Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00927
DEVELOPMENT SERVICES DATE ISSUED: 12/2/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 112 B D -00 700
SITE ADDRESS: 14655 SW 76TH AVE 13 ZONING: R - 12
SUBDIVISION: MARCIENE 11 APARTMENTS LOT : JURISDICTION: - FIG
Project Description: (4) branch circuits for washer, dryer & heaters. Job # R05 - 1310.
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/ SVCI 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: 3 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:
BOOTH - HEYDON LLC ABC ELECTRIC
PO BOX 1185 135 NE 9TH AVE
LAKE OSWEGO, OR 97035 PORTLAND, OR 97232
Phone: Phone: 503 - 233 -7551
FEES Reg #: LIC 26 -1226C
Description Date Amount SUP 5096S
ELE 161501
[ELPRMT] ELC Permit 12/2/2005 $66.80
[TAX] 8% State Surcharge 12/2/2005 $5.34 REQUIRED ITEMS AND REPORTS
Total $72,14
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: Permittee Signature: ` -
•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.
DEC-02-2005 08:13 AM P 0 2
Electrical Permit Application FoR 01..FicE um.: ()NIA
. t —
City of Tigard , ' P ' D R Iitm edved ,„
- i) ' Permit No.: 0 - ' 1
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639,4171 Fax: 503.598.1960 .:4,,,,ti:A.10iON DateW, Other Rennin ,
Inspection Line: 503.639A175 _d.j. • ,I. 1 Date Ready/By: I..* ill See Page 2 for
Internet: wsvw.ci.tigard.or.us , - ---- • Notified/Method: i
Supplemental Intermitted 1
• •::•••!! TYPE :0 7 4( eirit*Pi2.;::! , iiF:Ni;: . r i . ,...!'Li E '1 ''. '..;' 7 . 0 t * :1* 14 t tH . : ;:. ::' : 1 ; !: :'i' 4 : '.: ,::.: :• .: i .':::' ::.' .2' jii g ::' ,c !:;11:' ,.' 4
El New construction % 1S1 Addition/alterationireplacoment Please check all that apply:
0 )
0 SerViCe OVET 225 amps, comet 01-Iazardous location
0 t:hcr:_.,.•: .,/■'::1;1\!
Oservice over 320 amps — ratMg Oliluildng over 10,000 sei. ft.,
• .4,4;2: Demolition d
::: ; 4ii ,...,, tisfoititolo,wo i d •E.:ii;;;;INapao,:r2;;;;:i;;;i:i of 1- and 2-family dwellings 4 or more new residential
0 er structure
El 1- and 2-family dwelling )13.Conunereiallindustrial 0 Accessory building System over 600 volts nominal units in onc
ClEtuilding over three stories LIFeedere, 400 amps or more
I:1 Multi-family 0 Master builder 0 Other. :Occupant load over 99 persons IDManufactured structures or
'''!
71!:04 DEgressiligliting plan RV park
OHealth-care facility nOther:
Job no.: p . it() Job site arldreas r t , I A
Submit .2. sets of plans with any of the above. • City/StateJZIP: J 1 0. rcsi 1 () i , The above are not applicable to temporary construction service.
.. . l'ik:";'; PR ! :111101"g - :70'6110 - :•: , . , ,soileireisi!liiiiililitV, PliRillt
Suite/bldg./apt. no.: Project nam (
e. t 3 c ../..))/ 30.f nr:117
-,
" d , nagrIPtion • Qtr. 70 =. Total
Cross street/directions to job site: New residential single- or multl-family dweWng unit.
- — Includes attached garage.
1.000 sq. ft, or less 145,15 4
Subdivision: J Lot no.: ea. addl 500 sq, ft. or portion 33.40 I
Limited energy, residential 75,00 2
Tax map/parcel no.: ..,......,. Limited energy, non-residential 75.00 2
Z..i Each manufactured or modular
dwelling, servioe imcVor feeder 90.90 2 • 4 44 )6 La/Lill. z4 C(/ a'. ' - ,, L..IPA7( ,I Services or feeders Installation, alteration, and/or relocatlo
200 amps or less 80.30 2
',IIT;trsi.!..."''"wii.YA 201 ainP8 to 400 amps 106.85 2
-. ,1 • , • ,: . '1.1.. r • :!:',IT!1-i:it ..',.•11:!!..r.=.11 ma,:,.. -,J1....„.. ;-...,...... n... II 111 „..... ,.., ;..?,!: 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
Phone: ( ) I Fax: ( ) relocation
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, least, 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, • er .anel
. — " . 2"'d ' ' ' -or: '. .kr 1 for branch circuits with
• ■!:,1,:U 1 'ilil ', A, Fee th
'')AR1 :7 1 ' . ........ . !. ,.,P .. .„....... .. .. , . .. .. . . . — .,,k I. .
service or feeder fee, each
6.65
Business name: branch circuit
B. Fee for branch circuits
Contact name: 00 ci,t, without service or feeder fee, 46.85
Address: L3 5e t i /e: ‘17 a 0 e , . '.4- cach branch circuit
Each LAX' branth circuit I] 6.65 100111
City/State/ZIP: . _, ..-,, i ) , . Miseellaneoul (service or feeder not included)
Phone: ( ) 733 i
' t . `` / N 33 7 Fax: : ( ) Pump or irrigation circle
7 "" 0 7 3 - - z .. .,,
Si?. or outline li t tin 7 53,40 2
E Signal circuit(s) or limited-
1 li RPN:gi! ener altenIti °n' or
extens Describe: Page 2 2
Business narne: ply kk, cl CAT c..
ri
Address; 1
. iL \.,,, ) U
Each additional inspection over allowable In any of the above
55 L____CPc ._■1 -SL_ Per inspection 62.50
City/State/ZIP: - c5.1: 1 \ c- 0V. CA .,‘) ... -- Investig,ation per hotrr (I iv min) 62.50
phone: (51 4... 9_3c. (60 t Industrial plant per hour 73.75
CCB Lic.: // / Electrical Lic.V( p _/ Suprv. Lic.;57)Q (,, ,_S Subtotal b & so
Suprv. Electrician signature, required: ...::Si)7.,..,...._. .. Plan review (25% of permit fee)
Date:
State surcharge (8% of permit fee)
Print nalrle: L__elhO (.4)/U Dli 16 i') /0---
TOTAL PERMIT FEE -7 . / v
..... ,j
I Authorized signature: .- Thle permit application expires lf a permit le not obtatncd within 180
days after It has bean accepted as complete
Print name ' . s s i. %,_ ' Date: . y .. 211 — * Fee methodology set by Tri-County Building Induatry Service Heard • _• , — I" Number of inspections per pennit allowed.
, 03ontlia3kParinkt \ELC-ParrnitApp.doc 12/03 440- $T(1 0/02/COMAVE3
CITY OF TIGARD . ili
- -- BUILDING DIVISION PERMIT #: Et_C`. %005 00927
13125 SW HaII Blvd., Tigard, OR 97223 DA TE ISSUED: 12/7P005
Phone: (503) 639 -4171
A �
Inspection Requests (24 Hrs.): (503) 639 -4175 .- , I_;�
INSPECTION WORKSHEET FOR DATE: 9/18/2OO6 TIME: 7:01AM PAGE: 1
SITE ADDRESS: 146% SW 76TH AVE '13 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APARTMENTS
DESCRIPTION: (4) branch circuits for washer, dryer & heaters. Job # R05 -1310. 9/15/06: REINSTATED FOR FINAL
INSPECTION ONLY WITHIN 30 DAYS.
OWNER: BOOTH - HEYDON LLC, PHONE #:
CONTRACTOR: ABC ELECTRIC PHONE #: 503 - 23:3 -7551
Inspection Request Scheduled For: Date: 9/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 036715 -05 503 -267 -3668 N
Corrections /Comments /Instructions:
t \..
PASS) ❑ PARTIAL APPROVAL 7 CANCEL NO ACCESS
❑ FAIL n CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: �• N 06 Date: 9( C*, Phone #: (503) 718- 244