Permit xt sk ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2007 -00740
; COMMUNITY DEVELOPMENT DATE ISSUED: 11/1/2007
TIGOO 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S109AC 02500
SITE ADDRESS: 13001 SW BULL MOUNTAIN RD ZONING: R -7
SUBDIVISION: LOT : 002 JURISDICTION: TIG
PROJECT: 550 ZONE RESERVOIR 2 /PRICE PK
Project Description: Temporary electrical service. Job No. 14968
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
CITY OF TIGARD HASKIN ELECTRIC INC
13125 SW HALL BLVD. 6307 -B NE ST JOHNS RD
TIGARD, OR 97223 VANCOUVER, WA 98661
Phone: 503 - 639 -4171 Contact #: PRI 360 - 735 - 0898
FAX 360- 735 -0898
FEES
Description Date Amount Reg #: ELE 37 -400C
IELPRMT] ELC Permit 11/1/2007 $66.85 LIC 64312
!TAXI8 %State Surcharge 11/1/2007 $5.35 SUP 43485
Total $72.20 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Munidpa I 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
suspende r more •an 180 • s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r es are set fort' i •AR - 001 -0010 through OAR 952 -001 -0100. You may obtain copies o -ese rules or direct questions to OUNC at
503.24 .6699 or 1 .800.3.•
Issue By: / � / l •
L� � Permittee Si • - . J1�/% / ,
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.
NOV -01 -2007 08:22 HASKIN ELECTRIC, Inc 3607351196 P.02
Electrical Permit Application s � ' �` ` ",,` '' v ` , " r " 3'" °i
pp ,,' fr t ,1 ioR orrn r i15r ONEA - F
d.,Yt4 4u' •'t :`r),um*Lr. c .iY' n;{a' is k 1, rf L..`.
'r - City of Tigard Received r�� Nand No.: f 6
" ✓ g DatarBv /� // 'I'Ill o?p 7 ez7/
V 13125 SW Hall Hlvd.. Tigard. OR 97223 Plan Review
t' il r,, Phone: 503.639.4171 Fax: 503.598.1960 Date/13v. Other Permit.
-. c A k' Inspection Line: 503,639.4175 Date Readv /B ® See Pape 2 for
xi .,Qx:;--.tsrl Internet: vww.tigard- or.gov Nonficd/Mothod• Supplemental Information
A TYPE OF WORK PLAN REVIEW
New construction ❑ Addition /alteration /replacetnent - Please check all that apply (submit 2 sets of plans w /items checked below).
i
❑ Demolition ❑O ther: l Ser ice or feeder 400 amps or more ❑ Building over three stories.
- where the available fault current ❑ Marinas and haat.a
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Flomin( building.
less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ►Commercial /industrial ❑ Accessory building amps for all other install:ainus. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Install:d m, of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Joh no.: I 49 i pa Joh site address: 1 SoCA TsutL. J Ro I Six or nr more. Rec
❑ Si or more residential units. ❑ Rocrcatioual .chicle parks.
City /State/ZIP: T 1 cmc L ❑ Hcalth -enure facilities. ❑ Supply voltage far more thtm
�7w ❑ Hazardous locations. 600 volts nominal.
Suite/hldg. /apt. no.: Project ' name:"'"' ❑ Scr.-icc ur feeder 6 ( 1 ( 1 amps ur more, __
\ C>a�SLti r�Z.\10 l �. -
Cross street/directions to job site: [� t Dtptlon FEE 0 1 ) • 1
St/ C (� L c_ V{ � e, er -1 � On. 1 Rea 1 Total
New residential single- or ntttltl- family dwelling unit.
we ST ti n) Z LI t„..t , LA.fl. `7AJTFArti _ Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: - _ Ea. add'l 500 sq. n. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (aids above rtl. t).)
Limited energy, multi- family 75.00 2
- rL r Pc 2 A IZ.y �I \ ‘4...6 ,T-1:=(z residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
CSC a v OR 200 amps or less 80.30 2
fil PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106.85 2
/1 � cc ' T � y � dUl amps to 600 amps 160,60 V 2 eyv Name: l
601 amps to 1,000 amps 240.60 2
Address: 1 ? ‘ 7 5 t ,,, . X1.4 .v e) Over 1.000 amps or volts 454,65 2
City /State /ZIP: ; __ .___ "7 2 'Z " � Temporary services or Feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or Tess 1 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. (ease. rent. or exchange. according to ORS 447. 449. 670. and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new. alteration. or extension. per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder foe.
each branch circuit 6'65 2
Business name: 13. Fee for branch circuits
without service or feeder fcc.
Contact name: first branch circuit 46.85 2
Address: Each add'I brunch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 2
dwelling. service and /or feeder
Phone:
( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR • Sign or outline lighting 53.40 2
1-‘,90y ai c
Signal circuit(s) or limited
Business name:
m `f V energy panel, alteration, or
Address: (4307 . ti ) &(" .x4411.%3 9Nkl. extension. Describe: Page 2 2
City /State/ZIP: \) f_d , vr" kLi 1 Each additional inspection over allowable in any of the above
3 Fcr inspection 62.50
Phone: ( 1 C.y -uO� Fax: d 7 rr --
} �(� t�lp Investigation per hour (t hr min( 62.50
CC>3 f.iC.: LD`I I Electrical Lie.: -1100L,1 Suprv. Lie.: i ndustrial plant per hour _ 73.75
�//�� // !o / to ELECTRICAL PE FEES
Suprv. Electrician signatlfre�tgircd: ��, - Subtotal: (p(
e Plan review (25% of permit fee):
Print name: .%C...1-% S Date: i l 01 5J ,
State surcharge (8% of permit fcc):
Authorized signature: � 311 ��,�! ' � L � .. .s .. _ TOTAL PERMIT FEE: - �� 20
r•• _ .4 'this permit np expires ifs permit is not Obtained o ithin Om
Print name: - c_vse(NL0 S,,,, - rp- a Date. 11- ` - complete -
1, • Number of inspections allowed per permit.
1. tt3 u2di ga1rcrnliI&.E.I,C- PCrmlTApp ovum 440P46151111/05,COMM1CCa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLC3007••00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2007
Phone: (503) 639-4171 •
Inspection Requests (24 Hrs.): (503) 639 -4175 _ '":_.
INSPECTION WORKSHEET FOR DATE: 11/7/2007- TIME: 7 :00AM PAGE: 30
SITE ADDRESS: 111)01 SW BULL. MOUNTAIN R[) CLASS OF WORK:
SUBDIVISION: LOT #: 007 TYPE OF USE:
PROJECT NAME: 6150 ZONE RESERVOIR 2/PRICE PK •
DESCRIPTION: Temporary electrical service. Job No. 149168
OWNER: CITY OF TIGARD PUBLIC WORKS, PHONE #: 603-639-4171
CONTRACTOR: HASKIN ELECTRIC INC PHONE #: 360.73: -0898
Inspection Request Scheduled For: Date: 11/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1W Temporary electrical service 069175.01 360 - 735 -0898 N Y
Corrections /Comments /Instructions:
•
PASS PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 6-~ N(S0 Date: 1 0(0'1 Phone #: (503) 718- 1
CITY OF TIGARD A
BUILDING DIVISION •' PERMIT #: El_C,2007 00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2007
Phone: (503) 639 -4171 I C I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2007 TIME: 7 :01AM PAGE: 63
SITE ADDRESS: 13001 SW BULL MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: LOT #: 002 TYPE OF USE:
PROJECT NAME: 550 ZONE RESERVOIR 2 /PRICE PK
DESCRIPTION: Temporary electrical service. Joh No. 14968
OWNER: Ci IY OF TIGARD PUBLIC WORKS, PHONE #: 503 639.4171
CONTRACTOR: HASKIN ELECTRIC INC PHONE #: :60 7350898
Inspection Request Scheduled For: Date: 11/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical servi 058888.01 360135-0898 N
Corrections /Comments /Instructions: 14
1 PASS . ❑ PARTIAL APPROVAL • ❑ CANCEL U NO ACCESS
FAIL XCALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 66 Date: 11 °Z.' 01 Phone #: (503) 718- 2100