Permit CITY OF TIGARD ELECTRICAL PERMIT
y PERMIT #: ELC2005 -00722
• DEVELOPMENT SERVICES DATE ISSUED: 9/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 12 BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 21 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer, water heater & heaters. Job #R - 05 - 969.
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
5096S
Description Date Amount SUP 16150
ELE 161501
[ELPRMT] ELC Permit 9/27/2005 $66.80
[TAX] 8% State Surcharge 9/27/2005 $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: LQ_762& Permittee Signature: • J R �'
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.
•
SEP -23 -2005 11:20 AM P.04
• Electrical Permit Ao) p llca • ( y am= p1� q p , 1 () IZ (11 1 I ( 1 U, I O N I 1
City of Tigard Dula , � d �. _ .� �' t
13125 SW HaII Blvd., Tigard, OR 97223 Plan Rev' w Other Permit.
Phone: 503.639.4171 Fax: 503,598,1960 SEP 2 3 .. ? Date/By: g
inspection Line: 503.639.4175 . .r., - Date Beady/By: ]uric; S5 See Pa e 2 for
Internet: www,Ci,tigard.or•us Notified/Method; 1) t Supplemental Information
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■,.,�i� t , i ? �t .,,. . ,.. + .. ..1 S. Ia,_ r 1 1� .t,.: .,. �. �. iu , r }, ,,.` cr � r , .if , i u.,. ,,.1, .. fl. �,r1...1< „1f,1r.I .F]9ar
❑ New construction O. • ddition/alteration/replacement Please chock all that apply:
['Service over 225 amps, comm'I ['Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps— rating ❑ Buildng over 10,000 sq. ft.,
, l s i ' t l 411} ii t1' js , L i , I r ' of 1- and 2- family dwellings 4 ur more new residential
❑ 1 - and 2- family dwelling : Commercial /industrial ❑ Accessory building ['System ova 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
( f ❑ Multi - family ❑ Master builder 0 Other: ❑Occupant load ova. 99 persons ❑Manufactured structures or
le}.V' 1 !1 ,, 1 + ... . , , .., , . ...... .,, > facility Y 4 1 _. 1:_ I I
Job no.V.05. r • Job site address: ^ 1 s .D. ❑Hcalth� i ity
Submit sets of pitons with any of the above.
s ,� — ..The above are not applicable to temporary construction service.
_ ..l ,: , ,}.l I , �. 1 � I.V. r {i 1% I'll I i' ry1 ' �
Suite/bldg. /apt.no.: Project name: '' h i1.,.:...} I,t,1,:11. a..,11 r1, a}.,.1Li1trlft
(• t► 1 1 Deaeripdan Qty. F•e. Total --
Cross street/directions to job site • t * New residential single- or multi- family dwelling unit.
Includes attached garage,
1,000 sq. ft. or leas ' 145.15 4
Subdivision: Lot no.: Ea. add'1 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: 75.00 - ' 2
f ,(il,�'.,, i`r. ,,,f,'„--'
.1 ,. ,' ' ... I F_ _.:. � j ; „ .... Ea manufaccturedor modular
�
dwelling, service and/or feeder 9090 2
Services or feeders installation, alteration, and/or relocation
u a r ,{ . :. ` 1 i 201 amps or
o 400 a mps 106.85
2 2
-
1i1'�r, , itit ,,, ,.. 1 ,:.".),"..,.1.:.' ' ' ;.. r .. , ;.: ' ._.. _ :... ,. 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
Reconnect only 66.85 2
City/State/Z1P: Temporary services or feeders Installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation _
200 amps or less 66.85 t
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
l�{,I+ a n {' Fi) li i ' 1 i I A. Fee for branch elm-ills with
h, l c 11 .. _... .. ..... ! service or feeder fee, each 6.6 5 2
branch circuit
Is' B. Fee for branch circuits
Contact name: _ r. 11 without service or feeder tee, 46.85 2
each branch circuit v6.8rj
Address; Each add'I branch circuit •g 6.65 i 4, c_e 2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax :: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
4 jta51i IG{ ,1 i i l N.,1, °I . ' I ` , .r ' ? + { I :.
extension. energy DeaCnbation, or g 2 2
Page
Address: J .... t om . . , , Each additional Inspection over allowable in any of the above
Per inspection 62.50
/ , :� • investigation per hour (t hr min) 62.50
Industrial plant par hour 73,75
1 1 I l {F 1 1 r -'1.0 , '' 1 , t , : t II } . :i t # ''( 1, 11 ff ,-Il r
.. n_..:. 61).. .. ., zn r l J ,,,,i J, , . •t ., . Le . ,.c . Ii.F11 y,.�.�. �
EMEMILV
Electrical Lie 1 — 1 uprv. Lie.: / , /SQ/ Subtotal (s 4 .80
r 1 Plan review (25% of permit fee)
121:111111111M Date. '
State surcharge (8% of permit fee) 5 ,, t3 1/
�/
TOTAL PERMIT FEE 7d , i T
Authorized signature: 4>• ` fhb permit application expires If a permit is not obtained within 180
days after it has been accepted as complete
Date; 9, - • Fee methodology set by 7ri.Coutty Building industry Service Board
' Number of impactions per permit allowed_
I: mBulldina\Patmin\ELC- ParmkAnndoe 11/03 0 404d111(1 0/07 /COM WBB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2O05 -00722
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/27/2OOb
Phone: (503) 639 -4171 Stivilolo
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/12/2006 TIME: 7:O2A1V1 PAGE: (t1
SITE ADDRESS: 14065 SW 76TH AVE 21 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE 11 APTS
DESCRIPTION: (4) branch circuits for w►F::her, dryer, water heater heaters. Job {/R -0, 969.
OWNER: BOOTH- HE'(t7ON LLC, PHONE #:
CONTRACTOR: AE3C ELECTRIC PHONE #: 60:'.t-233-7551
Inspection Request Scheduled For: Date: 1//212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final O24791 -1J1 50'3-233.7551
Corrections /Comments/ Instructions:
•
•
PASS IAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-, N 68 L Date: U,b Phone #: (503) 718- 14%
CITY - -OF TIGARD _
BUILDING DIVISION PERMIT #: ELC2005.00722
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/27/2005
Phone: (503) 639-4171 ,.., ,^1\ 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: 57
SITE ADDRESS: 14655 SW 76TH AVE 21 CLASS OF WORK:
SUBDIVISION: MARCIENE 11 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APTS
DESCRIPTION: (4) branch circuits for washer, dryer, water heater & heaters. Job #R -0& -969.
OWNER: BOOTH- HEYDON LLC, PHONE #:
CONTRACTOR: ABC ELECTRIC PHONE #: 503- 233 -7551
Inspection Request Scheduled For: Date: 10/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017217 -01 503.233.7561 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v t\146_(.." Date: to' 3(C(5 Phone #: (503) 718 -10)