Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00042
DEVELOPMENT SERVICES DATE ISSUED: 1/19/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 34 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer & heaters. Job #R- 06 -99.
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 HMI 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: Contact #: PRI 503 - 233 - 7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: LIC 26 -1226C
[ELPRMT] ELC Permit 1/19/2006 $66.80 SUP 5096S
ELE 161501
[TAX] 8% State Surcharge 1/19/2006 $5.34
Total $72.14 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: 172 Permittee Signature: f f7,
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.
JAN -20 -2006 04:30A FROM: P.1
960 TO:81P5035981 P.
ivy® , 1� , NI V' F : k . ,� rn
• E lectrical Permit Ap � 1 t>' IC l ,., oNl a . t ,s .
City of Tigard Received J • V Permit No.: At1 l b
13125 SW Hall Blvd., Tigard, OR 97223 . 1 1 Plan Review
; 9
Phone: 503.639.4171 Fax: 503.598.1960 JA 2006 i 'II ? Date/B : Other Permit:
Inspection Line: 503.639.4175 •_ %Pt}d ' Date Ready /Hy: m See Page 2 for
CITY OF TIGA
Internet. www.ci.tigard.nr.us ' Notified/Method: Supplemental Information
iii 1ST°
... PLAN REVIEW :. ;
❑ New construction 0 Addition/alteration /replacement Please check all that apply:
• ❑ 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
❑ I - and 2- family dwelling ' la Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder 0 Other: El Building over three stories ED Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION - ❑Egress/lighting plan RV park
Job site address: L ❑Health -care facility ❑Other:
Job no.:
"Q`g 1 (O J S _ S l..) O ( Subrnit 2 sets of plans with any of the above.
City/State/ZIP: ( ,c.CA..eX 0 (L The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: - Project name: 4. ` ( N A FEE•. SCfLEDULE
t. 7 • t 1 \ , 1t1 -, Description 1 Qty. 1 Fee. I Total 1 ••
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 1
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
\ �)---Q- : - -Su '4.- (�Y`.p,9 -,� - Services or feeders installation, alteration, and/or relocation
` �a k -Y' l 200 amps or less 80.30 2
r 201 amps to 400 amps 106.85 2
0 PROPERTY OWNER ❑ TENANT
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 1
Owner installation: This installation is being made on property that 1 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
131 APPLICANT CI PERSON
ANT - A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Nbc, \r kA_ ' t branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, / 46.85 �Lt / V.--(--V.--(--- 2
each branch circuit 'O
Address: Each add'1 branch circuit 6.65 f f 9 c 2
City/State/ZIP: Miscellaneous (service ur feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ),_93 ) 3 7 ' ' I I Fax:: ( ) _ 3 7 .S Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: A l k- , Q* '
� Each additional Inspection over allowable in any of the above
Address: 1 55 ii E ( 1 a l∎L Per inspection 62.50
City / State/ZIP: -ems \Qg(`� � o no. D ... Investigation per hour(1 hr min) 62.50
(mot a � 7 - ( Fax (6} 5 3 7 , 5 a Industrial plant p hour 73.75
Phone: ELECTRICAL PERMIT FEES*
CCB Lic.: )( LS ) Electrical Lic.;9(0 _/ Suprv. Lic. Q ( Subtotal lY /„ .6 U
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) 5. 3 Y
Print name:LS i ( `) / U � 11 /2/ a n Date:
r n TOTAL PERMIT FEE "2,,,7 .
• Authorized signature: 2.l l r Thls permit application expires If a permit is not obtained within 1 0
days after it has been accepted as complete
Print name: , ,\ \\ /� Date: Yi 9' / • Fee methodobgy set by Tri -County Building industry Service Board
W i S t1 Q 1 _ Z < •• Number of inspections per permit allowed.
i:\ Huilding■Perraas \ELC- PermitApp.doc 12/03 440 -4615T(10 /02/C01.1/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 1W� i�
s.�0,') ,o;)
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i/19.(20K
Phone: (503) 639 -4171 * ,,,; i„ 1 t#
Inspection Requests (24 Hrs.): (503) 639 -4175 s± - I el ` ,
INSPECTION WORKSHEET FOR DATE: 1 /X'2OOb TIME: :03Aa', PAGE: 33
SITE ADDRESS: 11f bE-, SW 7 tiTH AVE 34 CLASS OF WORK:
SUBDIVISION: IVMARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APART
DESCRIPTION: (4) branch circuits for washer, dryer & heaters. Job 2. 05.99.
OWNER: BOOTH-HENDON LLC, PHONE #:
CONTRACTOR: ABC ELECTRIC PHONE #: E03- 233.7f61
Inspection Request Scheduled For: Date: 1/26/2006 Pour Time:
Code # Inspection Description -- Confirm # Contact # Message
ii
Electric f &- yh - in 6 a .ffl SO"3- 233.7f51 '1
%aq e" ;NO IN4
Correc • - • _ - - - ctions:
}\L 30 /Iv' 1 PsoN\
„PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Dat e: 1 " 4 °� Ph #: (503) 718 - �-