Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00236 DEVELOPMENT SERVICES DATE ISSUED: 4/5/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AA-00905 SITE ADDRESS: 10200 SW 90TH AVE ZONING: R -4.5 SUBDIVISION: TOWN OF METZGER LOT : 004 JURISDICTION: TIG Project Description: New panel & (12) 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: 1 W /SERVICE OR FEEDER: 12 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: DENT, MICHAEL OWNER 10200 SW 90TH AVE TIGARD, OR 97223 Phone: 503 - 813 -6366 Phone: FEES Reg #: Description Date Amount [ELPRMT] ELC Permit 4/5/2005 $160.10 [TAX] 8% State Surcharge 4/5/2005 $12.81 REQUIRED ITEMS AND REPORTS Total $172.91 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: Permittee Signature: 5..17,-e- ti), '2. A J� 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. ti 1 4 , , , l . 4r tU l ,t, w,a 'b0m.M3 F j ,. ,m.rx t c. ,� t i w l !�! -`i , "P Electrical Permit Application .L� � w � o o FFIC E t x SEEONLY 2 , °l � A '' Received City of 1 gard Date/By: t —5" - 65 -- / Permit No.:( b /�,�44� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 l l DateBy: Other Permit: Inspection Line: 503.639.4175 ' 1 1 isi' Date Read B Juris: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: 11 ( (/ Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction . UY Addition/alteration /replacement Please check all that apply: [II Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location ❑Service over 320. amps - rating ❑ Buildn over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential X 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure I=1 Multi family III Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons EManufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: I0 S (.j —I - R 4, ❑Health -care facility ['Other: Submit 2 sets of plans with any of the above. City /State /ZIP: "-V, 'Ur19\_ O 9 - 1 Z 7.-3 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE Description Qty. Fee. Total i ** Cross street/directions to job site: ! S L V New residential single- or multi- family dwelling unit. eQN\ �O thf t� Includes attached garage. LO C,u s\ \ O I p it t•-k-._ 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular oak I dwelling, service and /or feeder 90.90 2 c\ e.l0 o 'x Val_\ 4 61.01 k A ■ C \ V `L Services or feeders installation, alteration, and /or relocation 200 amps or less I 80.30 0 f ) . Zo 2 NO PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: mt r�\ .c, 601 amps to 1,000 amps 240.60 2 ,• Address. G Over 1,000 amps or volts 454.65 2 `� �� LA-) l ( /' -( Reconnect only 66.85 2 City/State /ZIP: - T v i ari ©� C -Z ZZ Temporary services or feeders installation, alteration, and /or ) - - Fax: (Sol) relocation Phone: (Col 1 3 " 3 " 200 amps or less 66.85 1 Owner installation: is installation is i • . - • ade on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, 1-ase, r- 1 t, or exc 0 ecording to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signatur • � _ Date: a U /c f /20 o c Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with 1L;- d service or feeder fee, each Business name: branch circuit 1/ 6.65 --1�e�" 2 B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'] branch circuit 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 extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal (6 .9 C7 . Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) t a . g I TOTAL PERMIT FEE 14.- Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete • Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. / �� / i:\ Building lPermits\ELC- PermitApp.doc 12/03 440 -4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 • Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* H Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918 -260 -260) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls H Clock Systems ❑ Data Telecommunication Installation • ❑ Fire Alarm Installation ❑ HVAC • ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other _ Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\Building\Permits\ELC- PermitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION PERMIT #:IL.C2 O 023 i,', 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41510 Phone: (503) 639 -4171 ILL Inspection Requests (24 Hrs.): (503) 639 -4175 _.. INSPECTION WORKSHEET FOR DATE: l-t -5-01 TIME: PAGE: SITE ADDRESS: 1020Z) SW °`Q AV • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: pmst, 12 Bootil c c EXPIRED OWNER:INII}C* DEIT 1 PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 4- 5 — a*1 Pour Time: Code # Inspection Description Confirm # Contact # Message EINAL Corrections /Comments/ Instructions: (Z A L LAM5 - - m fee..tnin ' S E19)tA C Z °v .Nob tR A)3 1 0\) s ►Dr (ioV 111 coq - Vv A00 c, Ll. ��.. E; t i ts- 05 i4GJ�. f p aan t 6100„L on.\( ft►LLw f) a61 1"tkti fir• 1.5 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS vj, AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6Y'- O8 L Date: 6 of Phone #: (503) 718- 2.14• CITY OF TIGARD BUILDING DIVISION PERMIT #: 6:- /C Z.o 8 g -0/ 3 6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone:. (503) 639 -4171 �d 11 �+ �— 2 D •Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: /0 2_0 v .S w ! 0 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: t DESCRIPTION: OWNER: PHONE #: CONTRACTOR:. PHONE #: • Inspection Request Scheduled For: Date: Pour Time: Code -# Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: J l • The e1 tricai `installation defects notes on this; port shall be corrected and an i ion request made within 20 calendar days per `OAR ^91` 71 -0030 ci 0 . 1 d _c '� :el 7.34. ,440 Let C o 7 p OA conrer-r }` v \ 1 , ❑ PASS __ ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1, Date: Co - 2 - 7" pI Phone #: (503) 718 - r CITY OF TIGARD ,!. >` BUILDING DIVISION PERMIT #: ELC 005 00236 AR 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/5/20415 Phone: (503) 639 -4171 4u Inspection Requests (24 Hrs.): (503) 639 -4175 , ' <.f_ �i. INSPECTION WORKSHEET FOR DATE: 6/24/2005 TIME: 7:08AM PAGE: 88 SITE ADDRESS: 10200 SW 30TH AVE CLASS OF WORK: SUBDIVISION: TOWN OF METZGER LOT #: 004 TYPE OF USE: PROJECT NAME: DENT DESCRIPTION: New panel & (12) branch circuits. OWNER: DENT, MICHAEL, PHONE #: 503- 813 -6366 CONTRACTOR: Dt•IMICHAEL, PHONE #: Inspection Request Scheduled For: Date: 6/24/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 010032 -01 503 - 236.3657 Y Corrections /Comments / Instructions: (1) /,_ x 4 per- r`-p r, L4 4___. p e ( (-0 C.u 4 1- ents/Ins 0 lei - f �i)-1 pJ pt4 k-e — v p ❑ PASS *RTIAL APPROVAL 111 CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A1 C)-- 4 6A Date: C " Z Y OSPhone #: (503) 718-