Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00029
Ilk f DEVELOPMENT SERVICES DATE ISSUED: 1/17/2006
< - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 113AD -01700
SITE ADDRESS: 16920 SW 72ND AVE ZONING: C -G
SUBDIVISION: ROSEWOOD ACRE TRACTS LOT : 030 JURISDICTION: TIG
Project Description: (37) branch circuits, (1) LV for fire alarm. Job #321144.
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: 1
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 36 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:
• BRIDGEPORT LAND LLC ROSENDIN ELECTRIC
3939 NW ST HELENS RD 1300 NE 48TH #1200
PORTLAND, OR 97210 HILLSBORO, OR 97124
Phone: 503 - 224 -2676 Contact #: FAX 503 - 615 - 0689
PRI 503 - 615 -8189
FEES
Description Date Amount Reg #: LIC 103939
[TAX] 8% State Surcharge 1/12/2006 $29.06 ELE 3071S
[ELPRMT] ELC Permit 1/12/2006 $363.25 SUP 37 -692C
Total $392.31 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: _ 14 f Permittee Signature: .5.e_. Sa `P p
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Elqetrical Permit Application FOR OFFICE USE ONLY
City of Tigard DateB - / Permit No.: "(L::w3 t - 4 A3 =` ) — , !
13125 SW Hall Blvd., Tigard, OR 97223 RE ! 1'
Phone: 503.639.4171 Fax: 503.598.1960 1 Other Permit:
Inspection Line: 503.639.4175 f D Ready /By: EN 0 See Page 2 for
Internet: www.ci.tigard.or.us .J t / 0 06 Not ified/Method:
g Supplemental Information
TYPE OF WO �T j�/I � PLAN REVIEW
ill New construction Addition/alterat t�{acgt�i Please check all that apply:
❑ Demolition ['Other: v�IRN1f(G� DM$'ON ['Service over 225 amps, comm'l ❑Hazardous location
DService over 320 amps - rating ❑ Buildn over 10,000 sq. 0.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
111 Multi- family ❑Master builder 111 Other: ❑Building over three stories [Weeders, 400 amps or more
DOccupant load over 99 persons Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑E /li plan RV park
Job no.: 32 // 44..) Job site address: /(,,e3 2 0 `,, 1 f 7, ❑Health - care facility ['Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: "7 i ,, tr) e- • = t t 7t. , j The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: ' , , 5 s .•; t..--- 1.•:.::.,-f-.
Description Qty. I Fee. I Total ,
Cross street/directions to job site: " J, G: 3a , , `' ?. t - 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 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 _ 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder 90.90 2
tt ge ►.tir,ac,_Si '1? "'t - - -, ?t!0,.! v._ - $ -- t><r? 1 . ' :, , Services or feeders installation, alteration, and/or relocation
t). - 4!,.t 1 , 1 e0 - 1 ",. - 1 t..C' 1r,r o t.,a - l . til $ S 200 amps or less 80.30 2
El PROPERTY OWNER ® TENANT 201 amps to 400 amps 106.85 2
w _ 401 amps to 600 amps 160.60 2
Name: : ' a. ,. 1 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
P ...,P..� ,.- ,.\
Reconnect only 66.85 2
City/State /ZIP: ., r , ;.. ; 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 600 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
J) APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: ' . . . -,,,::,,,,L,3::„ c 1 4-vt x. \ ` branch circuit
B. Fee for branch circuits
Contact name: , r_. t },.i t; `.y t: , ' ,. p •, , f - without service or feeder fee, / 46.85 l l 2
Address:. ty first branch circuit ^
1 ✓ E -�" - �' _ ___ Each add branch circuit : , 6.65 2x7;/. 2
City/State /ZIP: wt, - .t " cir, ti 4.71 0 7 ...j Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (:t: 6-`:,) ;:, p S" , ; yt I Fax: : ( a?) ,,` ,- -;.:4, Sign or outline lighting 53.40 2
E-mail: " „r i. :.., t f ..,,; e: ; .t,. ,. ,h, ° . t:: r.r:
�' Signal circuit(s) or limited-
.
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 ')) 2
Business name: Y (.. c ..c, t ,.,,„ ; „ :., c ;,?” T' = c,
Address: a tT µ - Each additional inspection over allowable in any of the above
<_ �t t `' L l ' Per inspection 62.50
City/State /ZIP: j\ .,` r r, 7). q 7 tZ. L. ` Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: ( 55733) c,. / ' (-t rel Fax: (S' (e' /r- rR L. P. j ELECTRICAL PERMIT FEES*
CCB Lic.: Electrical Lic.: Suprv. Lic.: ■ S
Subtotal - 3 r ' - 5'
Suprv. Electrician signature, required: Si .. V� Plan review (25% of permit fee) ._
Print name: C� '.,..��p,) , -� Date: i ,-/ :2. -.b State surcharge (8 % of permit fee)
� - TOTAL PERMIT FEE '
Authorized signature: � v, . _ � This permit application expires if a permit is not obtained within 180
` ,� days after it has been accepted as complete
Print name: c}6�...) , .AlA)I. ,cor ti Date: / - / Z -t • Fee methodology set by Tri-County Building Industry Service Board
•• Number of inspections per permit allowed.
i.\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Ele *trical Permit Application - City of Tigard
Paige 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
I Garage Door Opener*
U Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK+ONLY x
Fee for each commercial system $75.00
(SEE OAR 918-260-260)
Check Type of Work Involved:
H Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
(� HVAC
❑ Instrumentation
H Intercom and Paging Systems
❑ L andscape Irrigation Control*
❑ Medical
❑ N urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
H Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
is \Budding\Permits\ELC- PermitApp. doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: - 000 a 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ���� ^,,,����
Inspection Requests (24 Hrs.): (503) 639 -4175 s'y
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 6 Z Q 701 'i7ai' /4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
.�
CONTRACTOR: %OE S PHONE #:
Inspection Request Scheduled For: Date: 3-07 3 - 0 c Pour Time:
_ # Inspectyn De Confirm # Contact # message
- g/
Corrections /Comments /Instructions:
o C .0v , 0 1 C/ "etoiN S i NN "NaViSec k WAVAL,
StA0 iktV CPB .1 vaffias A. ofsimtzuls,\,-.
f
IA FASS I J PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: C-1 . Date J �� � j Phone #: (503) 7 18- 2g
CITY OF TIGARD
BUILDING DIVISION PERMIT #: x2 —00
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 °, ,iriCi�ll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /6 90)-0 7 Q /h- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: ')S
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -9-0 Co Pour Time:
Code # • _ _ - - • • I escri•tion Confirm # Contact # Message
Corrections /Comments /Instructions:
P iY1tN -1 L—$1d
PASS 'A PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:' • ( )
Date: 3 9 0 P hone #: 503 718- 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I c , I 0E; 000' 9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 1117000 .
Phone: (503) 639 -4171 :
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/220006 TIME: •7 :0 Am PAGE:
SITE ADDRESS: 1020 i lipyr 72ND) AVE CLASS OF WORK:
SUBDIVISION: mx.: 0Ul:) Acl f° •R - rt LOT #: 030 TYPE OF USE: .
PROJECT NAME: DSW SHOES
DESCRIPTION: (37) branch t._ircuit , (1) LV 10r firs alarm. Job #3.1144.
OWNER: BRIDGEPORT LAN[ t i r•, PHONE #: 603,.:01.1-2676
CONTRACTOR: ROSENDIN ELECTRIC PHONE #: ri(): 01 t 1t2t'r
Inspection Request Scheduled For: Date: 2122 f006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 l;;eilinq cover 02/33:.01 603-793.14 N
Corrections /Comments /Instructions:
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IA o`Q tZ1.A g .. 3tk ill
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PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CT 4%2)6 4e Date: 21:1 104> Phone #: (503) 718- 144 • •
J
CITY OF TIGARD
., . .
BUILDING DIVISION PERMIT #: El..c..200C.00(Y1.1
• 13125 SW Hall Blvd., Tigard, OR 97223 , c. DATE ISSUED:
44, 1/17/200;3
Phone: (503) 639-4171 14re
•
Inspection Requests (24 Hrs.): (503) 639-4175 ,.,,.„,... -,.... •
INSPECTION WORKSHEET FOR DATE: 21 1 612 OM TIME: 7:0Thm PAGE: 2.
SITE ADDRESS: .16 sw 72ND AVE CLASS OF WORK:
SUBDIVISION: -31:vvoor) AGRE TRAcTs LOT #: 0 ,.. TYPE OF USE:
PROJECT NAME: i xAl v s H 0 E:s
DESCRIPTION: - 10 branch cliciaits, (1)1..V for fire dan Job #32
OWNER: BR1DGFPOR1 LAND LLC, PHONE #: 6 03 , 224. 2E; i E . ;
CONTRACTOR: ROSENDIN ELECTRIC PHONE #: 503-615-610
Inspection Request Scheduled For: Date: 211612,006 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
Ceiling cover 027027-01 j!
___.-------
Corrections /Comments/ Instructions: •
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. -
•
1:71, PASS El PARTIAL APPROVAL El CANCEL 0 NO ACCESS
fl FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED .
Inspector: Aiitz- N (A 1 -- 1 Date: 2 - - 1 It Phone #: (503) 718- 1_44R
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El ,I.Q.00 f..C'0tcac
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1l17/:es`1f7.
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ..'+�:__..
INSPECTION WORKSHEET FOR DATE: - )/13/2006 TIME: 7:03AM PAGE: is
SITE ADDRESS: 1(.,:i.1.20 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: RoS WOO[) ACRE TRACTS LOT #: 030 TYPE OF USE:
PROJECT NAME: +;:) ;W SHOES
DESCRIPTION: (y/) branch circuit::, (1) LV for fire alarm. Job
OWNER: BRIDGEPORT LAN() LLC, PHONE #: 603- 2242376
CONTRACTOR: RO yENDIN ELECTRIC RIC PHONE #: 503-1,316-018.:1
Inspection Request Scheduled For: Date: 2/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 t1;ilirig cover 026799 -01 t;(,3-793-7416
•
Corrections /Comments /Instructions: r
Rft nt -- �'\1 \� X
4\ipPik- risIL IA) op
.)14 0 A trizzA I aa.spi 6(J -
•
•
n PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 Date: 2 E Itty Phone #: (503) 718- 14 %,
.... .
....
CITY OF TIGARD ,
. i ,_
BUILDING DIVISION. PERMIT #: E.I.J.:2006-00029 ._..
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/17/2006
Phone: (503) 639-4171 *14 '
Inspection Requests (24 Hrs.): (503) 639-4175
, • .
INSPECTION WORKSHEET FOR DATE: . 2110/2006 TIME: 7:04AM PAGE: 4
SITE ADDRESS: i&I.,() SW /2ND AVE. CLASS OF WORK:
SUBDIVISION: RO:f.31:: ACRE: EA 'I - LOT #: 02,0 TYPE OF USE
PROJECT NAME: DSW SHOES
DESCRIPTION: (37) branch circuits, (1) LV for fire rRlarat. Job 32i 144
OWNER: BRIDGEPORT LAND 11C, PHONE #: 503-224-26P3
CONTRACTOR: POSENDIN ELECTRIC PHONE #: 60.615.019
Inspection Request Scheduled For: Date: 211012006 Pour Time:
Code # I I • - ••ri Description Confirm # Contact # Message
130 Ceiling covet 026692-01 50'3•793-7416 N
Correction .-. -- -- e`•••;.••• . • • =:
13.0 ilt,cat j oN t-, • • .
•
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0 PASS 1PARTIAL APPROVAL D CANCEL D NO ACCESS
n FAIL CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: &AR
‘ 4 Date: 2/1 ng Phone #: (503) 718- gib
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: Fl_t: %t rl3 tptit ,c
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 1 12006
Phone: (503) 639 -4171 ea linq, ,l.'���
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2i6/2006 TIME: 7 :02AM PAGE: 9
SITE ADDRESS: 16 320 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: 1 QSEYVOO[) ACRE TRACTS LOT #: 030 TYPE OF USE:
PROJECT NAME: !.)SW SHOES
DESCRIPTION: (37) branch circuits, (1) LV for fete aI,:rrrrn. Job #32•11`14.
OWNER: BRIDGEPORT LAND LLC, PHONE #: 5503- 224 -2677
CONTRACTOR: UOSENDIN ELECTRIC PHONE #: 603-
Inspection Request Scheduled For: Date: 21 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
—44.44—` :.: , 0263M-02 %0 793 • 44d.i lit
044 WALL c j (L
Corrections /Comments /Instructions:
A (Ai ALL- ciz.J `R(L.
11 PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS •
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: G /, \► "V l Date: ZA '66 Phone #: (503) 718-
CITY OF TIGARD
.r •
BUILDING DIVISION PERMIT #: I !_s :iilxs:s tl + °i0?!)
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/i7 / ?t) )
Phone: (503) 639 -4171 Arp
Inspection Requests (24 Hrs.): (503) 639 - 4175 _ ;.
,
INSPECTION WORKSHEET FOR DATE: 2 /6/2OOG TIME: 7:07Am PAGE: 10
SITE ADDRESS: 'irA ^' #2() SW 72N0 AVE CLASS OF WORK:
SUBDIVISION: ROSEINOOD ACA TRACTS LOT #: 030 TYPE OF USE
PROJECT NAME: 1)SW SHOES
DESCRIPTION: (37) branch circuits, ( l..V for fire, a1,-nm. Job #321144.
OWNER: t3l= 2ID(EPQRT LAND Li_C, PHONE #: 224- 2(;76
CONTRACTOR: l kOAE.NDlN ELECTRIC PHONE #:t):
Inspection Request Scheduled For: Date: 2/6000G Pour Time:
Code # Inspection Description Confirm # Contact # Message
106 tdit+;$olgroun h:.. c:over 02G334 01
Correetienstebmments/ Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL 1 I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1Na Acv (-1( Date: 6 66 Phone #: (503) 718- 2q144
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CITY OF TIGARD
BUILDING DIVISION •
PERMIT #: 1= 1_200ti;.000' 9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .I/ 17f.?l:;OT;
Phone: (503) 639 -4171 _..._tili
Inspection Requests (24 Hrs.): (503) 639 - 4175 l
INSPECTION WORKSHEET FOR DATE: W3/2006 ; TIME: 7:02AM PAGE: 7
SITE ADDRESS: '16920 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: ROSEWOOD ACR.F. TRACTS LOT #: () () TYPE OF USE
PROJECT NAME: D ',7+/ SHOES
DESCRIPTION: (37) branch circuits, (1) LV for fire alc r n. Job #321144.
OWNER: I3RIDGEPORT LAND LLC, PHONE #: 6 -; ; 4.26 f6
CONTRACTOR: ROSENDIN ELECTRIC PHONE #: C:03-61f;-0189
Inspection Request Scheduled For: Date: 7 /3 /yK() )6; Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 E. iet:tr ic l rough -in 026262 -01 603-793.744f.- Y
1 2+" WALL CO ea.. ON E-11.1'_
• Corrections /Comments /Instructions:
Ptpp GUN fkLa 1 0 coves. poe4 teLoonnd or-F- at s
jai ' witaLL5 , (gii-kk. bF- g u LZN't
Nye tea “ 5plk wp.L_ 6K 70 csJam
n PASS A PARTIAL APPROVAL CANCEL n NO ACCESS
n FAIL L CALL FOR INSPECTION Li ADDITIONAL FEES ASSESSED
Inspector: G 9 V 4 5e `--, Date: 21 3 06 Phone #: (503) 718- 2 Li"1D