuits) or limited - CONTRACTOR energy panel, attention, or - - - extension. Describe: Page2 2 Business name: Oregon Electric Group Address: 1010 SE 11th Ave Each additional inspection over allowable in any orthe above Per inspection 62.50 City /State/ZIP: Portland, OR 97214 invastigstion per hour p hr min) 62.50 Phone: (503) 234 -9900 . Fax: (503) 535 -2763 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lie.: 203 Electrical Lic.: . - 95C • • . Lie.: 4460S Subtotal go .30 Suprv. E lectrician signature, required ! f �/ - � Plan review (25% of permit fcc) Print name: M Q r 14. S F4 • In e a Date: ' 21 U Suds surcharge (8% of permit fcc) . 4 a TOTAL PERMIT 1�E g �'� a Authorized signature. / This permit application expires If a permit is not obtained within Iute i� • �, / f2 days allot It ens loon accepted as complete Print name: M i 4, a - h e Date; (` ( I b s • Fa mabodoloty set by Tri County Building Industry Se vice renal ! •• Number of jpspeations per permit allowed V (5 A CITY OF TIGARD NI)re S/�ulwrn4 lark -r lootk BUILDING DIVISION ) PERMIT #: ELC2005 -00864 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2005 Phone: (503) 639 -4171 �virt l Inspection Requests (24 Hrs.): (503) 639 -4175 -'-! IL � i INSPECTION WORKSHEET FOR DATE: 11/29/2005 TIME: 7:05AM PAGE: 45 SITE ADDRESS: 12767 SW SORREL DOCK CT CLASS OF WORK: SUBDIVISION: SUMMER LAKE LOT #: 023 TYPE OF USE: PROJECT NAME: HERRLING DESCRIPTION: Replace main breaker. Job No. 88553 OWNER: HERRLING, GREG PHONE #: 503 -860 -3111 CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 -234 -9900 Inspection Request Scheduled For: Date: 11/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 022567 -01 503 -860 -3111 p A A i Corrections /Comments /Instructions: or ......,_ / 4 . SS ❑ P' • IAL APPRO . ❑ CANCEL ❑ NO ACCESS FAIL P ALL F 11": PECTION w , DDITIO L FEES ' •SESSED Inspector: /:‘,41, r Date: // Phone #: (503) 718- I