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Permit C ITY OF TI ARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00082 r•F ^ e �i DEVSWOP B DATE ISSUED: 2/2/2006 13125 503 -639 -4171 PARCEL: 2S 102CB -03200 SITE ADDRESS: 09975 SW FREWING ST ZONING: C -G SUBDIVISION: MASSIH OFFICE BLDG LOT : 021 JURISDICTION: TIG Project Description: Temporary service. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 0 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: KAMELIA MASSIH HALCYONE INC. 1831 SW DICKINSON LANE 7026 SW CANYON DR. PORTLAND, OR 97219 PORTLAND, OR 97225 Phone: Contact #: FAX 503 - 297 - 2401 PRI 503 - 297 -2159 FEES Description Date Amount Reg #: LIC 99762 [ELPRMT] ELC Permit 2/2/2006 $66.85 ELE 34 -385C [TAX] 8% State Surcharge 2/2/2006 $5.34 SUP 3045S Total $72.19 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaa odes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopte. a the • • .lity Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of • ese rul: ......,, _ o • NC at 503 - 246 -6699 or 1 0 -33 2344. Issued By: Permittee Signat - • OWNER INSTALLATION ONL The installation is being made on property I own which is not intended for sale, 1- _ : - , 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. ; • Plkctrical Permit A." t - ; , w ... , j , , �.9. 'g .. " I (0R O I 1.1 C I U ti l O 1 City of Tigard "� 1. y g ` Received `J Date/: - ■ i . g_I Permit No.*/ 1• 0, if "Oaf 13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev : 4.,,, x ?• Other Permit: Phone: 503.639.4171 Fax: 503.598.1 1 DazeBy. Inspection Line: 503.639.4175 g 2 2006 . � r l! D ate ReadyBy: 1uris: El See Page 2 for Internet: www.ci.tigard.or.us , ,, N otified/Method T`6. Supplemental Information ,gi , i' �V PLAN REVIEW. ' B!.,1* - �i � t j�c Nnt Please check all that apply: ❑ New construction h• ��� ❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential K I - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi - family 0 builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or _ JOB SITE INFORMATION AND LOCATE -- ..__ ❑Egress/lighting plan RV park Job no.: Job site address: - . 'lealth - care facility ❑Other: ` Submit 2 sets of plans with any of the above. City /State/ZIP: ! l` . iv I� � 7 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE Description Qty. I Fee. I Total I •• 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 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK R Each manufactured or modular � d welling, service and/or feeder 90.90 2 • �- - /t/V t/u Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 - ❑ PROPERTY` OWNER - ' I ' ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 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 relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 is 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 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, first branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) • Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- - CONTRACTOR energy panel, alteration, or extension. Describe: Paget 2 Business name: 25,67/ _ (.-- k, ® v". - ....„4 /t i c - Each additional inspection over allowable in any of the above Address: 7c / L ! ),- C e� � ) Q .J (2 ..__ Per inspection 62.50 City /State/ZIP: l it /� 0 ( A (, I Investigation per hour (I hr min) 62.50 Phone:` j�)�,? �y, I Fax: (��� �Y\ /1 Industrial plant per hour 73.75 / v ELECTRICAL PERMIT FEES *. CCB Lic.' Electrical Li t 4 l Suprv. Lic. ` � 4C Subtotal , �' Suprv. Electrician signature, ret , Plan review (25% of permit fee) Print nattgp_i_ Date State surcharge (8% of permit fee) b`// �' �J Al A. State TOTAL PERMIT FEE 7a. g 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 \Permits\ELC- PennitApp.doc 12/03 4404615T(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* ❑ Burglar Alarm ❑ Garage Door Opener* _ ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMER �_CIAL �_ WORK ONLY -, ' Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* - n ❑ Protective Signaling M1 ;- - ❑ 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 #:(... �►oD3� 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 , ,,' 1 k Ins Requests (24 Hrs.): (503) 639 -4175 iJ.. INSPECTION WORKSHEET FOR DATE: Z/( '/o TIME: PAGE: SITE ADDRESS: �4 75' k/5 CLASS OF WORK: SUBDIVISION: �Q (� LOT #: TYPE OF USE: PROJECT NAME: ma'C !� %,Lj \t"�/(t -/C1L 13/de DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Descriptio Confirm # Contact # Message • T , rvs 13 o I 02, - / S Correc '. . -- -• _ • II .: •- • • i 1 1 j 4 PASS 1 PART AL APPROVAL f CANCEL ❑ NO ACCESS • ❑ CI . •R INSPECT 'IN ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Z/ 3I 64 Phone #: (503) 718 - 2.., .1 CITY OF TIGARD BUILDING DIVISION PERMIT #: � 2a616 — 1 � 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 I1If , Inspection Requests (24 Hrs.): (503) 639 -4175 �_' INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: "( "! 7S Fy�j,C/ /r/5 CLASS OF WORK: `d/91/� SUBDIVISION: / LOT #: TYPE OF USE: PROJECT NAME: /171 41 ©4 `j /4 DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message I qg paw Corrections /Comments /Instructions: (, ¢ '‘ F EnE sbvir (5 1'2.6' pffi tb 6.6 • PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- 7 1 CITY OF TIGARD . BUILDING DIVISION PERMIT #: .I 00p,.00 Y) 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 000; Phone: (503) 639- 4171■4 Inspection Requests (24 Hrs.): (503) 639 -4175 '' INSPECTION WORKSHEET FOR DATE: J8/200G TIME: 7:01 AM PAGE: 9 SITE ADDRESS: (WM W F REWiN(; ST CLASS OF WORK: SUBDIVISION: MA 3S =IH OFHCE F3LDG LOT #: 021 TYPE OF USE: PROJECT NAME: MASSII -1 OFFICE BUILDING DESCRIPTION: Temporary service. OWNER: MA; SIK KAMELIA PHONE #: CONTRACTOR: FIALCYONE INC. PHONE #: 503-297-21f';9 Inspection Request Scheduled For: Date: ` 1tif:: 006 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 - 1 iriporary electric: al se:ivic:e 026501 -01 60:3-109- 346 N Corrections /Comments/ Instructions: ‘ CASO—RF:a i CS IN) UV A-0%W 1 4 *IC N \.) AN8Z1, e, : rx»n N . ..(U ctin1'�� rri� 'l - 6.v C Pte. c - E Z O : 5 0 Co v"R'(L CAF 2akt4(2kt_ P ANf 16 1� 1 (6 op .. l P n PASS n PARTIAL APPROVAL U CANCEL ❑ NO ACCESS 1I FAIL A CALL FOR INSPECTION /E/ ADDITIONAL FEES ASSESSED Inspector: a. V e, L ' Date: 27 I,' 0 6 Phone #: (503) 718-111113 CITY OF TIGAR® BUILDING DIVISION PERMIT #: El_C`2.00tf; -01.1e 2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 /; /)00j Phone: (503) 639 -4171A i 1 t Inspection Requests (24 Hrs.): (503) 639 -4175 �.. INSPECTION WORKSHEET FOR DATE: 2lfJ2006 TIME: 7 :02A M PAGE: SITE ADDRESS: 09975 Fp ms's §iG ST CLASS OF WORK: SUBDIVISION: Itii /k.`;„;;ft t" FFIC : I:si_ DG LOT #: 021 TYPE OF USE PROJECT NAME: F >i A; S!I-; O FICE: I._If)lN(, DESCRIPTION: 'I eir! y servico OWNER: f( AMR IA PHONE #: CONTRACTOR: I"IALCYONE lN('. PHONE #: 603 2i'.1f) Inspection Request Scheduled For: Date: 21612006 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 ^e liporary elect rie- :aI ; ervic :e 02't;33$. 01 503 - 7B8 - 2345 N Corrections /Comments/ Instructions: M Q U`P A LL ta,vi t Fmikx\ri T O co E � G`FLZ I CO COtj E YY� J ?)ts - , < Pasowg r iko t34,41) f t s v Fist, 0.4 U • ` tkc Cri 0* i E itit)06 c)31)( C-41\ 061 si L \)q w ►�'I SY C N'��. 1 PASS _ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ►�,1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: 6 61) Phone #: (503) 718 -1