Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00394
DEVELOPMENT SERVICES DATE ISSUED: 7/20/2006
1
-- 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S 1128D -00700
SITE ADDRESS: 14655 SW 76TH AVE 9 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: 4 branch circuits.
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 #: ELE 161501
[ELPRMT] ELC Permit 7/20/2006 $66.80 LIC 26-1226C
[TAX] 8% State Surcharge 7/20/2006 $5.34 SUP 5096S
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: } ,��G2��i�� Permittee Signature:
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.
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rec>�: Kcal Permit Appl><c �® 1.. � 4 :m. t� ,n.,i Vii ; . A
• City of Tigard t Rece
Da e 0 , D6 -
13125 SW Hall Blvd.. Tigard, OR 97223
1 ZOOS Plan Revie ,
Phone: 503.639.4171 Fax: 503.598.t96 . ',tlri(cili �^ Dat : : Other Permit:
¢
Inspection Line: 503.639.4175 T 1GAA0 ; . a 1. `,• „- Date Ready/By Ju b. ® See Page 2 for
Internet: www.ci.tigard.or.us clr(( B� OG � ivist O
is t O Notified/Method: Supplemental Information
it -OF'WORK ' PLAN REVIEW.'
❑ New construction Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other ❑Service over 225 amps, comtn'1 ❑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 )51,,CommerciaVindustrial ❑ Accessory building CI System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family 0 Master builder 0 Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: IL-0(o 8( Job site address: Ne0�h / ['Health-care facility any ❑Other:
/ �`� Submit 2 sets of plans with an of the above.
City/State/ZIP: �' t�r / U , ., 5 6 •
The above are not applicable to temporary construction service.
"``IVVV! + FEE* SCHEDULE
Suite/bldg. /apt. no.: Project •
name: �/t:1I�! �..�� _
J Description I Qty, I Fee. I Total 1 ••
New residential single- or multi -famil dwelling Cross street/directions to job site: �C���(/ g Y g unit.
Includes attached garage.
C? /- e • 1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy. non - residential 75.00 2
:'DESCRIPTION'OF WORK ;:
_.: .._,_ Each manufactured or modular
�11
p ( / t / dwelling, service and/or feeder 90.90 2
i /V• �� 1 A � 7 o � r " ' Y, Services or feeders installation, alteration, and /or relocation
/ 200 amps or less 80.30 2
'' ❑ PROPERTY ; Q�'VNER ' 1 .. D TENANT _ 201 amps to 4 amps 106.85 2
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
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 I
Owner installation: This installation is bcing madc 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
❑ APPLICANT I .. , 1 p CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: \t)C \ - �. � ( - branch circuit
Q /'� t J B. without for service circuits
es
Contact name: t
t "_ without service ar feeder fee, ' 85 . �2
Address: each branch circuit 46 oy�p
Each add'( branch circuit . 6.65 /9, 95'
2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I p er; ; ( ) 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
1 extension. Describe: Page 2 2
Business name: �' k e r 1
Address: 1 55 m E. (- ` . r Q Each additional inspection over allowable In any of the above
` ` Per inspection 62.50
City/State/ZIP: --..M,"\ \G.'nC‘ (� L tC' ? ) 2 l Investigation per hour (1 hr min) 62.50
r� 7 ' Fax: (� O( /
Phone: (5'35 t� ✓ `' t ^ 5 ` / 3 y '� �a Industrial plant per hour 73.75
� ELECTRICAL PERMIT FEES *,
CCB Lic.: JO /SD ) I Electrical L i c . 6 2 6 _ / 0 7 c ? ( p Suprv. Lic. , 9 (0 Subtotal 66 6
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name /� ' Dan.' Date: / t9,7 State sur (8% of permit fee) 3
/ TOTAL PERMIT FEE `,2 ,1
Authorized signature: This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete
Print name: � - " �( u3 r ��� ( Date: 1 1 / � / • Fee methodology set by Tri -County Building Industry Service Board
L� •• Number of inspections per permit allowed.
i:\ Building \Permits \ELC•Pc nirApp.doe 12/03 440 -46 5T(10/02/COM/WEB
I'd 096T86S2121SdT8 :O± :NDad dST :20 9002- 8T -111f
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL C2006-00394
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: M00006
Phone: (503) 639 -4171 ''�� p >°\l∎'(i
Inspection Requests (24 Hrs.): (503) 639 -4175 s':- '`,..
INSPECTION WORKSHEET FOR DATE: 8/11/7006 TIME: 7 :06AM PAGE: 65
SITE ADDRESS: 14655 SW 76TH AVE 9 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MtRC1ENE 11 __�
DESCRIPTION: 4 •
1�rat�ch circuit:. .E"t` 51 A1' 4 6e n A z__-,
OWNER: 13OOi H- HEYDON LLC, PHONE #:
CONTRACTOR: ABC ELECTRIC: ____— PHONE #: 503_233. p313
1
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Co. - • Inspection Description onfirm # Contact # Message
199 Electrical final 0'4817-01 503 -233 -7551 Y
Corrections /Comments /Instructions: I � 0 °
t rh i ) - 3 - 6 - 61 A
c .., \ 2
M c \ :: ,
F` 'N :\
\* IV \
N ig PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q Ne(es°
Date: l V i Phone #: (503) 718- 2.