Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00956
7:1 DEVELOPMENT SERVICES DATE ISSUED: 12/14/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S125DD-04000
SITE ADDRESS: 09845 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT : 048 JURISDICTION: TIG
Project Description: Gas furnace
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: SIGNAUPANEL:
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:
JAMES B. WILLIAMS BEN'S HEATING & NC
9845 SW VENTURA CT PO BOX 80607
TIGARD, OR 97223 PORTLAND, OR 97280
Phone: 503 - 293 -9408 Contact #: FAX 503 -651 -3345
PRI 503 - 233 -1779
FEES
Description Date Amount Reg #: LIC 64597
[ELPRMT] ELC Permit 12/14/200' $46.85 ELE 49LHR
[TAX] 8% State Surcharge 12/14/200' $3.75 SUP 531LEB
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: /R A%) /3 444_0c g._ Permittee Signature: J EE 4 PP_ / co¢j /O &j
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.
DEC -13 -2005 08 :17 AM BENS HEATING 503 651 3345 P.03
EYCctr�ica1 Perms A,p 1 ^artj, n ; i IT-7 r ._.' - ,,,-..,..-, ,„,-,. ',, r
1'(llt t 11 1.1t 1 ti,sE t) N
City $4' T� and $
4
13125 SW Hall Blvd., Tigard, OR 97223 Rc : L —/J -O5 es; Permit Nod L 20,95 73-..
Phone: 503.639.4171 Fax' 503.598,1960 � . . \ pla Review
Other Permit
Inapechon Lino 503 639 4175
DEC 1 20 � .. � ' t ' �� � i _ . O siers Read
e ady/By:
not w ww et hgard or us Notiife Mill Bee Pano 2 for
d/Method; r�(�#
1 , 1 „ >r" supplementai information
y1�€;u ,T,,, � { L � p L iy
o- � i� 111] Sit VG:r. VV',IIj i 11, i) r . 1 , , 1 � i , i 1 " 1(f1l Ili l ' -'" J I 0 " 7,7 ' d�[ � • 1 1 ,) r1 f 1r•); +'r " :,yJ Ii.i..'S , • ? ,., N ,,... e' rr ; a Y ,7 .. ir r l ,r u • • t
}. r..: 57 .n „ ,... , .,‘. ,6, .:-.. : v n, IL. IF v 'r l'T_� IY'� ,J' k�Ftll a�ly!.�. �'t +' }(4 } i �ll't �l lT � l J, 1 .i . I ' I , . , �;; ',.
El New construction � , , � ; �. ut.i” ,�., � 1. q _.X� �cl� t«�fihr��iiiP�' ' I�..,ar���'��' it
1 t77 igliP _m>/ p ! Please check all that apply:
Ej Demolition w Other: []Service over 225 amps, comrn'l ['Hazardous location
�rR,S',' �1pii, t ar �� 1 F ' l 1 11 l i , 1 ' I ' Sai l ,` l et tt • rr.r. 1 if : • t,, ( ro '; i A t , ,r if .J 1 1 . , � „ ' 1 �3 in ; : : f i, 1 El Service over 320 amps — rating ❑Buildng over 10,000 sq. ft ,
3;5I, n 1 .,, yi I „s,.d!iI..F 11 .� }_a . 1w:' { „1 , i.Mf i e 1, , ` �,L.t i�; lli ii of 1- and 2 -famil dwell
. x�r >, ,,r � ,,, L t e�,.:: „��; r , �,,_ y dwel lings 4 or more new residential 1.! 1- and 2- family dwelling [l Commercialhndustrial ❑ Accessory building ❑system over 600 volts nominal units in one structure
■ Multi family ❑ Master builder 0 Other ['Building over three stories [Weeders, 400 amps or more
y 1 ', . yi t , , , , , , , ,:.-,, , ,-,. )r c,,!r,,, .. r ,, ❑Occupant load over 99 persons ❑Manufactured structures or
l :'1 il ,1 ' , 1,1 .', 4. il 1 �i �. , � 4 /1 , 1I 'I I I l 3 1 , r t; : t 1 � S J V. 1 '+ i : 1 f r
a.l,i i ,. _ ,. 1 ,-'4 't,_', .a...:, I Yr h . e.. ,c t "., 1 11 3 � i ;i l, ' S %6`t j ;-:.t ! ‘. l ❑&
'j s / lightng plan P V park
Job no.: Job site address: 9 A ..n ? „ ❑Health -care facility ['Other:
Submit 2 sets of plans with any of the above.
City/ State/ZIP: 'Tr OR , Q 3 The above arc not applicable to ter
-1 � -'•, q " r pP f �.i itt t lr .Y !I g or any construction service
Suite bldg. /apt. no Project name: i ,' N` . ; ::Ai:rt..�P'lil GV l ij,i Oir aw1r�
Ducrtplioe Qtr. Few Toml *'
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: Lot no.: Ba. add'l 500 sq, ft, or portion 33,40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
I � , � i
I I ,) tr : ii F Q ,pp" 1�1 r S ➢ I d� , 1 111 I i Y ' - � ,qs R + I!' t , Limited energy, non- reeidcntiai 75 00 2
I8j a !e ! /4th .14 it1. 0--1 . I1 1Hr i f,!ft _!? . . , ,,: 1 P i , .!l S . fi i [ti, .1 41J 1:' l nr t.,�
..�...a.., _��..,. 11J. .,t,.s,,'I°�W��I_t!,, E ach manufactured or modular
• 6): S,1 �,�� dwelling, service and /or feeder 90.90 2
Ch �,
Services or feeders Installation, alteration, and /or relocation
1 200 amps or ices 80.30 2
t ir i'9S�i ' 1141,[ is ,i. lit , i1 r1II1 II a a i t Y IV i i,:,: D�1I,nifir fgr9 ,;'C 1 1 1r:-`•' 201 amps to 400: .. 106.85 2
.d � 1 rt %.'1t +.,311 : , 4n '' li (.' ..�'!k � �;Nh ', .e"d1 .. 1: rrt!/ .-'. h , _.... J. _ ...Twi ( ,I l , ".`r,1i
401 amps to 600 amps 160.60 2
Name: a 601 amps to 1,000 amps 240.60 2
■„ Jress: qQle “) w�.Ot
vt Ci Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: 1 G. q, a. 4 3 Temporary services or feeders Installation, alteration, and/or
Phone: & )J 49 3 - e I Fax: ( ) relocation
epilog, 200 amps or lass 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 1 1 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
Lri I , }1 I 1 - I S r 7,i i i -,SI r I � ) I J ( { K } .;:r7.).:';':.'".-.. . 1; A Fee for branch circuits with
. hula ,1 Il...; l i.:2 t. „ 7 1 - i' ∎, :0: ,I, .Ai J. , yI- J t,7gi " 1.;.;')1, ,-,
service or feeder fee, each
Business name: branch circuit 6.65 2
I B. Fee for branch circuits
Contact name:
f....., I.
without service or feeder fee, / 46.85 2
Address: each branch circuit
Each add'' branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: fyv .. ) 313, 3 fig 0 Pax. : ( )
Pump or irrigation
tl i ne lighting L 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(a) or limited-
L�!_ ib�il111.:,i: �1 .5 i ll. .. .,,,. P,-. + r , Il�lf'i 'i ,l h,t., r �i. ll I!`r'ht6i ?'' l;II rl rl t.hilA,.,, � t � etosi„ Descnbe
, or 2 2
I s } � • �l. i,:�. ". 'I ex to . Page
Business name; a _-
Address: Q �9 ®6O Each additional Inspection over allowable In any of the above
J 7 Per inspection 62.50
City/ State/ZIP: Di o k (,I -7 k irO Investigation per hour (1 hr min) 62.50
// � V( �� // Industrial lant per " h p our 73 75
,-
Phone: (CP ) a Fax (a03) ��r' '1'G'l1� " ('r n •�1r cIi S � v - � �' i NL . I {) 1I . I �•l }' ) .1 t t11,1 Ik i7ii1
1�.'rl:l G11. ., 11 ....,. IL � '. h.l .• r
Electrical Lic.: i • k i Suprv. Lic.: Subtotal , •
prv. Electrician signature, required: Plan review (25% of permit fee) not name: 111.i AO State surcharge (8% of permit fee) 3 . � ,5
�
TOTAL 1PERMIT FEE O ,tic e
Authorized signature . � This permit application elrptrel if a permit V not obtained within 180
•ra( d _ � days after It km hose auepnd ae co mplete
gi
Date: • Fee methodology set Oy Tli•Couety Building industry Service Board
•• Number of inspections per permit allowed
rl BuildlnalPer ,dts\BLC•ParmItAppdoa 12/03 440- 461sT(le/02/COM/ BB