Permit C ITY TIGARD ELECTRICAL PERMIT
1 PERMIT #: ELC2006 -00169
e�� DEVELOPMENT SERVICES DATE ISSUED: 4/3/2006
' ---' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 26 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (2) branch circuits for washer, dryer & heaters.
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:
MICHAEL O'GORMAN ABC ELECTRIC
PO BOX 1574 135 NE 9TH AVE
HOOD RIVER, OR 97031 PORTLAND, OR 97232
Phone: Contact #: PRI 503 - 233 -7551
FAX 503 - 233 -7552
FEES _
Description Date Amount Reg #: ELE 161501
' LIC 26 -1226C
SUP 5096S
Total
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 onh ' BAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rul or direct questio to OUNC at
503 -2 -6699 or 1-80e- .
Issue By: , A _,,,, / ,, % -!_d Permittee Signatur i �---,.....,
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: 14'— 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.
MAR -31 -2006 04:50A FROM : ® TO 81P5035981960 P.2
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`J g �� ' �O �Y 1, 5- / ' Permit No.: e�,14:1 ! f0/
D ateBy:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 C; O K r' }��tn'Il Date/By: Other Permit:
Inspection Line: 503.639.4175 WIA J R 1 14'z, : ' , Date Ready /By: ruris- 21 See Page 2 for
Internet: www.ci.tigard.or.us TI Notified/M Supptemental
r'tTY 0 r ., c- tfl�`)
'A ri PLAN REVIEW
❑ New construction ' ddition /alteration /replacement Please check all that apply:
C Demolition ❑Other: ['Service over 225 amps, comm'l ❑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
❑ 1 - and 2 family dwelling taColnmercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant Toad over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION R park
❑Egress/lighting plan P
Job no.: (,Q0. Job site address: ' t ( 1.7.15 .Li•. "1 1 ❑Health -care facility ❑other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: \ (01C The above are not applicable to temporary construction service.
^ ... . FEE SCHEDULE Suite/bldg. /apt. no.: l Q Project name: ■ N`
D escription I Qty. ' Fee 1 Total I *'
Cross street/directions to jnh site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision. I Lut nu.: Ea. add'I 500 sq. R or portion 33.40 1
Tax snap /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
- DESCRIPTION OF WORK Each manufactured or modular
� \ . C ` r �� dwelling, service and/or feeder 90.90 2
� x �� (�� Services or feeders Installation, alteration, and/or relocation
�\ Js "' - \ C S 200 amps or less 80.30 2
i PROPERTY OWNER i.' 1 ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: M t c... t+ i i_t_ i _ o r 6 .,0 601 amps to 1,000 amps 240.60 , 2
Address: PD 6 0 k t /57 q Over 1,000 amps or volts 454.65 2
PA n Reconnect only 66.85 2
City/ State/ZIP: 1456 PA J EA — Oa. 970 31 Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I 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 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
LS APPLICANT i . ❑ CONTACT PERSON
A Fee for branch circuits with
1y service or feeder fee, each 6.65 2
Business name: Nbc 4�` k. f . k, ( ` branch circuit
� B. Fee for branch circuits
Contact name: ( y \ without service or feeder fee, 46 85 2
cach branch circuit ii6 k
Address: ) 1Q\ a -0 Each add'l branch circuit 3 6.65 r7 Q 5- 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I pax :: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
' CONTRACTOR energy panel, alteration, or
` extension. Describe Paget 2
Business name: , i `�1 ekr \(
Address: Q� ` t,p V�� grove
Each additional inspection over allowable In any of the
� � ^' ' + b �� �' Per inspection 62.50
City/State/ZIP: -(5\:4c \cl. gi investigation per hour (1 hr min) 62.50
Phone: ( 3 73 Fax: (�j 5 a 5 3 7.---5-i5-cp. Industrial plant per hou 73.75
ELECTRICAL PERMIT FEES"'
CCB Lic.: /( /S 1 I Electrical Lic. 696 6 _4 ( Suprv. Lic. 9 6 S Subtotal // __ Q ` ( �
�W +Jy
Suprv. Electrician signature, required: Plan review (25% of permit fee)
'] ,, /n� /� Date: State surcharge (8% of permit fee) 5 -V
Print name:
vhQ (t)NlDo, 6S F TOTAL PERMIT FEE '" , )
- Authorized signature: V This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete
Print name: --- -- - . ' ')I Date: • Fee methodology set by Tri-County Building Industry Service Board
�- ` ` ,n •' Number of inspections per permit allowed.
i', Build mg' Pnmiis\C LC- l'a App. dnc 12103 440 -461 ST(10/0'JCO.WWEa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006. 3t.,i0:i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/312m;
Phone: (503) 639 -4171 l , •
Inspection Requests (24 Hrs.): (503) 639 -4175 ''�' I
INSPECTION WORKSHEET FOR DATE: '1/1712006; TIME: / :05AM PAGE: 82
SITE ADDRESS: 355 SW 1tTTF1 AVE 26 CLASS OF WORK:
SUBDIVISION: MA !ENE 11 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIL'IE. II APARTMENTS
DESCRIPTION: (2) branch c. : for washer, dryer & heaters.
OWNER: O'GORMAN, WC 1A EL PHONE #:
CONTRACTOR: AI3C ELECTRIC PHONE #: iO3-233-7Y:; 1
Inspection Request Scheduled For: • Date: V1712006 Pour Time:
Code # Inspection Description ••nfirm # Contact # Message
120 Electrical rough-in 028 18-01 50:.-23'3-756•1 Y
Co do omments/lnstructions:
•
PASS 1 PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
1 1 FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: v ` ' ic—r) Date: 1 I C6 Phone #: (503) 718- 2 -44 (-
•