Permit CITY OF TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC2005 -00928
tn. DEVELOPMENT SERVICES DATE ISSUED: 12/2/2005
! 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S1 12 BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 24 ZONING: R - 12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
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/ 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: 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: - s
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 :14 AM p. 03
Electrical Permit Application Folz oLvick: I.J. 1
' City of Tigard A Received .
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Pax: 503.598.1960 , ;4;11 Date/By: Other Pemlit:
Inspection Lint 503,639.4175 .!1. JJ- i - • Dine Ready/By. El See Page 2 for
Internet: www.ci.tigarcLer.us Notifiedahethod; J'( ( r
. Supplemental Information
1 Y ;1' :t*it,0;#7003:Nf.AgiAlgigW.3 ;: : 1 iiiii:.:..i;:I. 1. 4 : ;i;i;:;71 . 0XIM...gtYtEW.:',11F:!•.4::.:4A!:'..,- - :...;:,N;..:0;U;:.
0 New construction '15L Addition/alteration/replacement Please check all that apply:
OService over 225 amps, comel 01.1azardous location
0 Demolition 0 Other:
.... 0 Service over 320 amps - rating El Bunting over 10,000 sq. ft.,
*: ::;::: ! Z - :;• ' " , 7i' . .A!'j':; 1 -i .;:!1N of 1- and 2-family dwellings 4 or more new residential
0 1- and 2-fkmily dwelling s' 15. Commercial/industrial 0 Accessory building 0 System over 600 volts nominal units in one Stnlettire
0 Building over three atones ElFeeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other. 0 Occupant load over 99 persons EJManullictured structures or
4 . 4 *Elt i tt; iiiiblikk tfi5:VS,W.O.14 ;'66i f);O s jiliMit ' Ale; i 4IP.4:[1 : 1;'"J 0 EgressAightin8 Plan RV park
Job no.: e /5/ () Job site address/W/05;5 SL...) 2 6 ttc2V 0Health-oare facility °Other:
Submit I. sets of plans with any of the above,
City/State/ZIP: c., 4 a. rcsi , O ia ,, . The above are not applicable to temp:nary construction service.
_
i PariElEVF;1141e5f,i'Afkkisltith4ttiltigrItIliqpiqi1VinrybrAit
Suite/bIdglapt no ci I Project name: ' iP (2M : L nes.ipti •: . -• 1 ----•••••-•..-- ---.. -.
Cross street/directions to job site: V New residential single- or multi-family dwelling unit.
Includes attached garage. ..
_ 1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. addl 500 sq. ft. or portion 33.40 I
Limited energy, residentia/ 75.00 2
Tax map/parcel no.:
Limited energy, non-residential 75.00 2
retkV Bach manufactured or modular
lling, service End/or feeder 90.90 2
, 4 e(-) a 4
d/LZ . ° 'd eti - y_ii - > „I/ dwe
m-1'0.'1S .
Services or feeders Installation, alteration, and/or relocation
200 amp a or leas 80.30 2
' ' j,11411i4411 PITCIV. 4, 01. / .44 , k 11 00041 1 4P r IOINONalategg i Atikeatt l igiNgig; • 40 2° 1 arn amP p s : 610 amPss . 106.85 2
Name: _601 amps to 1,000 amps 240.60 2
-
Address: Over 1,000 amps or volts 454,65 2
Reoonnect 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 arnps 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
1: :ig i tP^ " ij '11 4 1 10414 4 - 1 04 1 .V..... bligigiaiiitiNEOFEEP.;40(MOTAWSWEIINg A. Fee f branch circuits with
service or theder fee, each
Business -:-_arn 6,65 2
branch circuit
B. Fee for branch circuits
Contact name: it)t) rtt, without service or feeder fee, r
' each branch circuit / 46." OA e 2
Address: t_L3 <_16,-_ Q a vke. Each ackt'l branch circuit 1 6.65
Ciry/State/ZIP: . . Misesilanimua (service or feeder not Included)
_,.... C1570./ Pump or irrigation circle _ . 53.40 2
Phone: ( ) c v3 7 3 --/ Fax: : ( ) 6 ; 4 33 7 53";:a -
Sign or outline lighting 53,40 2
E-mail: Signal circuit(s) or limited-
: en on ' cz
Page 2 2
Business name: /t? -- vti e+ . r c
_...., .,
Each additional Inspection over allowable In any of the above
Address: 1 5 5 kW- C tt rt_V4_ ITh 1/4 CI Pet inspection 62.50
City/State/ZIP: ■ • .
Investigation per hour (1 hr min) 62.50
Phone: (5:1t) c g515 7 , S'S 1 Industrial plant per hour 73.75
FaX: (61)5 ( 5 3 7 ' - 5 J7,11;!!gR.p.ir:;:!:: ELEcritiekti: .1. titi
CCB Lic.: i‘ / 1 1 Electrical Lic.(0 _/ Suprv. Lic)g ('' ....S Subtotal t 6 a50
Suprv. Electrician signature, required: 5e7 Plan review (25% of permit fee)
State surcharge (8% of permit fee) 5.3 4 /
Print namea t . ,4 2) 4 1) 7:) 4 a f - ) Date: AD . -- - 'r
TOTAL PERMIT FEE 7 . /V
Authorized signature: --. k j - 0 - This permit application empires If a permit is hot obtaleed within 180 •
=Oh '
days after It has been accepted as Complete
. --
Print nainc' •
' t ‘. Date: _■ .2. • Pee methodology sat by Tri•Courity Building Industry Service Board
** Number of inspections par penult allowed
1:141i:dint:Tam in \ ELC•PermitA pp,elo c I 2/03 440-96 15T( I 0/02/CW4/WM