Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00968
- DEVELOPMENT SERVICES DATE ISSUED: 12/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S102A6 -01902
SITE ADDRESS: 09380 SW TIGARD ST ZONING: I -P
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. LOT : 055 JURISDICTION: TIG
Project Description: Replace panel. Job #8749.
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: 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:
GENERAL CONTACTORS NEW TECH ELECTRIC
PO BOX 23144 13970 SW 72ND AVE
TIGARD, OR 97281 PORTLAND, OR 97224
Phone: 503 - 292 - 5002 Contact #: PRI 503 - 648 - 1900
FAX 503 - 223 -7007
FEES
Description Date Amount Reg #: LIC 41868
[ELPRMT] ELC Permit 12/20/200' $80.30 SUP 26 498
[TAX] 8% State Surcharge 12/20/200: $6.42 ELE 26 -418c
Total $86.72 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: — 7 &�� Permittee Signature: - P� p r , p
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.
•
Decl. 19 05 04:21p p.1
/_. ,
Electrical Permit Ap !' a I V E D
i t 14'0114'012. O OFFICE USE ONLY
City of Tigard Received , I S ' ,-
13125 SW Hall Blvd., Tigard, OR 97223 i Date/13 :� PcrmitNo. _ 0 �>t
Phone: 503.639.4171 Fax: 503.598.1960 DEC 1 9 20Q Plan
ate/13 Review V V
,,• ��I I hate/13 Other Permit: Inspection Line: 503.639.4175
Internet No fl a JMe Ready/By:
www.ci.tigard.or.us tigard.or.us CITY OF TIGA.' 7' s s ee e
N uHed/Metho page 2 for
.� T -7,;-„,-1::,..:..-s..7.-:,f-:,-a-,,''=.,',..-r-.., 1 supplemental information
❑ New construction - _ ° . - . _, �_ .. _; 1-',"' _ ..�.. :.= .._ ;.. ��' n
Addition/alteration/replacement Please ` ^, ■.� ! 31zc.sz ` ice; " r.
ease check all that apply: �"
❑ Demolttlon ❑Other ❑Service over 225 amps. comm ❑Hazardous location
❑Service over 320 s -
; ' i t' i1 iI l, 1Uf �(6rtiva 5�t �13c.a i:f;S , amp rating ❑ 4 o more new over residential s
i
of 1 - and 2 - family dwellings 4 or mre
❑ 1- and 2-family dwelling ja ommercial /industrial ❑ Accessory building DSystem over 600 volts nominal units in ane structure
❑
❑ Multi-family ❑ Master builder ❑ Other:
Huildt over duce stories F
I ❑ ceders, 400 amps or more
�'.:: yl ` ?'��,� t�s s l +, o t �il� It�Onc' \ q i , i ❑Occupant load over 99 persons ['Manufactured structures or
❑Egress/lighting plan RV par
k Job no.: &14q Job site address: s GOP hyJ TI L,A_I� I vF. , ❑Hea -car e lity ['Other: ['Other: City/StCity/State/ZIP: Submit lth 2 sets of faci plans with any of the above
I� 17 - 17-7- The above are not applicable to temporary construction service
Suite/bldg. /apt no.: Project name: r 'viii
V l )• ��v r- " 17 I .. ( r.g. r fl ! �7u f ay ,�. I.' E 3�I A a
Desenptian Q4'. Fee Total
Cross street/directions to job site: PAN F
�.L c-e c LA %-r-7- New residential single- or multi dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add') 500 sq. ft. or pardon _ 33.40 1
-
Tax map /parcel no Limited energy, residential
i. ^.,, ',Ci... �r ` �,fLL1 II "�(�II I�QI'. L�p� �3 iq ^ � - 1 Limited energy, non- residential
7$.00 2
r, ` ' " - r ; •;,I ' . __.:� :1 Each manufactured or modular
LAY -e ( �Tl t∎1 t,. e' Vim/ P - li - TANG dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 b p .?:;0! 2
r 74 ? i :? _ g1`!A 1 tLCt'+ - � i ,FA ,Ct u N; ._. , ',.: ; 5`. f ` _ . + I 1 20l ampsto400amps 106.85 2
° 401 amps t o 600 amps
160.60
` - 2
Name:
r - L - " 1k C r - 601 amps to 1,000 amps 240.60
Address: 2
�/ (/ h 2 . , Over 1,000 amps or volts 454.65 2
City/State/ZIP: � Reconnect only 66.85 2
1 ), b I Temporary services or feeders installation, alteration, and/or
Phone: (h( 212„ •76 0 Fax: ( ) relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less 66.85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 100.30 2
Owner signature: 401 amps to 600 amps 133.75 2
Date: Branch circuits- new, alteration, 7 :_ }tl' �1 � ? �7 n�� ,\ �r � .77 � l � I m-�.� i , s rm, r r^ tCratlOn, or extension, per and
P• •
_.._ .cJi::7 47 ' }r if'.;: ,f•4I +�I'� �Alil .31 M STSP . I•� 1, t ° J 71'6�.'rf. Fr' Iliti 1 i 9 rk ' panel v.. ,u;5 ° ^�+ ,1, �) I ,-�, r,.,��', �»� �1? , ' ,' l = 1 A. Fec for branch cirzuits
Business name: service or feeder fee each with
branch circuit
6.65 2
Contact name: B. Fee for branch circuits •
without service or feeder fee,
Address: each branch circuit 46.85 2
Each add') branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ; ( ) Pump or irrigation circle 53.40 12
E -mail:
Signal circuit(s) or limited -
Sign or outline lighting 53.40 2
ti- ? r. -, . c :..ry . _
•
i'y��.. t il���t:ur,...!' �',f�,e.�i:- w.,�` "as� �F U� a ifLr���s� m +..y,,-- Fia< - 'n•+ 7t +; ,
�`1 .Ci W,,,�:r•'�r ,,, �;, '� ' 111 energy panel, alteration, or
Business name: New Tech - Electric extension Describe: Page 2
Address: 13970 SW 72nd Ave Each additional inspection over allowable in any of the above
City /State/ZIP: Port land , OR • Per inspection 62.50
Investigation per hour Q hr min) _ 62.50
Phone: ( 5 0 3) 648-1900 Fax: 0 3 )648-3131 Industrial plant per hour 73.75
CCB Lic. 41868 2 6 - 4 1 .-11t x;': 4" - :,�4`!: u wi.�Fa �'�` airii' G :q & it -
Electrical Lic.: Suprv. Lic.: S- _ a i l ' � , -., vim + ! :
Subtotal 60 r Zf � 7 r '`
-• 0
Suprv. Electrician signature, required: /
Plan review (25% of permit fee)
Print name: 12.1 v Zu rAt l Date: l 2 f t 1 ■ a c-, State surcharge (8% of permit fee) 1 �
Authorized signature:
TOTAL PERMIT FEE I ?(0 72
This permit application expires Ir permit is not obtained Within 180
Print name: days after It has been accepted as complete
Date: • Fee methodology set by Tri- County Building Industry Service Board
i.V3uIWm a,e
•• Number of inspections per permit allowed.
g rtnits\El.C- YrnnirApp.doc laJm ter, 440- 45151(I0M1r2lCUM/wEB
CITY OF TIGARD .
BUILDING DIVISION PERMIT #:'ELC,Zgara oo4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Y24 ,l7
Phone: (503) 639 -4171 �'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 `_.
INSPECTION WORKSHEET FOR • DATE: TIME: " PAGE:
SITE ADDRESS.' ci0 6 t) "p 1G-isAb STP i CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: ) js 1 t 40 3 Pour Time:
Code : -' .n Description Confirm # Contact # Message
Vi cc L-
i structions:
"1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t ■)46 Date: 1 � Phone #: (503) 718- - 2.A `v
1