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Permit 4 � ' CITY OF TIGARD ELECTRICAL PERMIT i1 DEVELOPMENT SERVICES PERMIT #: ELC2006-00514 - *Awl - *Awl DATE ISSUED: 9/12/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134DD-01500 SITE ADDRESS: 11777 SW TIEDEMAN AVE ZONING: R -4.5 SUBDIVISION: LOT : JURISDICTION: TIG Project Description: (1) Branch circuit for water heater. Job # 1546. 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: VAN DOORNINCK, WOLTER H CONDUIT ELECTRIC 6555 SW DALE AVE 19461 SW 89TH AVE BEAVERTON, OR 97005 TUALATIN, OR 97062 Phone: Contact #: PRI 503 - 692 - 1428 FAX 503 - 692 -3652 FEES Description Date Amount Reg #: ELE 26 -905C [ELPRMT] ELC Permit 9/12/2006 $46.85 LIC 109669 [TAX] 8% State Surcharge 9/12/2006 $3.75 SUP 4501S Total $50.60 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:(] j ` Permittee Signature: v, � C , 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. 2006 /SEP� /12 /TUE 10:54 AM Conduit Electric FAX No, 5036923652 P. 003 • • a= Electrical Per A ; ; ? ? $ FOR OFFICE USE ONLY City of Tigard . i f Received r - - 0 . i ,.._11._ Permit 14a: ,..K 13125 SW Heil Blvd., Tigard, OR 97223 - plan Ravi tuber Permit: (A ° 't'' j� . +' I l • Date/BY �v ®. s�,1 :'I Date zieady/By lug: to SeePage2 for Phone: 503.639.4171 Fax: 503.598.1960 Inspection n Line: 503.639.4175 rd.o ` `, Notified/Method ' i J i r , supplriji tol boormation Internet: www.et.bgard,or.us yy "� � �p�� ... .f• 1 4 f�• ' - ; >:. F : :.,,�. _r. . •': ` :� •'ya F .: ::!-:; .: ...tigf of l iirglgi.1��<[n%..V•.'*1 Y.' af:�w l .:'.... ;,5.+',i{,'' P + •^-'-:.Y:;*}:''::• :: ;;j�� ", i ;�, •',^ �,; �•4.��'e''�.a.''';..�:•.' :�!E_ O� OR'�i :i :,�'3t.'e'��., ,, ......� . ............. >..1`�,.�, c +v "cr'�- Please check all that apply: . . New construction CI Addifroh/alt9 ia/replacel ❑ Demolition CI C7tFier• ❑Service over 225 0 amps -ran g ❑Buui dog over O OO.0 sq. it, of l -and 2- : :+, :L it ° " ''"` " ' "R family•dwelhtigs 4 or more new residential ' "r11� :�• " •.i7 'r "> - ''I�11;(s''� $� , Ci' Cj�1S��RY:T��(�i(*l:; "�s ^IL' >' •.�i::;;;';�:: i' 'i ' ,:• ,,' .. , ; �� rr�'•- - �;•:.rr:a.; D� �.� ... : � ti • .. 'v�;- El 1- and 2—family dwelling ❑ Commercial/industrial ❑ Accessory bvildbuilding _ ©System over 600 volts nominal units in or1eSWCtllie []Building over three stories ❑Feeder$, 400 amps or more Multi-family El ❑ Master builder ❑ Otbef: DOccupant load over 99 persons ❑Manufactured structures or r' , � ) ' }` •c; • N}_ !7A • I�1 .r1':'a;r;:;';.'":,,• : •`'' D�ess/ligbttnnplan RV park >E'' "� ";;t"� J; : : :` { i., '•- ",;. r�JO� ._ 17'l; . l.i:[I ti1Q r, ` .,, � ,[ •.t::.,,t.,:.ay : r.:. • ` :•::. �Health� ere facility ❑Other: Job no.: 159 Job site address: 1 I - j `7 1 • - V 0-11 Submit 2 sets of plans with any of the above.. , City/State/Z1P• — r i; • Cn The above are not applicable to temporary construction service. i. ;�r.�.� n;i Ati ..i..• t om*!+'! � . y � .''::".+}$': ,1: tip.:: ,d4�"b•I!:r•. +e:'iY°'"^� :•w.'•_' � Suite/bldg. /apt no Project name: nacria inn I Qty. I trot, I Total I -' Cross Street/directions to job site: • New residential single - or multi•famlly dwelling unit Includes attached garage. _ • • 1,000 sg ft or less 145.15 4 Es_ add'! 500 sq. $. or portion 33.40 1 Limited energy, residential 75.00 2 Limited energy. non- residential 75.00 2 a , c Each manufactured or modular - dwellin:, service and/or•feeder .90.90 2 4 ' I . Services or feeders installation, alteration, and/or relocation - • . • 200 amps or less • . 80.30 . 2 i • sri r.:,, '•Kak:k :t .20 1 amps to 400 emu_ 106.85 2 • �::;" Il;(� ' b ;" r te r. N l i ra ,...e lF��4 8i•. •. • M ....3 � " ti : (4.0.::. ,.... . muy •.160.60 2 P � : �t r I . .r .s.. + . • 401 s to 600 .'�- i:..s;d: r�... L :..: +•:, % T^S�' • • Vii_ ' y'.•' app Name: 601 amps to 1,000 amps 240.60 2 • Over 1.000 amiss or volts 454.65. , • 2 Address: r Recotmect only 66.85 . 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) • 1 Fax: ( • • ) • 206 amps or less .. 66.85 1 Owner installation: This installation is being made on 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: • Dale: . Branch cireuibl -utew, alteration, or extension,. per panel 4.r- • �a +: A Fee for branch circuits with ?' `S�°:� ?; �}►a2�^ ?vr� O r .• » {17t �S:s �?! .....? {t'�'! �.•..Tl , service or feeder fee, PaC _, •- { b 6.65 2 Business name: • • • bradcb circuit .... . .g. Fee for branch circuits' • Contact name: without service ar feeder fee. 1 • 46.85 y =? 2 • . each branch circuit . Address: Each add'l branch circuit 6.65 2 City/S1ate/ZIP: Miisecllaneoosketvice or feeder not included) • • • Pump or irrigation circle 53.40 _ 2 Phone: ( ) Fax: : ( ) Sign or outline lighting _ 53.40 2 E -mail: Signal circuit(s) or limited- • ..•..: �...: .,,.• ,.'; ; an eta tint`;` ` �..:: ;�., ; f::f •,a : Ci7NT1t7► 5''' - be: Page 2 • 2 :,_ � �� „• i'r. ... �':U1<t ; "� ::_s. ° % >.° extension. Desch gn Business name: C nn C J U ' _ ..... _ I Each additional inspection over allowable in any of the above h. Address; 7 i h. - - - Per inspection 62.50 City /State/ZIP: ! 1. n q_70L p� Investigation per hour (1 hr min) I 62.50. . _ _ �CL _ - e _ _ • 1 73.75 Phone: \ � � � - '-L� 1 max _ � /✓ ��� �� i S ' ! *: •:_ .: • ' %: •r' . . , w ;, �•�C.�'�1tMl� DES •. CCB Li 10 -1 3 1 .4 ,1 2 q Electrical Lia: �� : , tv. I na: < Subtotal y is " . d: ' Plan review (25% of permit fete) Suprv. Electrician signature, required: 11, State surcharge (8% of permit fee) Print name: Date: (yu ' - 1° TOTAL PERMIT FEE SD • Authorized signature: This permit application expires if a p.rmlt Is not obtained altbio 180 _ • days after It has been accepted as complete Date: .• Fee metbodolo6, set byTri- County Building Industry Service Board Print name: 1 Date: . •• Number dim per permit allowed. 11nuilen;WUmhsna.c.romi1APP.deo was 44a4disixlWO2/COM/W58 • CITY OF TIGARD BUILDING DIVISION PERMIT #: EL.C2006 -00514 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2006 Phone: (503) 639 -4171 Aso- Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/10/2006 TIME: 7 :06AM PAGE: 60 SITE ADDRESS: 11777 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: VAN DOORNINCK DESCRIPTION: (1) Branch circuit for water heater. Job # 1546. OWNER: VAN DOORNINCK, WOLTER H, PHONE #: CONTRACTOR: CONDUIT ELECTRIC PHONE #: 503 - 692 -1420 Inspection Request Scheduled For: Date: 10110/2006 Pour Time: ode # Inspectio ` -scription Confirm # Contact # Message Electrical final 037918 -01 503-598-6694 N Corrections/Comments/Instructions: (ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G Wkr(61.1 Date: 't f 6 6 Phone #: (503) 718- 1-,IN