Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00977
el4► ._ DEVELOPMENT SERVICES DATE ISSUED: 12/27/2005
---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112BD-00700
SITE ADDRESS: 14655 SW 76TH AVE 27 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer & heaters. Job #1415.
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: Contact #: PRI 503 - 233 - 7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: LIC 26 -1226C
[ELPRMT] ELC Permit 12/27/200: $66.80 SUP 50965
[TAX] 8% State Surcharge 12/27/200' $5.34 ELE 161501
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: • Permittee Signature: c, \c).
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 -27 -2005 11:10 AM P.01
•
Electrical Permit AppliC I �1 1r ED Hilt ()FuI('1. tl..Sl`. ONLY
Rece . P ettntt No. (,) ` e R g f f
-- , ' of Tigard ` ; %: 20 05 Date/B ' _ r i��
13125 SW Hall Blvd., Tigard, OR 97223 - Plan Review
�
Phone, 503,639.4171 Fax: 503,598.1960 ''"" """
„ 0 F4: � ��' " Date/B , t�tOther Permit;
C�1 6ae P 2 for
Ins 639,4175 Line: 503.639,4175 ' 1 aF rr ' Ai l rase Roady/By: rn
P G� # " " "" Notified/Method: Supplemeatal information Internet: www.ci.tigard,or.us 41°4-,DMIG DNfSI(a
6idy :
❑ New construction •Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'I ❑Hazardous location
❑ Demolition Other ['Service over 320 amps •- rating ❑Buiidng over 10,000 sq. fl,
,! ;:;,::,' .,.., :.:.:::::" . �� ',2 ' :' 4 or more new residential
..... , - ,:.. G" 1"< Ul� :ii;ilu��;; %'I;i �:':i:; ?;i�ii�.�: of t - and2- thttul dwellings al t'
�.. �.,;:: - -.: �I:aa; i � lid , y
`'I;:ll:'�I _!.,r!2/ ?yl•A:::iJS[ „' ;l '. "II •. r; .i:ir�;, �.... � .. ,.rn,,,i ,....... .. @ ` ^ .., .., ,....,.
1- and 2- family dwelling Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal tutus in one structure
°Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑Occupant load over 99 persona
Master builder
- . •::..... , er. i , ri_:' ris; l ?U.' '!„ iii i E s/li tin RV P k� ed structures or
i• .!" ,( ly. :7, i I ::: - SITE l l.)Z_fiv[rk`!'IQ --- ..I LO , ' � ,..I.. ... _. ❑ Pfb 6 lan P
Di- lealth -care facility El Other,
Job no.: Job site address: r - ds. Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary consfuction service.
, i , ' , Il::a:,.,,,�,� .- �L,i�y �.�� �Ini. Ni:i��i..n..�i�: ,���. �_I�,.�i� i,i:i,: ;
Suite/bldg./apt. no.: Project name: j 11 pe.vtptioe •• Qtr- Fee Total ..
Cross strect/directions to job site: ty 1 New residential single- or multi - family dwelling unit,
' "C �' Includes attached prase.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft, or o�rtion 33.40 l
Limited energy, residential 75.00 2
no.: non-residential 2
Tax map/parcel Limittui energy, non• . 75.00
'vt:,un riu ��'F:'-; .: o; �,mc,��u >, _ .......... ; '1111 .:rill�fa
�!
,,.�r,.,., r , -. • - ” " t t l ,,,; "- -k'r ° i l' Each manufactured or modular ,�,::.1� EIll , '� �I..., _ it I I Idl " N ' . t II� .� �Q �.f.';x: • R 9 i ID . '' ,. �I1! ';tael�1! 151. i :11 I
-,.. ,,,.:!hlC.� ° ,,, ' ' 2/.1:..51111,. � ,,,t:i�P, . � ,_, ,.,.,,,,� ..,. ,,. ,
n dwelling. service and/or feeder 90.90 2
_
_-4 . 4,(1LGr `f dy--e. S ervices or feeders in ttaUation, alteration, and/or relocation
/..P. s 200 amps or less , 80.30 2
, , r:ei , l t �" �j
,'i , yi ' !» i
; $11' 201 amps to 400 amps 106,85 2
4w::;1 ', � IikY?'. a ,.. = .w�N,,.;� t r. ; '';wish:. a , r.. „le
s' i- ' 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, olteratlon, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less - 6 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
- a ^',Ills;; .,,,� - w ar r..iiY;,�rl u la:us 31 :hu . ;:,i , r,,',1., `' bi 'ilk A, Fee for branch circuits with
.:ir�:i py � } � .
. .: , , , ,i1;•
- .`:�;mi�, ""3, , ,�, � 1, - ,, -r... : i i. � 4;;.. tr •,,,,,,,, „�.• service or feeder fee, each
Business name: N rn �., 1 f . .. c _ - —
breach circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder tee,
7 • L1 1' each branch circuit I 46.85 � 2
Address: Each add'l branch circuit .5 + 6.65 I /9.9f 2
City/State/ZIP: Miscellaneous (service or feeder not included)
_ Pump or irrigation circle 53.40 2
Phone: ( ) Q S 7 5 I Fax :: ( ) Sign or outline lightin 53,40 2
E- mail: Signal circuit(s) or lintited-
r�n :, aiii �a,w „m.,,,,diil;t "' ;;:I : !' "_'S 'r! i?"'! . - ' "®a , :: :: ... „ ,i i litrii%iar:i �a1Cif„ nli;i i, energy panel, alteration, or
I
„ �::.�- �.d�„n�,c� : x,,;,,, 1 1 ' .•II ua.,:, ".LI,,., .I _..,. ,..,r.�`�� � �' . ".� I _ iii!!,, � Iraem:r_,_::i;,...1.;.;.cd
....... , 1:.11:::,,:: , •:4r,i.,llii I.,:ni_ :,,:.::.. i �i , . �. 4�11 ,.. .•l:ap! !fit':
� 1 - extension Describe: Page
Busineaa name: e...-,r
Address: I �� �� - * Each additional iaapectlon over allowable In any of the above
l Per inspection 62.50
City/State/ZIP: S,/�RA ` . t) Coo �., Investigation per hour (1 hr min) 62.50
Phone: ` "5 S . Fax: ( ED 3 3 3 7 S 5 c industrial lent hour 73 73
!.l:al; l: -;i hour )'FRIVrI`r;:R 75 Ili .,!s.
CCB Lic,: j(o /S Electrical L ic.6V6 ./..1 1 Suprv, Lio.: ) .3 Subtotal i _
Suprv. Electrician signature, required: plan review (25% of permit fcc)
(� Date: ^"• Suite surcharge (8% of permit fee) 5 3 i/
Print name:
c3 (I ��� 11 /7 n _ TOTAL PERMIT FEE 7,,,2,/ V
Authorized signature: Tills permit application expires If a permit is not obtained within 180
...-- days after it has been accepted u complete
Print name: 0111 - . • ■ V-. Date: J , „�0 • Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
t: ltiulldlna \PamltalELC•PetmitApp.doc 12/03 440-46157(1, /02 /COMAVEH
CITY OF TIGARD ' - a
BUILDING DIVISION PERMIT #: E1.,C2 ,� -'
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 :'=
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: % — a 3 .. 0 e TIME: PAGE:
SITE ADDRESS: V N %1 211 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
P _ _ - ; 0 Lea
-- : - - - - - - - - -- ctions: ` t ° V\06VIS - .
N
•
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PASS n PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS
n FAIL It C' . FOR INSPEC , 1 ❑ ADDITIONAL FEES ASSESSED
••• /1471 / j Inspector: Date: 7 �� Phone #: (503) 718 - I f fob