Permit 4a CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC2014-00444
Date Issued: 08/11/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1108D01500
Jurisdiction: TIGARD
Site address: 14680 SW 117TH PL
Project: ANNENBERG Subdivision: SHADOW HILLS Lot: 6
Project Description: Temporary electrical service for construction
Contractor: DREAMHOUSE ELECTRIC LLC Owner: ANNENBERG, ROBERT F
221 SW MOONRIDGE PL 11430 SW PINTAIL LOOP
PORTLAND, OR 97225 BEAVERTON,OR 97007
PHONE: 503-519-6711 PHONE:
FAX: 503-648-9723
FEES
Quantity Description Date Amount
1 ea Temp Services or Feeders- 08/11/2014 $59.36
Specifics: 200 amps or less
1 ea 12%State Surcharge- 08/11/2014 $7.12
Type of Use: SF Electrical
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $66.48
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in a • • • - with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT - TION: Oreg•• law re. 'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 0010 through OAR 95 )00 1094 Y• may obtain a copy of the rules or direct questions to OUNC by callin�5ae 232.1987 or 1.800.332.234
Ise d By: Permittee Signatu � •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' -
Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
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.
Electrical Permit Alli liCiPi fl `WE') FOR OFFICE USEONLI'
Cih' of Tigard 1 2-C114 tteoarva� �I • PermaNa.t 7`7'
Dan, ,:
17125 SW['all Blvd..Tigard.OR 1113 1 P4mRrv.;�.
a Prone. 503.718.2439 Fax: 503.591.1960 Dale•Bv: Ma Perin
TIGARD Inspection Liu: 503,6394175 CITY OF'TIGARU I DaisRoadw'B%: _. .? .... .�_ - ■ !he Pep 2Ar
Internet: www.tigard-o gtiu�vp i NKifwd'11:tN�.t. f ! teIt•6rnr�rb„n
14eve COtlaieetion ❑Addition+altcralionircplaccmcnt P•casc cb c.at:hot mph i.utlnit j ot:ls nf piles*Mass chect ed he.na.
0 Suwon:of-..dc:400 merit;te MUM ❑Brindle@ over ih•:c.:.ti c•
❑Demolition ❑Other nacre Ilk as slabk rauii c.r.•reiw 0 Mornas aid bor..arJs
ie • ".2;;;;;;:;;,,::-.,..:
{•.''J''` aa-N,i0000 amps at 150voli or 0 FIcal ng b.rld,op
tasty w
s.: rest,.x ea.;coG,1•t,IN.4 O Carr:mrn.d-use aeti ic•wat.at
❑ I-and 2-family dwelling ❑Commercial/industrial ❑A xCSwry building amps ka all:N:xf toerallA11.1% bookings
❑Multi-family ❑Mater builder ❑Other: ()File`'7pomp. 0leslalix000l-73 KVAar
l..l E+• ,:escv sylarrw _a diet**SSW,derived f1 QC J'
JOB SITE INFORMATION AIN'D:LQCtTIQA-.:. CI Addesie:.:I 11C V*luau:awes' 0 6-••F••-I•v- _I_t
p� �]'� �)� imp...,more. .rccupurcv
Job n0.: 706 Ssic ir4dr s, /1// �(� // � T'��"� Q W IN more ic..wka:i a_.�:iAs. ❑k••cr.ahr+ul whet.lark.
Gily?5tatt.-,, W flHeath-caretavir:e• OSapplvvo:ia titern,,;•:Ns I
Ti bm I 0ltmrardae kr:drsn (•0::v:'II•ouival
St.ilelbldg.>'apt.no.: Project r amc: /�i,J t4 i9 P- , C O%ervice r„'tutu aC0 LIT..or more.
:::::;. :. .' :... .IFFF SCHEDULE
IToss sheet.:directitnts to job siic: '. `t7 Run�..r (hd. r::. 7trat T'_
• New residential sink nr multi-Tamil}d,v riling unit.
_ _.. ____ Includes atraetbed garage. —
I 11,0111 s rl w um 1 u3._ l subdivision: L0'.no.
Fs asd'1 500 sq t:.or portion 33.92 I
t Tate tapfparcci no.: mini an.::c..•rcuie,v.aI
Lie •
; • . ......-r::!..'. . •DeSCKIPTION`01.'WOIR '''`:••: .. . {■ tenth aboecsq ft;
— I irrukd criers),multi-farad) 75% I
-*
d W w lip-- `rLV ---- rtvden:.al(with ahavesci.11)
1 Services or feeders ialallalio n.alteratian.and/or reW_a lima
200 amps or lea ! iUU.70 I :
•0 p&O.P.i1/7'1{ :i••-• } � ' 201 units to 4tiO apps 133 56 1 :•
Name: 'dory a— /l4 Y%Kl 101 amps to 600 amps i •200 3� ,
601 imps to 1.00G amps .101.64 i :
Address: 1rseas fW /(r ia."ifivum /�g4=. s unto Over:. amps ut woks I 552 36
`���? dot. 7 5 / r,ioea Temporary services or feeders installation.atlhralima,and ar
C'lt3lStakrZlP: �sg 9-2/ e' MOralrcNt �---
Pt nee( Mumps w km .1 91 - I-
So�# �-79�► Fax:(
Owner installation:This installation is being made on property that I own which if nettI amps w 40D amps ; t�-Ce :
intended for sae.tease,rent,or exchange,according to ORS 447.4749,670,end 701. 101 amps to 399 amps I 161154 te
Braga n •K meanies,p er panel
Owner cignatre: Date A.Fee or bruit*crvws�
r <r ry c t ,Acq s,, , above service or feeder fee.
/Jd•2�%;�•'..�. .Y . ei .'T -... :v'f'+.v"r� .x�h hue:ch c;ro.•i1 ,...-.....__742 2
Business name: �f E L� X77 �'/"'XiLtli s B. to rot bra.^.:r CI NUM trrrA°sr
...... :e or:crJcr Ice,Ng t8
FC
Contact name: ��lr�4� ' lh.dr l,ein__a q I
c-z.=__ziL. both mien bench omen 7 43 : 1
Address: i Miscellaneous omelet or feeder not included) 1
Each ISSAIlfaccused or modular
• C•ii IStatc/L1P: �N dwel.. service ar ur feeder 67 84
Phone:( ) v ` � Fax::( ) Re�vnnmet aal► ,�67�d - •.
1•remit ti N Pump or irrigation circle : 6714 I-7-
, a
/�/��I Sign a al lbw hgMina 67.W
•
•:• �;': :: � •lac:• +:7.::':: .::. swat cireteua7 t •:anited!-rnerR►
Busindas name: Dram Howse Electric.LLC nl,ainantion-ot Vag MUM 2 [ ■
r__...._ ____- Eat•h additional inspection veer alo,.abk le age of the abo,e i
Address: 221 SW Moonridge Place ___ Additional inspection I I Itr min) 1 6625:hr
Con?$rate+Etta: Portland.OR 97225 ._._. ___.__ :instigationt1irmn) i 6623'br - _•
I Phone:t 103) 5194711 f Fait:{S03}618-9723 irwustrial plant(1 1 he rein) 1 ' 7tt.11ir►r r
1. �1
i —
C'Cli(.id:.: 196726 j Electrical C-848 Suprv.Lie.: 4560S 1nsp::ua,:for which no foo IS t 90.00:itr
Apc::fI lI, hsl:dt''-'s brmini
Sum.Electrician signature.tvgtf J ... : .. . itAt litcAt,.1'kltlii FllfX!
Print name: Chris Mahoney . Date: Ixf5//� I
Plan review(arses of pemtil foe) 6..-------
-� - 1
Authorized signature: i '
at State surcharge(I2%ofpv unit 1rc) A, 7-/2
Prim name: Date: TOTAL f'ERM1T FEE. i ip&/ g
I Jla'it'y/lbsdkZLCalrriitkood.c°rtal•to ,48.4.61erl I levta:MAAVka
i
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14680 SW 117TH PL, TIGARD, OR, 97224
Residential - Electrical
110 Temporary electrical servi
PASS
ELC2014-00444
Herb Stabenow
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14680 SW 117TH PL, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00444
David Young
Temp service removed.
Violation Summary:
Inspector Contractor