Permit CITY OF TIGARD ELECTRICAL PERMIT
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'. ,° PERMIT #: ELC2006 -00704
v.! 1- COMMUNITY DEVELOPMENT DATE ISSUED: 12/8/2006
19 T � tG � A � RDi 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102CB -03400
SITE ADDRESS: 09850 SW FREWING ST 46 ZONING: R -12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
Project Description: Electrical reconnect only
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:
ALEX FINKE
PO BOX 23562
PORTLAND, OR 97223
Phone: 503 - 244 -5824 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 12/8/2006 $66.85
[TAX] 8% State Surcharge 12/8/2006 $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 wor a one )n accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspe ded for more than,180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Or- z n • , - . cation Center.
Thos rules are set forth ih A . -.2 -031 -0010 through OAR 952 -001 -0100. You may obtain copies of t - --res •r direct questions to OUNC at
503. 6.6699 o 1.800.332. 44 7 / A
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Issue y: )��� C�� Permittee Signature: ,1 G
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.
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Electra al Permit Application ;.a -� T ` 'I () 6 i :MCI . usl ; oI -,,, ,N � � w T
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Receive / (/
City of Tigard Date/By Ai" Permit No.: gk e�� X76 r
0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
, ! ® Phone: 503.639.4171 Fax: 503.598.1960 Dae/By. Other Permit:
'i "7-'- Inspection Line: 503.639.4175 Date Ready/By: Juris El See Page 2 for
b T,l G'Alk D'
611Oiki t+1! Internet: www.tigard or.gov Notified/Method ' - r : te , Supplemental Information
TYPE OF WORK • PLAN REVIEW
❑ New construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
P /1 ii 0 Master builder 0 Other: ❑ Fire pump. 0 Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: `/ y5 O SW rEEtAle 100 ormo more. o re residential units. ❑Recrea occupancy. ❑ Six or moional vehicle parks.
City / State/ZIP: T( ' • j�,6 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 44, , Project name: L7et/ � ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 •
S JA 1 r ,1 r New residential single- or multi- family dwelling unit.
`L� J Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK 1 (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 arttps or less 80.30 2
J PROPERTY OWNER I ❑ TENANT 201 a mps to 400 amps 106.85 2
/// �� "` �/ 'A/k6=
401 amps to 600 amps 160.60 2
Name: r
� 601 amps to 1,000 amps 240.60 2
/`�
Address: (?, e/ Z 3 Z Over 1,000 amps or volts 454.65 2
City /State/ZIP: T om/' /a 7 ', r , Temporary services or feeders installation, alteration, and/or
4Idx: relocation
Phone: ( 3) _ ' ( ) 200 amps or less 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, lease� t, Ar exchange ' ccording to ORS 447, 449, 670, and 701 401 amps to 599 amps 133.75 2
r Branch circuits — new, alteration, or extension, per panel
e: Date: 9 //
Owner signature: SO A. Fee for branch circuits with
❑ . APPLICANT 1 ❑ CONTACT PE N above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Ale e , Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only =B•• 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR . • Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: , , 4 J extension. Describe: Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): r1
Authorized signature: TOTAL PERMIT FEE: 73 . O U
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I :\ Building \Pezmits\ELC- PernitApp.doc 05/23/06 440-4615 T( 1 1/05/COM/W EB
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
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•
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: y
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved: •
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number. of commercial systems: _
*No licenses are required, Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 03/13/06
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BUILDING DIVISION PERMIT #: B .G")006 0070.1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/8/2806
Phone: (503) 639-4171 �
Inspection Requests (24 Hrs.): (503) 839'4175 .,--OP' ',IL
INSPECTION WORKSHEET FOR DATE: 12/19/2006 TIME: 7:OOAk6 PAGE: 3Q
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SITE ADDRESS: 0985Q S�/�AE]/MM(� G[ � x " � CLAGS OF WORK:
SUBDIVISION: CHARLOTTENHOF AP � k4ENTS LOT #: O89 _ TYPE OF USE:
PROJECT NAME: CHARLOTTENHOF
DESCRIPTION: []ect/imF.11 /ec:onneci. only
OWNER: FINKE, ALEX PHONE #: 503
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 1119/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 []*cL,icsdomnime 041271'01 603-244-6824 Y //
Corrections/Comments/Instructions:
PASS | 1 PARTIAL APPROVAL 1 | CANCEL NO ACCESS
. / . /
FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
U &Phone Date: IL '- / / ~7 — b h ky Phona #: (503) 718-