Permit 1 ° CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2009 -00025
COMMUNITY DEVELOPMENT DATE ISSUED: 1/20/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S1026D -01001
SITE ADDRESS: 09975 SW WALNUT ST 6 ZONING: R - 12
SUBDIVISION: WALNUT COURT APARTMENTS LOT : 007 JURISDICTION: TIG
PROJECT: WALNUT COURT APARTMENTS
Project Description: Repair exposed wiring on exterior of laundry room.
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: 1 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:
GILSON LIPP ALLIANCE PROPERTIES PACIFIC NORTHWEST ELECTRIC INC
4280 SW 109TH PO BOX 310
BEAVERTON, OR 97005 OREGON CITY, OR 97045
Phone: 503 - 350 -1200 Contact #: PRI 503 - 657 -1188
FAX 503 - 722 -9058
FEES
Description Date Amount Reg #: ELF C6
IEI,PRMTj EI.0 Permit 1/20/2009 $53 50 LIC 162893
['TAXI 12% State 1/20/2009 $6.42 SUP 5089S
Total $59.92 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
suspende r more • -n 180 days ATTENTION Oregon law requires you to follow rules adopted b the Oregon Utility Notification Center
Those r s are set fort 'n e - 952 - 001 -0010 through OAR 952 -001 -0100 You may obtain c c •f these rules or direct questions to OUNC at
503.24 6 699 • 1.800.
Issued y: / �l _ Permitt Siggature: �; „!alto? , <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:
CON RACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: - f. =M 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.
5 '1/16/2009 14:28 5037229058 PACIFIC NW ELECTRIC PAGE 01/02
Elect Pe rmit Application rim 1,1:F1 1 SF ONI
City of Tigard ITO 9 Pernrit No.: 4 jp pG 9„,,75 '
• 13125 SW Hall MO, Tigard, O� Flee Review
Phone: 503.639.4171 Fair. 503 960 /� 0 09 D t Other Permit
r t C; u. f: [ la 2 far
Internet www,Lin.: 50d� goo I I` ,` 1 v cd/M t Suppk a1 ioninnagon
crrtct• b `v �
, Tyra OF 0/ t r • , 0V '11 ,, Allsl o � PLAN REVIEW ,
V „ „__ Play amps or mom � Building check all that apply (submit 2 sots of Om w /itcnn checked below),
❑New construction la ,
d Demolition ❑ Other vv �i 0 Service or feeder 400
over three stories
where the available fault current ❑ Marlon% and boatyards.
' CAy'F X+Cb1Rk.9Yr C#�1Vi371llUtTrd(d . , eertCds 10,000 =Pa at 150 volts or El Floating buildings.
. - less to ground, or exceeds 14,alO ❑ Commercial-Inc agricultural
111 1- and 2- family dwelling ❑ CottunerciaVmdustrial ❑ Accessory buildin g
ICI ivrtllh- fAtl1]l Amp: all caber =tonal= building
y ❑ Master builder ❑ O ther ❑Fie pomp. 0 Installation of 75 KVA or
�� ,Am) � � QE Emergency larger separately derived system
�
❑ Additnm of new motor load of 10 ^A ", 'F,". "1 -2 ", "1.3 ",
.lob no.: Job site address: taoliP or mere. oeeupmay
q`7� 5 GJ v v I') v' r r ❑ six or most residential u its ❑ ltec eational vehicle pork•,,
City/State/ZIP: ' Ct ` Q n _ ❑ Healt facilities 0 Supply voltage for more than
, +� 01leaarde rr locations 600 volts nominal.
SWtc/bldgJapt, no.: I `Y' . ( ` Project name: ❑ Service or feeder 600 anrlr. or more.
Cross street/directions to job site: ring JLE ' l
°r eerrtgtoe I Qh• I Fee. I toms I •
New residential single- or multi - family dwelling mitt.
includes attached garage.
Subdivision: Lot no.: 1.000 sg. IL or less 145.15 4
E.a. add? 500 sq. f. or on _ 33.40 1
Tax map /parcel no,: 4 1
Limited energy. residential
75.00 2
_,_ r . , , ,... _, _ ,. !ASCRIPTION _OP _WOW( ._ .., , , ._ (with abovo sir. A.)
� ta ► ID l n Li energy. multi-Wray
:... r residential (with a AL aq R) 75.00 2
A An A/ Services or &miens ieslyltn alterntion, and/or rt loadion
PROPERTY . 200 amps or lees 30.30 2
. , (] TENANT 201 amps to 400 amps 106.85 2
Name: 401 aminto600amps 160,60 2
Address:
^ - 601 amps to 1,000 amps 240.60 2
Over 1.000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax:
( ) 200 maps or less _ 66.85 ]
Owner Installation: This installation is being made on property that I own which is not 201 OMPR tO 400 amPa 100.30 2
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133,75 2
Owner signature Date Rrsmebl circuits - new, alteration, or ex tension, per panel
A. Fee for branch circuits with
• Ci APPLiCANT :•'' 1 " C CONTACT PERSON above service or feeder fee,
6.65 2
each brooch circuit
Business name: pa G r 4_ 0 — , ( f j B. Fee for branch circuits
CplttaCt name: C t without service or feeder fee,
�i , W _ first branch circuit D 46.85 y� • gt" 2
Address: Each add') bmrnch circuit 6.65 _ 2
box �j. ' n centtneom (service or feeaernol it
City /State/ZIP: 0 ye,oii alt. t Q_ q" oy'' Each tmumfbcturcd
9)b """J T dwelling, Service and/or feeder 90.90 2
Phone: � ) - Fax :: () 5) "') 22 -9- a t ] Reconnect only 66.85 2
E -mail: . `- .r ;1 1 ■ We � c C • a 0...., Pump or irripadion circle 53.40 2
a N' fACI'OR _ Sign or outline lighting 53.40 2
BuSi Luterine: l
4�/a �~�C 0 t (
N (4 --
Signal circuit(s) a limited-
__Address: ` i� ' 1
energy panel. alteration,
Page 2 2
F r
City /State/ZIP: Each addkional ite.Jrection over allowable in mty of the above
-
Phone: ( ) Fax ( ) Per inspection 62.50
lnvestirortion per hour (1 hr mm) 62.50
CCB Lie.: 0 3 L______________ leetrit0l Lie.: G I Suprv, Lie.: sp 9 S lncmurial plant per hour _ 73.75
Suprv. Electrician signature ELEC1 FEES
_ Subtaatl: S
Print name: ) 0 a , -. .. f -() Pure review (25% of Permit foe):
I tC Slate ( 1 2 %
Authorized signature: '�
..- — _
TOTAL FEE: , f{
Print name: She i ,I - i s permit e a.athm expires Ifs
,n 1 � I Date: (...1 1 _� Va
Q P i PP permit ta inn abta wlth(n
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| BUILDING DIVISION PERMIT #: ElC780900025
| 13125 SW Hall Blvd., Tigar , OR 97223 DATE ISSUED: 1/2w3809
Phone: (503) 639-4171
Inspection Reque�a(24Hryj:(5O3)63Q-4175 .J— w�� ^��� •
INSPECTION WORKSHEET FOR DATE: 1/23/2OU9 TIME: 7 g0mvi PAGE: 14
SITE ADDRESS O99MSW WALNUT STG CLASS OF WORK
SUBDIVISION: WAL1UT COURT APARTMENTS' LOT #: au TYPE OF USE:
PROJECT NAME: WALNUT COURT A RTMENTS
DESCRIPTION: Repair exposed wiring on exterior of laundry room
OWNER: ALIJANCE PROPERTIES, GILSON LIPP PHONE #: 6O3,350i200
CONTRACTOR: PACIFIC NORTHWEST ELEcrRIC INC ~—\ PHONE #: 503-667-1188
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Inspection Request Scheduled For: Date: 1/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
\
- 199 E|muoiva503-969-8839 | 079961-01 503-969-8839 ��39 �~ y
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Corrections/Comments/Instructions:
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i',. ,1 PASS | | P�S8 PARTIAL APPROVAL | CANCEL �� �� NO ACCESS
- ^ E] CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: G n\66 Date: A~ Phone #: (503) 718- 1411