Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00163
yl DEVELOPMENT SERVICES DATE ISSUED: 3/18/2005
" ��' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S134AD-07800
SITE ADDRESS: 10619 SW WINDSOR PL ZONING: R -7
SUBDIVISION: WINDSOR PLACE LOT : 015 JURISDICTION: TIG
Project Description: (3) branch circuits for attic fan and hot tub. Job No. 832
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: 2 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:
AASE OTTO WILLAMETTE ELECTRIC INC
10619 SW WINDSOR PL PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: 503 - 639 -4137 Phone: 503 - 624 -3631
FEES Reg #: LIC 75059
Description Date Amount SUP 3 4
ELE 34 --2828
3C
[ELPRMT] ELC Permit 3/18/2005 $60.14
[TAX] 8% State Surcharge 3/18/2005 $4.82 REQUIRED ITEMS AND REPORTS
Total $64.96
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 orth in • • R 95 :; -00 • through OAR 952 - 001 -0100. You may obtain copies of these -s or direct questions to QUNC at
503 -246- 99 or 1-800-'3 -2344
Issued y: /1LV� L / Permittee Signatur • : J i � ,J //rte �� �'
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 IN TALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 5--,5 l �W { DATE:
LICENSE NO: /q / 6
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.
MAR 18 2005 8:06AM HP LASERJET 3200 p.
i iIVE�
,El rica>1 Permit Ap ruu url iri. use o\l.v
AR 18 Received / 7� a1
City of Tigard M Dawn /, PetmicN ,� A. ,
13125 SW Hall Blvd., Tigard, OR 97229' 2005 Dstes view
Phone: 503.639.4171 Fax: 503.598d ' .( ?) ;k Other Permit:
p _�i�l ` Date/By
Inspection Line: 503.639.4175 CITY OF TIGA • ' �.!� � � RtsdyBy. J ,. 63 See Page 2 for
Internet: www.ci.tigard.or.us a Notified'Method: / I Supplemental Information
1iF, 'F 1 V.' pp'�wp'IM1,VI T �f �I1ir,.. Iillx. ,�i, +� l 1 qT P Na - lig . , t• til I"1 I :r r iL.- ff
a i v.?s, : .- ,
N. • as r .y u * '/! L 1 , I , a ,,'' aC:''� .
1�•� lJl ��-' �IF�1�1IJlii :11'e!di;:l1`11II�II'1,119 �. l :� 1 �.tC'J'�Y w� ?i11LLSiW _Lf.�{ �, :1 . �i
� i � I� �J(i i.4, l+E '1• I SI'.L:c!3.a.F.�� i3(I:A4f '
❑ New construction RAdditionhilterationfreplacement Please check all that apply:
❑ Demolition ❑ ['Service over 225 amps, comm'l ['Hazardous location
s v D " , ";. : ;'; 'i :r. c; <� F'r ^.tai F ^ii y "IA ri r' x ss , ; _ ;_ t' ;? ? r' .�Ta� "'L : ❑Service over 320 amps rating ❑Buildng over 10,000 sq. ft.,
F 1 Y I !i t Y } , p 4 l , 1 d i 1 , �. F jr i y I a y { t"d 1 11 1 , !t � l /, r +4 rt t!•a �y,l. of 1- an d 2 - f a m i l dw 4 or more new residential
q:s±rit:a... , LABS ,1111 �, ..1t11 . ... ^a 4filr.:.` - Pi . .:r�:.tit. t , idyl x.'..,_:.._::..,25, it' Y g
r 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
12 Multi 11 Master builder ❑Other; ❑Building aver three stories [Weeders, 400 amps or more
141utrG:R Frg,T ! , •• J s lames 1 rsia. lc y t p ;.) ArJL f r' ' r '{ 7 I ry , t
['Occupant load over 99 persons ❑Manufactured structures or
1 U 1d,, 0 r .1 1 , . I e1 t aill'd
(r11 1 Ilrl - f 1 ; ri ,(1 I t Iri 1,4 i d 51 I 1 /i' i,e. ! , i9 j L ,1 J i I t 1 s ,Q11 ❑ggesa/lightingplan RV park
ir •�?_, .tm,,: ilk,: a11J..S 4 . ;11..iL ❑ WAV. rt.:`C1,Zi i.1 ;cu.r: L C_� `,.....47 511 1,1 :,.{771 ❑Other.
Job no.: F3.2... �'.eJ id �J Job site address: i , ❑Health -care facility
f4 2 Submit I sets of plans with any of the above.
City/State/ZIP: _ e Z The above are not applicable to temporary construction service.
p I! �19 .�u .. r. . 6y nscn- ^r�
Suite/bldg. /apt. no Project name' • - , , . J ' . #1- ua sly, -... n . .: , , k '' ..
�' �• = i!! J1.; 1r? il J�
E, CS. , : :vh�.nruuu.r,n�9ct.� "._ ��•�e
r r •"" Q De ertpdeo Qty. Pre. ... Total
Cross street/directions to job site: Sk, �� aw d _ New residential single or multi - family dwelling unit.
includes attached garage.
1,000 sq. ft. or leas 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. R or portion 33.40 1
Limited energy, residential 75.00 2
Tax trap / no.: r 1 L energy, non - residential 75.00 • 2
�� tit 1 11 1 , ! iii Ir"1
'`1 61 $V. a FP I �Ur V ���11, %, 1r : -i rr 4t�I`}}'Igl'Su I .Iri
l! t n t - 1 5 ` (�i1 Ii ET F Ill0
ilex ..] ?c.1 :0 ri7 ,[ , , .r.__.,w,. Y1l fht, 14 :flu, - : ia ,h ,11, e.:t_ , :,,..id.,,. .i g,S. . 1 �s4L.•_ - .. ; . ,,t, Eac _
manufactured or modular
dwelling, service and/or feeder 90.90 2
1 r• Services or feeders Installation, alteration, and/or relocation
�. !I rJ { 200 amps or less 80.30 2
I, 1 h � ( II I - j 1 , i 4 1 � r ill ;101 � j _ y' . 071 4 �� I:� r;!Ii :; ttili � ,;'� i 1 x 1 7Y - f7 � l � i ;r :F F, 201 amps to 400 at'rtps 106.85 2
r , .,l ( ,ti:: , .r ,1..(.1 ;;, u ua l l al; , 1_' 31 c.-�_. _.1,i _ fl d c,A: }16 'spa i ,ti Ant ,. Stu.: i'a � �._LP7' 401 amps to 600 amps 160.60 _ 2
Name: I t r.,,, CD-1.---0 601 am to 1 am 240.60 2
Address: d , • LO . SO k Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/Stat ZIP ' 1 se. Ca 1 7 7-A Temporary services or feeders installation, alteration, and/or
Phone: 'ON Fax: ( ) relocation 0 amps
200 amps or leas 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 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 an to 600 amps 133.75 2
Owner signature: rr g� LL Date: S Branch dre nits - new, alteration, or extension, per panel
f t L . 'i i ii I 1[Jl I Rt iI G FI a•11 i /� /' ) I F lr , I i' l^ Vx alr l 11;1,) I IV Cpl - L i ii A. Fee for branch circuits with
u - 1� t° ii. ri' �; i t t 1 i, t > I�, G" li �t si' I a. i a I. :,I i,�l
to .� ,1 : ;Ci .D. rr .:_u)�,J,.� .i_u11�, _1 l,. � 1,f'1,rc4,�.5"�mu.__ . .. N ,fiEvL.:lnc oJrvII I service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit / 46.85 [„ _ 2
Address: Each add'l branch circuit 2_ 6.65 l 11U 2
City/State/ZIP: Miscellaneous (service 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 -
■!111 I.�, l�v�MC53K L li iyiti /IP lI tl � r t e .,1 7 1t 11,1 a tiller >>.�.�� + .:, L.,... ,t l +r R� S tU '4' it . r energy' panel, aheratirn, or
(. , l Ii
11 �!y i� l.. Lpl� 4I ?� `I>�rnrrJ� extension. Describe: Page 2 2
Business name: : . ,L A. C -
Each additional Inspection over allowable In any of the above
Address.
/ / , k 22 1 TN '7 Per inspection 62.50
City/State/ZIP: -- t Q ` z41 Investigation per hour (1 hr min) 62.50
3 ) Fax �Z - ( ) , _ t 3 � lndustrial plantperhour 73.75
Phone: ( � Q3 Z l r T, I ), f Z , , ,..,+ ; yI x i = d 1 e
Q: r iK 11 I. , r lj Y, � :9,7v,3Ct,' Uti'1 AI /1,il, ,'.,'Lt „iL'aL- �_ ( �,I ALL, -�• a.r. ,. 1.
,,
: 1 Electrical Lic.: ? _ I , e_ Strprv. Lic.: Ls- Subtotal 6 , / f
Suprv. Electrician signature, required: ,j i Plan review (25% of permit fee)
State surcharge (8% of permit fee) q 1 t Z
Print name: Date: 3 i . S is
TOTAL PERMIT FEE y q
Authorized signature: This permit application expires if a permit Is not obtained vAthfn
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per pemdl allowed.
t\auild,ngWPerroMMIC- PermitApp.doe Ivan 440.46 15✓ {10eveonvwsB
i
' CITY' OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00163
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2005
Phone: (503) 639 -4171 :N itlx. 3, 1i t
Inspection Requests (24 Hrs.): (503) 639 -4175 _
•
INSPECTION WORKSHEET FOR DATE: 4/20/2005 TIME: 7:11AM PAGE: 50
SITE ADDRESS: 10619 SW WINDSOR PL CLASS OF WORK:
SUBDIVISION: WINDSOR PLACE LOT #: 015 TYPE OF USE:
PROJECT NAME: OTTO
DESCRIPTION: (3) branch circuits for attic fan and hot tub. Job No. 832
Cc,L{ W -S
OWNER: OTTO, AASE PHONE #: 503 -639 -4137
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 5036243631
Inspection Request Scheduled For: Date: 4/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 004945.01 503624 -3631 Y
Corrections/Comments/Instructions:
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I Li �n C
Inspector: ' � ' Date: 'T '`'� 7 44e #: (503) 718-