Permit CITY OF TIGARD ELECTRICAL PERMIT
T PERMIT #: ELC2005 -00975
ill 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 31 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/ 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: 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 5096S
[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: S2 �
OWNER INSTALLATION ONLY a
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-23-2005 05 :41 PM • P.03
• - Electrical Permit A OPl&!" 1 VED ..,"-- ,,., .,, i,-..,,,-.:,=:.: - :1:9k,.)1..1.1,1.: A -si.,,,•.:.\.-_±,_,,. , ..,- ,
City of Tigard Received 6 ..."" ..,...-
Date/B . _ -■ 7 - v . r , hntit' de) ' e,' 7
13125 SW Hall Blvd., Tigard, OR 97223 . r Plan Revisit
Phone: 503.639,4171 Fax: 503.598.1960 EC 2 3 2005 P..„, Date/B ! Other Permit;
Inspection Line: 503.639.4175 Date Ready/By:
, ......•• : rAMI GS See Page 2 for
Internet www.ciligard.or.us CITY OF TIGARD Notifled/Ntethod., Sapplemenuti information
, !: . !:.' , .fr - ' ,,,, ,
1 :::;;;:illillf=1;i:;:1;!, •,!1:Aillin.. WITor211 'rretOtt1341014 ill;;2PliV.4;')
w--.: .. ..di*,ho. q..;:.-.;-::tim.. .i.. ::,...g..::..101 .17- th. .:-. ,..,..t.nm,..p,;,1(,,,v,„„Er-,y.
' CI New construction Addition/altcration/replacement Please check all that apply:
°Service over 225 amps, corrun'l °Hazardous location
El Demolition 0 Other: °Service over 320 amps- rating °Building over 10,000 sq. ft.,
; lag;gliri!:::!per.,R:;,'
ii001)
•:Mr ,4161/A .. il '.' ,E4 1
i. 0„.4,4
q qtE.1, of 1- and 2-fltmily dwellinp 4 or more new residential
. iii !! . ?f21!..7!Pr''''" :. 't? 410. - . • 1 ...1.. e. -, `e --.., . . m.........r.' - -..'.. ' " """ '''''''.'
0 1 - and 2-family dwelling El Commercial/industrial 0 Accessory building C)Systern over 600 volts nominal units in ono strucurre
°Building over three stories I:Weeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other: ['Occupant load over 99 persons OManufactured structures , or
,ii '. V.Zat4i,Z-77:-7 ' 1.' .! j Egregoighting Plan RV park
Job no.: / / Job site address: . , - - ' • , -.H 3 I O14eallit-care facility °Other:
._. - Submit j sets of plans with any of thc above.
11E=EIMIFIAIMMIIIIIIIIIIIIII The above are not applicable to temporary construction serviee.
Suite/bldg./apt. no.: p ro j ect name: Alr :,,,Rop.o.itto„iroo.A,„4..itg,..etsilumm . ,i8..toraeistulifig
Description Qty. I Fes. Total
Cross street/directions to job site: ' Alswimmlwaram New residential dngle- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. it or portion - 33A0 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
- Limited energy, non-residential 75.00 2
inmrp'li4 f'-' 'VErYMEWF 'Li. ' t Each manufactured or modular
, . . - . - aa r 4 u I' , i,1■•••;r. IT . . N1 441 -- , '. ' ,... 1 IA A . ',:..1.:ulki .
dwelling, service and/or feeder 90.90 2
Services or feeders Installation, alteradon, and/or relocation
IIIIIIIIIIIIIIIIIIIIIIIIIMII WIIM1111.11.1111111111111111
200 amps or less 80.30 2
" - ."1,sx.m., i 1. ,. •
ggritaltil '. 7iiiFIVIFRIZMWAR ' Ki , t amp l acsi t 201 amps to 400 amps 106.85 2 -
. , •• . re. rt, q..... • .4.4.24t.ti, - . . 1 i, . .il !vow • -- - .,. -.mes.41 ult r 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
Reconneot only 66.85 2
City/State/ZIP: Temporary services or feeders Inatalistion, 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 snaps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
r -
-
A 1: 664 :',.: i:■-Rifgl i t AME 1. '' :46 i qrg ,1 4 '
A Fee for branch circuits with
Sin= or feeder fee, each
branch circuit 6.65 2
'
B. Fee for branch circuits
Contact name: 4 a without service or feeder cce. / 46.0 4 c 2
ircuit
Addr each branch c
ess: Each acld'I branch circuit 3 6.65 j 19 5 2
City/State/Z1P: , Miscellaneous (service or feeder not Included)
- Pump or irrigation circle 53.40 2
Phone: ( ) .: 3 7S- Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
min gil,EVIVIi:.11E14 -.1 EM.IEg'P ellergY panel altatic41. °•
extension. Describe: Page 2 2
: mne LilIll t N I UIMMMr utrk
Each additional inspection over allowable In any of the above
Per inspection 62.50
riZE 4 •.1KifirCW.-.111.1111. Investigation per hour (i hr min) 62.50
Phone: Fox: (6)3
Industrial plant • er hour 73.75
... is. F ImEmititt. , ., 7: 'F '',;:. ''?I%I.:;;!;:::N",:le:!::!
rinlingani Electrical Lic.(o .../.,_ , Suprv. Lic.: .7.6 * , Subtotal Ro
- Suprv. Electrician signature, required: .....-•------- --41111t PISA review (25% of pc:1mi' fcc)
State surcharge (S% of permit fee) 0 5
CII=WilingerMONgS/11 Date: .........
TOTAL PERIVIII / y
......... 0 .-
, Authorized signature: ___. ._ . This permit application expires If. [twat Is not obtained within 150
'"
Erns ._41,151111M Date: ..... Fee m
day, after it has been accepted as complete
* ethodology sat by Tri-County Building Industry Service Board
Number of inspections per permit allowed. .
imsuiidies\PermluTLC-PemritAppdoe 12/03 440.4615TO OM/COM/WEB