Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00106
DEVELOPMENT a Tigard, oR 97223 ES (503) 639 -4171 DATE ISSUED: 2/23/2005
PARCEL: 2S102CB -00302
SITE ADDRESS: 13185 SW PACIFIC HWY B -4
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT : 033 JURISDICTION: TIG
Project Description: 2 branch circuits.
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: WISERVICE OR FEEDER: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
ALADDIN MOTOR INNS BECK ELECTRIC INC
BY BENZENISTE, IRVING 9318 SE CHURCH ST
10155 SW CAPITOL HWY CLACKAMAS, OR 97015
PORTLAND, OR 97219
Phone: Phone: 656 -7396
FEES Reg #: SUP 5024S
LIC 00002629
Description Date Amount ELE 3 - 5C
[ELPRMT] ELC Permit 2/23/2005 $53.50
[TAX] 8% State Surcharge 2/23/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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 -8 00 -33 344.
Issued By: L� �� �1� Permit Signature: ,n
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 639 -4175 by 7:OOpm for an inspection the next business day
Electrical Permit ApIRECk 1 \i E. P FOR OFFICE USE ONLY
City of Tigard R pp
o) 5 his e 6 Permit No..' t j 00 � , / e26
1 3125 SW Hall Blvd., Tigard, OR 97223 FEB 23 200 " Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' � 'f � t - Date/B : Other Permit:
Inspection Line: 503.639.4175 y!- Date Ready /By: H See Page 2 for
Internet: www.ci.tigard.or.us CITY OF Il IG ` _I Notified/Method: Supplemental Information
tli+i, - ([I J VlSriUJ\ PLAN REVIEW
❑ New construction Addition /alteration /replacement Please check all that apply:
❑ Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition 0 Other:
['Service over 320 amps — rating OBuildng over 10,000 sq. 0.,
CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or more new residential
❑ I - and 2 family dwelling g Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑ Other: ❑ Building over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
'1 15 Job site address: 132is 51,0 1� L �� ❑Health -care facility ❑
Job no.: 10
QGI�t�. � r TlJ�1y Submit 2 sets of'plans with any of the abovee
.
City /State /ZIP: - C Aid( ,,, Q a_ 0112..23 The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: J Project name: FEE* SCHEDULE
Description I Qty. l Fee. ` Total 1 **
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Ul A
.L T—CAL 2. ' F Arri Gas Tote- otC. Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER C:1 TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160,60 2
Name: "1— 1 ` S 4We_ 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
( ) 1o 3�5 3� ( )
relocation
Phone: J Fax: 2000 amps or less 66.85 I
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, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit I 46.85 2
Address: Each add'I branch circuit I 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
1 extension. Describe: Page 2 2
Business name: --- 6.ecx. E LC$f1 �, _ c_
E-- QQ Each additional inspection over allowable in any of the above
Address: 1 5(600 SFoie Moe.. C+. v Per inspection 62.50
City /State /ZIP: jacra ( O R. C 1 101 S- ` / ;5 Investigation per hour (1 hr min) 62.50
'�� 165t ei ( , (�5) IoSCo — ' (391 � �\ Industrial plant per hour 73.75
Phone: ) Fax: -
ELECTRICAL PERMIT FEES*
CCB Lic.: 2,6Z9 IL. Electrical Lic.: 3-5e_ Suprv. Lic.: 502.4-5 1 Subtotal S $
Suprv. Electrician signature, required: C Plan review (25% of permit fee)
•
I I s State surcharge (8% of permit fee) '4. 2_'•
Print name: '(� la v%vlt 5 Date: '2_,2, 3 p
TOTAL PERMIT FEE 5 7 . 1 8
Authorized signature: " This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Clevmete s '..-6g0lrlt 5 ... Date: 2.3 pc * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per pem» t allowed.
i. \ Building \ Permits \ELC- PermitApp. doc 12/03 440- 4615T( 1 0 /02 /COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 QQ1Q6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/23/2005
Phone: (503) 639 -4171 6 Inspection Requests (24 Hrs.): (503) 639 -4175 __.._
INSPECTION WORKSHEET FOR DATE: 3/10/2005 TIME: 7 :30AM PAGE: 48
SITE ADDRESS: 13285 SW PACIFIC HWY 7 -11 CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 033 TYPE OF USE:
PROJECT NAME: 7 -11
DESCRIPTION: 2 branch circuits.
OWNER: 1 ) PHONE #:
CONTRACTOR: BECK ELECTRIC INC PHONE #: 656-7396
Inspection Request Scheduled For: Date:. 3/112005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 001128 -01 50365E -7396 N
Corrections /Comments /Instructions:
*SS 1 PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
actor: Date: - 6 — Phone #: (503) 718 -