Permit A . CITY OF 1 I AR D ELECTRICAL PERMIT •
PERMIT #: ELC2006 -10033
�i� DEVELOPMENT SERVICES DATE ISSUED: 3/9/2006
c ` - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S102AB -01200
SITE ADDRESS: 09305 SW COMMERCIAL ST 9 ZONING: R -25
SUBDIVISION: VIKING APARTMENTS LOT : 064 JURISDICTION: TIG
Project Description: Electrical reconnect
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BRIAN COLLING
13835 SW HALL BLVD
TIGARD, OR 97223
Phone: 503 - 705 - 2295 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 4/1/2006 $66.85
[TAX] 8% State Surcharge 4/1/2006 $5.35
Total $72.20 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 -6 or 1 -800 -3 C _
Issued : (%cY Permittee
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.
Electrical Permit Application . l< 1 i i• r r( I : I NI" i o N 1.1
C ity of Tigard .. _ 3 9 d 6-- P e r m i t No.: � c e t o ( O - fC 33
13125 SW Hall Blvd., Tigard, OR 97223 pin Review
Phone: 503.639.4171 Fax: 503.598.1960 ' ': Date/By: r Permit:
Inspection Line: 503.639.4175 � '1 L. . Date Ready/By: hair RI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New constriction ❑ Addition/alteration/replacement Please check all that apply: '
❑ Demolition Other. ['Service over 225 amps, comm'l ❑Hazardous location
elService over 320 amps - rating ❑ Buildng over 10,000 sq.
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residentit
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one srrucaue
litt Multi family ❑ Master builder ❑ Other: ['Building over three stones ❑Feeders, 400 amps or 111,
['Occupant load over 99 persons ❑Manufactured structures
JOB SITE INFORMATION AND LOCATION RV
❑Egress/lighting plan park
Job no.: Job site address: - - S AI. C..oiii rn Gv G t ['Health facility ['Other.
Submit sets of plans with any of the above.
City/State /ZIP: / - 1 - 0 _,...47 ^ 0 7 Z 3 n The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: ' 1 Project name: ppt CL) PtPA (LIME 0� * SCHEDULE
Fee.
Cross street/directions to job site: i . N residential single- or multi-family dwelling I I
nit
r*+ ` `' n 5.A.. f- /; \--",../., Includes attached garage.
�'� kAA-✓ Ili'.- 1 - rs -r/! -5 J 1,000 sq. ft. or less - 145.15 -
Subdivision: 1 Lot no.: Ea. add't 500 sq. ft. or portion 33.40
Tax map/parcel no.:
Limited energy, residential 75.00
Limited energy, non - residential 75.00
DESCIUFI1ON OF WORK Each manufactured or modular
�� o ` � T ! dwelling, service and/or feeder i 90.90
Pe 1J vI Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30
a PROPERTY OWNER.: 1 ° p TENANT 201 amps to 400 amps 106.85
Name: ^' 401 amps to 600 amps 160.60
r I LD (/, . 601 amps to 1,000 amps 240.60
Address: / j J 3 » /1 - // /l fVc4' Over 1,000 amps or volts 454.65
�. c� 2 — Reconnect only ) 66.85 66,1;1';
City/State/ZIP: ,�C.,, , U /Z. / 7 ,z- 3 Temporary services or feeders installation, alteration, and/o
Phone: ( v 3 2...? Fax: ( B ) „� relocation
) S 2 S" I f � 9 - .� ( / •>— 200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030
intended for sale, l ease rent, or exchange, according to ORS 447, 449, 670, and 701.
_s- -, ) 401 amps to 600 amps 133.75
Owner signature: ;� - ( e- Date:24 6 Branch circuits - new, alteration, or extension, per panel
gAPPLdCANT I CONTACT PERSON A. Fee for branch circuits with --
J L service or feeder fee, each 6.65
Business name: A- / rre�✓T/cs branch circuit
B. Fee for branch circuits
Contact name: g✓" 6e /kip i without service or feeder fee, 46.85
Address: /.1f3 S' )6 � ' /?r` first branch circuit
_Each add'1 branch circuit 6.65
City/State/ZIP: 7 ; :ye. 0 2 y' 722. 3 / _ Zc 3 y Miscellaneous (service or feeder not included)
Phone: ( 5 b . ) j S -� �5 s ' I Fax:: ( fib 3) t� Pip or irrigation circle 53.40
Sign or outline lighting 53.40
E ' C,,l /e": fie/,?! %et$/: /I e--/ Signal circuit(s) or limited-
CONTRACTOS energy Panel, alteration, or
extension. Describe: Page 2
Business name:
Address: Each additional inspection over allowable in any of the abov
Per inspection 62.50
City/State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) I Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL FER III FEES"
CCB Lic.: Electrical Lic.: I Suprv. Lic.: Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee) ,, ,
Print name: Date: State surcharge (8% of permit fee) yr '
TOTAL PERMIT FEE 72 - �,,,"p
Authorized signature: 'this permit application expires if a permit is not obtained within 18
Print name: Date: * Fee days after ft has been accepted as complete
methodology set by Tri- County Building Industry Service Board
CITY OF TIGARD Cu
BUILDING D I V I S I O N P E R M I T #:) JO 6'.-- r 043 3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
A ° ,. , 1 At
Inspection Requests (24 Hrs.): (503) 639 -4175 .�� ° _..
INSPECTION WORKSHEET FOR DATE: W ■. / 6 /'_ TIME: PAGE:
SITE ADDRESS: S O S C e °•--Q CLASS OF WORK:
SUBDIVISION: LOT #: q TYPE OF USE:
PROJECT NAME:
DESCRIPTION: . i ( _
OWNER: z PHONE #:
CONTRACTOR: V3 V- ` PHONE #: 7 0 S — ZZS E--
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspecti•• Description Confirm # Contact # Message
I
` r
Corrections /Comments/ Instructions:
C f\
K PASS i , '. � �; S AL APPROVAL n CANCEL ❑ NO ACCESS
1 F, % ! C' LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
//eivi !l l
Ins• , tor: Si i .i % Date: Z' ` Phone #: (503) 718 -