Permit ir;.,t CITY OF TIG ARD ELECTRICAL PERMIT
. . PERMIT #: ELC2007 -00530
F COMMUNITY DEVELOPMENT DATE ISSUED: 7/31/2007
T Ot 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
v PARCEL: 2S102CB -03400
SITE ADDRESS: 10055 SW GARRETT ST 21 ZONING: R -12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
PROJECT: CYPRESS CREST APTS
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:
NORRIS & STEVENS INC. OWNER
621 SW MORRISON #800
PORTLAND, OR 97205
Phone: 503 - 225 - 8483 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 7/31/2007 $66.85
[TAX] 8% State Surcharge 7/31/2007 $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
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: 9 GG !
ii ‘ r. 1 .± e die c .,7, Z(______ Permittee Signature: !� .►.
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.
' Electrical Permit Applicatio FOR OFFICE USE ONLY
i t Received
7,1 . City of Tigard l)i) l DateB : V j Permit No
° 1 3 125 SW Hall Blvd., Tigard, OR 97223 Plan Revi
Phone: 503.639.4171 Fax: 503.598.196e V u , v? L e Date/B : Other Permit:
TIGARD Inspection Line: 503.639 1 , PL,O ���t ;-) Ct 0VDateReadyBy: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 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: Reconnect 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
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
® Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ 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: 10055 SW Garret 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 21 Project name:�(r. �,� » t- ❑ Service or feeder 600 amps or more.
`- v ca,- FEE SCHEDULE
Cross street/directions to job site: Pacific Highway to frewing to 9800, Description 1 Qt 1 Fee. 1 Total 1 •
New residential single or multi - family dwelling unit.
walk to back bldg 10055 apt 21 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 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Reconnect inspection Limited energy, multi- family
P residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 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, 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 ® CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Norris & Stevens, Inc. B. Fee for branch circuits
without service or feeder fee,
Contact name: Michael Henniger first branch circuit 46.85 2
Address: 621 SW Morrison #800 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 972005 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 225 -8483 Fax: : ( ) Reconnect only / 66.85 t 2
E -mail: mikeh @norrstev.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Owner Signal circuit(s) or limited -
energy panel, alteration, or
Address: 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: /e".5
Print name: Date: Plan review (25% of permit fee): ll
-
r State surcharge (8% of permit fee): 3 Authorized signature i TOTAL PERMIT FEE: ad This permit application expires if a permit is not obtained within 180
Print name: ( ,,r • � PM N t p Date: 7.- 36 7 days after it has been accepted as complete.
` / • Number of inspections allowed per permit.
I: \ Building\Permits\ELC- PermitApp. doc 05/23/06 440- 4615T(1 I/05 /COM/WEB I (V---V 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -0050
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ;"_��
INSPECTION WORKSHEET FOR DATE: 8/3/2007 TIME: 7:03AM PAGE: 6/
SITE ADDRESS: 10055 SW GARRL.I 1 ST 21 CLASS OF WORK:
SUBDIVISION: CIIARLOTTENHOF APARTMENTS LOT #: 009 TYPE OF USE:
PROJECT NAME: CYPRESS CREST APTS
DESCRIPTION: Reconnect
OWNER: NORRIS & STEVENS INC., PHONE #: 503. 225 - 8403
CONTRACTOR: . OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 053179.02 503-225-8483 N
Corrections /Comments /Instructions:
NN_/\/
PASS n PARTIAL APPROVAL U CANCEL NO ACCESS
1 ( F' CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: Y V o e) Lt Date: t '3 Phone #: (503) 718- 2.4