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Permit CITY OF TIGARD X O ELECTRICAL PERMIT PERMIT #: ELC2006 -00426 r 1° 14, DEVELOPMENT SERVICES DATE ISSUED: 8/2/2006 s 7 ' I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 104A6 -09000 SITE ADDRESS: 12400 SW 131ST AVE ZONING: R - SUBDIVISION: MORNING HILL NO. 6 LOT: 119 JURISDICTION: TIG Project Description: 2 branch circuits for AC. 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+ ampNolt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: ROB KOLBERG OREGON ELECTRIC GROUP 12400 SW 131ST AVE 1010 SE 11TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 590 - 5154 Contact #: FAX 503 - 535 -2763 PRI 503 - 234 -9900 FEES Description Date Amount Reg #: ELE 26 -95C [ELPRMT] ELC Permit 8/2/2006 $53.50 LIC 203 [TAX] 8% State Surcharge 8/2/2006 $4.28 SUP 44605 Total $57.78 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: Zj Ze Permlttee Signature: 66)- 4 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. AUG -01-2006 03:56PM FROM-OR ELECTRIC SVC 5035352763 T -634 P.002/002 F -120 r.ieei rical Permit A • • l: � C.ty of Tigard E® ri,tz c,l etc t xl, r> 440, !3125 SW Hal! Blvd Ti Received, Phone: 503.639.4171 Fax 03.98.1 jG 1 2006 Dates Permit �- pv L/ab Inspection Line: 503.639.4175 � 4 1 ' plan R Intnet: ww.ci ti CITY O F TIGARD - - other Permit: &rrd0r Date Ready/By: • ■ a Noti fa d/Metbod ®See Page 2 for • ► Suppleaaeatal lotarmatloo TYPE OF WORK • New construction 21 PLAN PLAN REVIEW Demolition Please check all that apply: CI Other. ❑Service over 225 am CATEGORY OF CON �• comrrt'1 ['Hazardous location STRUCITON ❑ Vice over 320 amps - rating ['Bulldog over 10,000 sq. R ® 1 and 2 family dwelling ❑ Commercial/industrial oft - and2 - wily ❑ Accesso buildin ❑S a dwellings 4 unor its more new residential ❑ Multi-family ❑ Master builder g System over volts nominal taritsa in one structure Other: ['Building ova three stories ❑Feeders, 400 amps or more JOB SITE INFORMATION AND LOCATION ['Occupant load over 99 persons ❑Manutacturcd structures or Job no.: 24623 Job site address: 12400 SW 131ST ❑Eg ess/lightms plan 1W party ❑Health -cane facility ❑Other Submit 2 sets of plans with any of the above. City /StatcJZlp; TIGARD, OR 97223 Suite/bldg./apt. / . The above arc not applicable to temporary construction service g apt• no.: Project name: ROB KOLBERG FEE" SCKED,E Cross street/directions to job site: Description Qtr- Poe row •• New residential single- or multi-family dwelling unit. Includes attached garage. Subdivision: 1,000 sq. R or less =�_ Lot no.: Ea add 1500 4 Tax map/parcel no.: sq. R or portion 33.40 =mil Limited energy. residential en 75.00 _© DESCRIPTION OF WORK err ', non 11111 75.00 _ INSTALL OUTDOOR A/C UNIT Each errant letured or modular dwellin _, service and/or feeder 90.90 - © _ Services or feeders installation, alteration, and/or relocation ❑ PROPERTY OWNER 200 and or less _ 80.30 r ❑ TENANT z0l amps to4oaamps I06.85 a Name: ROB KOLBERG 401 amps to 600 amps 111.11 160.60 Address: 12400 SW 131 AVE 601 amps to 1,000 amps NI 244 60 =© Ova 1,000 amps or volts - 454,65 MIEN City/Statc/ZIP: TIGARD, OR 97223 Rtxxnmat only II. 66.85 r© Phone: ( ) Temporary services or feeders installation, alteration, and/or relocation Owner installation: This installation is being made on property that i own which is not 200 amps or less r intended for sale, lease, rent, or exchange, 201 66.85 _ ge, according to ORS 447, 449, 670, and 701. t0 400 amps 100.30 _ 401 amps to 600 amps MI 133.75 r Owr1t.T sigaattue: Hate Branch circuits - a. Dew alteration. or extension. per Panel ❑ APPLICANT ❑ CONTACT PERSON A Fee for branch circuits with t Business name: aviee or feeder fee, each ��� Contact name: branch circuit II B. Pee for branch circuits Address: e a c h b service or feeder fee, 111191 I'I .$� each branch cilCUil 111 II Each add'i branch circuit v 6.65 •- . To 'i© Miscellaneous (service or feeder not Included) Pump or irrigation circle 53.40 � © Phone: ( ) E-mail: s3.ao _0 Signal circuit(s) or limited CONTRACTOR energy panel, alteration, or extension. DerctDescribe: Page t Business name: Oregon Electric Group Address: 1010 SE 11th Ave Each additional Inspection over allowable in an of the above City /State/ZIP: Portland, OR 97214 , Per inspection 62.50 �= Phone: (503) 234-9900 investigation per hour (1 hr min) 62.50 Fax: (503) 5352763 Industrial plant per hoar ilIl 73.75 _- CCB Lin: 203 Electrical Lic•: 26-95C ELECTRICAL PERMIT FEES" Suprv, L ic.: Suprv. Electrician signature, required; C a Submt tl 53. CJ. D O M M C1111 C1111 Plan review (25% permit fee Print name: F■ GVI �YeI ('1 cal 1^ ^ ' y --- - �. ie•• � (25.G of fee) MEM �7 Da �► // State surcharge (8% of permit fee) Authorized `,A ` r 57.78 I� TOTAL PERMIT FEE This permit application eepi.ca It a penult 6 not obtained within 180 Print name: R 1 ctri a r M C I a Dale: $ t Fee m days after It has been accepted as complete 0 •• Fee sel by Tel-county sanding Industry Service Board Bu ildinePamitsiE LC- PermitApp.doc 12/D2 Plwnberorinspections 44046 rsrtl WMrCOMAVEB per permit allowed