Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00619
DEVELOPMENT SERVICES DATE ISSUED: 10/31!2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 102C B - 03400
SITE ADDRESS: 10055 SW GARRETT ST 11 ZONING: R -
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
Project Description: 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:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Contact #: 7/
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 10/31/200( $66.85
[TAX] 8% State Surcharge 10/31/200( $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 mor 80-days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification - • - .. Those rules are set
fort n OAR 952-00f=0010 ,ugh OAR 952 - 001 -0100. You may obtain copies of these rules or direct question aro at.503- 246 -6699 or
1- 0- 332 -2344. \ !: i A.,
Is ed By: I • / Permittee Signature: , L
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.
Elect is 1 Permit A 1• �+ l cm lrr i :. \ / - PI/
i� IV ED ® Roceived /� ' 0/0.-• ar ' ot(f 06 / Permit No.: , • 0
1 11 City of 'Tigard Date/By: / 060 . " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie Other Permit:
a Phone: 503.639.4171 Fax: 509 19 �p 9 2006 Date/By )mis: Ed See Page 2 for 1
Inspection Line: 503.639.4175 ° 4
T f I ; 5036394175 Date Ready/By:
;; I P Notified/Method: - Information www.tigard- or.gov CITY 0.F TIGARD
r .. „ !IAN REVIEW a ;•
;•, r "TYM�I{� IVI5ION ... -
CI New construction ❑ Addition/alteration /replacement
Please check all that apply:
[(Service e over 225 amps, comet ['Hazardous location
❑ Demolition Other: ❑Service over 320 amps - rating ['Bulldog over 10,000 sq. ft.,
CATE OF CONSTRUCTION of 1 - and 2 family dwellings 4 or more new residential
•
❑ 1 - and 2- family dwelling ❑Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
B over 600
stories [Weeders, 400 amps or more
Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
RV
.'' SITE INFORMATION . AND• LOCATION ,• . ' _ p
❑Egress/lighting plan ['Other:
park a
t / "
Job no.: j Job site address: �O .- (J 'lK � ❑H e alth -care facility
Submit sets of plans with any of the above.
� � / 071' 7 The above are not applicable to CitylState /Z1P: / j /l�' : ..•FEE *: SCHEDULE
':
no.: / / V j Project name: Derrri n Qty. Fee. 1 Tom I •.
S , v r � J „ f / New residential single- or multi - family dwel unit.
Cross street/directions to job site: j I J /T Includes attached garage.
1,000 s ft. or less 145.15 4
L ot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Subdivision: d l Oi det9-rie.rtriv
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
(Iu� Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 ' 2
r: PR0 T
201 amps to 400 amps 106.85 2
PERTY' OWNER ENANT t; 401 amps to 600 amps 160.60 2
Name: 44- f /!J fly 601 amps to 1,000 amps _ 240.60 2
r� Over 1,000 amps or volts 454.65 2
Address: (�, ' 7( 3 � Reconnect only - -'p' ( 2
City /State/ZIP: "7" ' c _ -
_ ,J O /b� ` 7 7- / Temporary services or feeders installatio , • n, and/or
_ �} ' / relocation
Phone: � ,2- d 0"7' 1 Fes: ( ) 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, rent, or exchange, according to ORS 447, 449, 670, 7 . 401 amps to 600 amps 133.75 2
Owner signature: Date: 1 (0f 00 Branch circuits - new. alteration, or extension, per panel
•„ :, _ •
APPLICANT • , ❑ CO NTAt:T' PER$ON ' . ` A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: ,tom — L�r r �%- I, l�� branch circuit
/ s ` B. Fee for branch circuits
Contact name: without c circuit
or feeder fee, 46.85 2
� first st branch cir rcuit
Address: O /1 Each add'1 branch circuit 6.65 2 _
tad - Miscellaneous (service or feeder not included)
City/State/ZIP:
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
energy panel, alteration, or
CONTRACTOR / extension. Describe: Page 2 2
Business name: 4 of . , It . _ (
IP r • • Each additional inspection over allowable in any of the above
Address: Per inspection 62.50
City / State/ZIP: ' I investigation per hour (I hr min) 62.50
Industrial plant per hour 73.75
Phone: ( ) ' ( - ` ELECTRICAL "R lilts l i'
/ .
CCB Lic.: 1 Electrical Lic.: 'I
j Suprv. Lic.: Subtotal: , ' 4 7
Plan review (25% of permit fee):
Suprv. Electrician signature, re • i3 `5
{ State surcharge (8% of permit fee):
Print name: 1 Date: TOTAL PERMIT FEE a, ow
Authorized signature: This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: j Date: • Fee methodology set by Tri- County Building industry Service Board
• • Number of inspections per permit allowed.
r:lauildin$ Pamila\ELC- PamitApp.doe 03/23/06 4404615T(I I /0S /COM/WEB
CITY OF TIGARD _ _ . 0o I9
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: , i / `'c of TIME: PAGE:
SITE ADDRESS: 1 oo � CLASS OF WORK:
SUBDIVISION: LOT #: I, TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 C VI ' 244 5'C 24
Corrections/Comments/Instructions:
\A L t \ ow e-' oa- 16 , (.OA ,o
EL) 5 VkN5 c-61
P
L- 1\) \
/ fl PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�,
Inspector: Cr '``��� Date: \t 6 • O‘ Phone #: (503) 718- 1044