Permit 4 ELEC OF. TIGARD
TRICAL PERMIT
PERMIT #:.ELC2005 -00240
l � DEVELOPMENT SERVICES DATE ISSUED: 4/6/2005
c�I I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 103 DA - 00700
SITE ADDRESS: 13205 SW WATKINS AVE ZONING: R - 3.5
SUBDIVISION: DERRY DELL LOT : 007 JURISDICTION: TIG
Project Description: Panel change and (3) branch circuits. Job No. J23408
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: 3 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:
JANET HATCH WEST SIDE ELECTRIC CO INC
13205 SWWATKINS AVE 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 -639 -5639 Phone: 503 - 231 -1548
FEES Reg #: LIC 13306
SUP 46
Description Date Amount - 15
ELE 26 -135c
[ELPRMT] ELC Permit 4/6/2005 $100.25 •
[TAX] 8% State Surcharge 4/6/2005 $8.02 REQUIRED ITEMS AND REPORTS
Total $108.27
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 OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these ules or direct questipns to OUNC at
503 -24 699 or 1 -80 3
Issue By: 1_ to ,_=, /_■ Permittee Signat e' i i6-..L.
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 � d'%-- --- DATE:
LICENSE NO: 4
Call 503- 6394175 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.
w
I. Electrical Permit AD li " I. IV E® FOR OFFICE' USE ONLY
City of Tigard
^b �05 � )( Permit & 4.4:4496-."%90,2 ,
13125 S W l latl Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
APR 0 6 200 ``� l
' Ii- rt> OtherPerntie
,. DaloR1 .
Inspection Line: 503.639.4175 !
.tr. ,,,, Date ltoa6y /By: lute H See Page 2 for
www.ci.tigard.or.us F TIGA a Notified/WOW; OW; t{0 Sr informa
Internet; www.ei.ti 61 7Y O `r
i'' , . it 1 PLAN lz1W Ew
❑ New construction O • d. ition/alleration/replacettrent Please check all that apply:
❑ Demolition Cl Other: ['Service over 225 amps,comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑Duildng over 10,000 sy. (I.,
CATEGORY OI' CONSTRUCTION of I - and 2- family dwellings 4 or more new residential
[ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑Systen over 600 volts nominal IS in one structure
Multi- family ❑ Master builder El Other; ❑Building over three stories ❑Feeders, 400 amps or more
JOB St1 SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑Ma u a tured structures or
['Egress/fighting plan RV park
Job no.: ,�� S L+ 0 Z..',' Lob site address: I1 �f l � , t � � t vr_ ['Health facility ❑Other _
it Submit sets of plans with any of thc above.
City / State/ZIP: ,, 4 C -7 2.7 e The above arc not applicable lu temporary construction service
Suite/bldg, /apt no.: I Project nname: : 14 . l4 . "t FEE" SCHEDULE
- .
...e... onerlplbn 1 Qty. L Ns. I Total l _
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
- ' ' - Includes attached garage.
1,000 sq. f or less 145 15 4
Subdivision: Lot no.: Ea. add'I 500 sq. it or portion 33.40 - - I
Limited energy, residential 75.00 2
nt
Tax ap/pareel no.: Limited energy, non•restdentint 75.00 2
—
DESCRIPTION OF WORK Each manufactured or modular
welling„ service and/or feeder 90,90 _ 2
� • C � ' f " "•'i % A I %C l - ] -.�n.a v ` t ' t -- f . £ - , u ��tC! dwelling,
s or f e e d e r s installation. alteration, and/or relocation 2
' 200 amps or less ( 80.30 'Sp, 4 . 2
PROPERTY OWNER o TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name
<''t �i? •t Gl { c., 1. 601 amps to 1,000 amps 240.60 2
Address: ‘ ,
L LvvL-Z,. Over 1,000 amps or volts 454.65 2
City / State/ZIP: Reconnect only 66.85 2
Temporary services or feeders installation, alteration. and/or
Phone: ( �,z 2 V Z f tQ o �'bs q Fax: ( ) relocation 00 ms o
rr 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 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
[] APPLICANT 0 'CONTACT 'P • • A. Fee for branch circuits with
service or feeder fee, each i
Business name: - branch Circuit 3 6'65 iii,/ 2
Contact name: - 13. Roc for branch circuits --
.. _ without service or feeder fee, 46x115 2
Address: each branch circuit _ _
- Each add'l branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not Included)
_ _
Pump or irrigation circle 53:40 2
Phone: (^ 1 ) Fax: : ( )
Sign or outline lighting 53,40 2
E-mail: Signal Circuit(S) limited
^___ CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: WEST SIDE ELECTRIC CO.
Address: 1834 SE 8 AVE. ^r - Each additional Inspection over allowable in any of the above
- Per 62.50 —
---
City /State/ZIP: PORTLAND, OR 97214 Investigation per hour (I hr nao) 62'S0
Phone: (503) 231 -1548 I Fax: (503) 736 - 0677 Industrial plant per hour 73.75 —
ELECTRICAL PERMIT FEES*
CCB Lic.: 13306 1 Electncal L' • 26 -135C Suprv. Lic.: bc-t j s Subtotal 1 ear2.5
ie :2A - ' 7 Z --- Suprv. Electrician signature, required:
Plan review (25% of permit fee)
1
! State surcharge (8% of permit fee)
Print flame: Y L0. cK ' P...-0\C2_e...,/‘ -tS Date: LI /4:• l E S _ . OA
TOTAL PERMIT FE
Authorized signature: M This permit aimlieation expires if a penult la not Obtained wither tau
days after It has been accepted se comp:etc
Print name: I Date: • Foe methodology set by Try- County tluildirrg llydlntry Somme gaged
^ -•- " Number of inspections per permit allowed.
i• Uruildma \PermlttELC•Perm1iAppeac I7/03 44Q- 4611T110ro2/COM/WEn
Z•d LL90 - 9EL 1E0S) •03 ot.1' OaI3 apTS 1.sam eS0 t60 SO 90 Jdd
CITY OF TIGARD , ! , ,
BUILDING DIVISION PERMIT #: ELC2005 -00240
13125 SW Hall Blvd., Tigard, OR 97223 j DATE ISSUED: 4/6/2005
Phone: (503) 639 -4171 4 / nnorypi gl
Inspection Requests (24 Hrs.): (503) 639 -4175 1 � —
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 61
SITE ADDRESS: 13205 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: DERRY DELL LOT #: 007 TYPE OF USE:
PROJECT NAME: HATCH
DESCRIPTION: Panel change and (3) branch circuits. Job No. J23408
1
OWNER: HATCH, JANET 2�� PHONE #: 603639 5639
CONTRACTOR: WEST SIDE ELECTRIC CO INC I�� PHONE #: 503 - 231 -1548
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service/reconnect 004635.01 503-231 -1648 N
Corrections /Comments /Instructions:
,e>2i aptoi,u,c4 vcca c).-c
The electrical Installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar nays per OAR 918-271-0030
Ill a&
w
NO .
A - , ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• ❑ FAIL ❑ C , .' FOR IN y' t N ❑ ADDITIONAL FEE ASSESSED ,, iii
�!� I � � �
Inspector: Date: Phone #: (503) 71 Ert /
,,r.,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00240
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2005
Phone: (503) 639 -4171 taro
Inspection Requests (24 Hrs.): (503) 639 -4175
•
INSPECTION WORKSHEET FOR DATE: 9/28f2006 TIME: 7: 02AM PAGE: 55
SITE ADDRESS: 13205 SW WATKINS AVE CLASS OF WORK: •
SUBDIVISION: DERRY DELL LOT #: 007 TYPE OF USE:
. PROJECT NAME: HATCH
DESCRIPTION: Panel change and (3) branch circuits. Job No. J23408
OWNER: HATCH, JANET PHONE #: 501639 -5639
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503-231 -1548
Inspection Request Scheduled For: Date: 912812006 Pour Time:
Code # Inspection Description Confirm # Contact # essage
199 Electrical final 037292 -01 503-639- 9 N
Corrections/Comments/Instructions:
.. CX ) //)
PASS ❑ P '•TIAL APP' 'VAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL It C . / T SPEC ION ADDITI• AL F ' ASSESSED
Inspector: / / Date Phone #: (503) 8
P ( ) 71