Permit C ITY OF TIGARD ELECTRICAL PERMIT
W PERMIT #: ELC2005 -00409
�i� ` DEVELOPMENT SERVICES DATE ISSUED: 6/15/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
_A ILL
PARCEL: 25111 AB -08800
SITE ADDRESS: 09435 SW VIEW TERR ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT : 033 JURISDICTION: TIG
Project Description: 2 branch circuits.
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: 1 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:
TAKEDO, CHIJO & JENNY BADGER ELECTRIC INC.
9435 SW VIEW TERRACE PO BOX 55446
TIGARD, OR 97224 PORTLAND, OR 97238 -5446
Phone: 503 - 670 -7035 Phone: 503 - 288 -4756
FEES Reg #: LIC 156851
ELE 3-571C
Description Date Amount SUP 4951 S
[ELPRMT] ELC Permit 6/15/2005 $53.50
[TAX] 8% State Surcharge 6/15/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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 14. ti-332-2344
Issued By: Ap / Permittee Signature: ?Ty/ Ce • � ,-;,
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.
'_ ECEVED ,...,
.ft,
City of Tigard Itlyved ii
13125 SW Hall Blvd., Tigard, ORl3 4 05 p,aa Phone: 503.639.4171 Fax: 503) 8 =19 Date/By: I Other Pcnnil Inspection Line: 503.639.4175 _ - , Darr ReadyiB : I � � Internet: www.ci.tigard.or.TY OF TIGAR Notirtod/Metbs / / G 0 Sec Pagel l for
Supplemental Information
BUILD1 &oN 1 III PLAN REVIEW
❑ New construction B' Addition /alteration/replacement ase check all that apply:
Ill] Service over 225 amps, comm'l ['Hazardous location
❑ Demolition 0 Other IIII Service over 320 amps - rating ❑ Buildng over 1 0,000 sq. lt.,
CATEGORY OF CONSTRUCTION III of I- and 2- family dwellings 4 or more new residential
d 2 family dwelling ❑ Commercial/industrial ❑ Accessory building I System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other. IIII Building over three stories ❑Feeders. 400 amps or more
III Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION IIII Egress/lightingplan RV park
Job no.: Job site address: ill' Health-care facility ❑Other:
°� 435 S� � _ e bmit 2 sets of plans with any of the above.
City /State/ZIP: . I I ra
above are not applicable to temporary construction service.
I i
FEE* SCHEDULE
Suite/bldg. /apt. no.: I Project name: % •thy_
I paws I Qty. I Fee. I Total I ••
l ,I residential single- or multi - family dwelling unit.
Cross street/directions to job site: ! f K
I eludes attached garage.
i 111100 sq. R. or less 145-15 4 -
Subdivision: Lot no.: 1 til . add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no. I U ' lilted energy, residential 75.00 2
11I; iced energy, non - residential 75.00 2
DESCRIPTION OF WORK 'I' ch manufactured or modular
{� 1 ]ling, service and/or feeder 90.90 2
F-3 / 1 i I , rvices or feeders installation, alteration, and/or relocation
I ' 10 amps or less 80.30 2
•
❑ PROPERTY OWNER I ❑ TENANT I' I I mops to 400 amps 106.85 2
n 1 1 • 11 amps to 600 amps 160.60 2
Name: - 1'..i) H `i ] amps to 1,000 amps 240 60 2
' I J
Address: A—P d , / 11 1 cr 1,000 amps or volts 454 65 2
V II P connect only 66 85 2
City / State/ZIP: • `I� mporary services or feeders installation, alteration, and /or
location
Phone: (Z, ) 4 7a „„„- 0 5 i Fax: ( ) G 1110 amps or less 66.85 I
Owner installation: This installation is being made on property that 1 own which is 1 I
li ti l amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. II !II 1 amps to 600 amps 133.75 2
Owner signature: Date: I anch circuits - new, alteration, or extension, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON r i Fee for branch circuits with
1 service branch circuit or feeder fcc, each
6.65 2
Business name:
el Fee for branch circuits
Contact name: III each without b ran c service
rcu or it feeder fcc,
' 46.85 2 '
Address: _ i ! eh add'I branch circuit fa 6 -65 b ,(,r 2 '
ll1 iscellaneous (service or feeder not included
City / StattZIP: , ; ( included)
Phone: ( ) I Fax : : ( ) i 'I l mp or irrigation circle 53.40 J 2
I or outline lighting 53.40 2
E -mail: 1 '•• at circuit(s) or limited -
CONTRACTOR 1 l ergy panel, alteration, or
� r i ( tension. Describe: Page 2 2
Business name: tx,/`+ t
11 ch additional inspection over allowable in any of the above
Address: -" P'0- 544 _ !II r inspection 62.50
City/State /ZIP: 8 p I' estigation perhour(i lirntin) 62.50
Phone: (� 'Z t' _ — 1 . 5i 0 Fax: ( 563) .q 93 —� I— 3 ~ 1 I i I ustrial plant per hour 73.75
' ELECTRICAL PERMIT FEES"
CCB Lie.: Jam`) I I Electrical Lie.: ?, - 51 i (, Suprv. Lie.: 49S 15 I Subtotal S3 fj
Suprv. Electrician signature, required: I Plan review (25% of permit fcc)
` ate: State surcharge (8 %ol' permit fee) �(2,
Print name:
C- 11N1.5 I I I TOTAL, PERMIT FEE: 5' .' l (2
Authorized signature: • is permit application canines if a permit is not obtained within ISO
days after it has been accepted as complete
I Print name: J Date: , L I Fee methodology set by Tn -County Building Industry Service Board
Number of insneclioas ocr Permit allowed.
Z - d ELTLE6frEDS PPol d6tP:20 SO isI uf(
CI�OF TIGAR® 1 .
BUILDING DIVISION - .. PERMIT #: ELC2005 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/15/2005
Phone: (503) 639 -4171 � '
Inspection Requests (24 Hrs.): (503) 639 -4175 ' - --
INSPECTION �.'KSHEET FOR DATE: 9/14/2005 TIME:' 7:09AM PAGE: 95
SITE ADDRESS: 0' SW VIEW TERR CLASS OF WORK:
SUBDIVISION: PEN , TERRACE LOT #: 033 TYPE OF USE:
PROJECT NAME: TAKED ►\
DESCRIPTION: 2 branch ci -,its.
6
OWNER: , TAKEDO, CHI, 0 JENNY, PHONE #: 503
CONTRACTOR: BADGER ELECT'. INC. PHONE #: 503 - 2884756
Inspection Request Scheduled For: Date: 9/14/2005 Pour Time:
Co • e # ----. -- I escription Confirm # Contact # Message
199 Electrical final \ \015574 -01 971 - 563 -1924 N
Corrections /Comments rrx ions:
Q --)- V i' c 1
1 s� V ► - ). - b y C CAN \ -. (- (
•
1S ''∎ 1- Vo\v-Oycc P\A&
� 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -
Inspector: �� f/ / z
Date: 7 -/ -3 Phone #: (503) 718-