Permit ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2005 -00306
c�i�� DEVELOPMENT SERVICES DATE ISSUED: 5/9/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101BD - 00105
SITE ADDRESS: 12805 SW 77TH PL ZONING: I -
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (2) 200 amp, (3) circuits. Job # 7993.
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: 2 W /SERVICE OR FEEDER: 30 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
B R + G CO LLC NEW TECH ELECTRIC
PO BOX 23009 20811 NW CORNELL RD #400
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 - 1900
FEES Reg #: LIC 41868
tion Date Amount SUP
Description 26-41
p ELE 26 -418c
-
[ELPRMT] ELC Permit 5/9/2005 $360.10
[TAX] 8% State Surcharge 5/9/2005 $28.80 REQUIRED ITEMS AND REPORTS
Total $388.90
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: _cf.__ 6 �p,c
OWNER INSTALLATION ONLY ii
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
05/09/05 MON 06:46 FAX 503 640 0571 NEW TECH ELEC a001
' - Electrical Permit Application F OFFICE USE'. O NLY ' `
City of Tigard
�` Received
13125 SW Hal] Blvd., Tigard, OR 97223 � DawB _ / � Permit No.: 6� J (9� .16
Phone: 503.639.4171 Fax: 503.598.196F% 9999 aaa���a� Plan Review
^,1 /nn +` ° ''S °:tilt. ^'� I ) bate/$ : Othw'Perrnie
Inspection Line: 503.639.4175------ �l 9 L `_■ J.. . ' j Date Ready/By
Internet: www.ci.tigard.or.us ‘4\11.1 p`l + NottfiedtMethod: RI See Page 2 for
Supplemental Information
I I t l pl It ti r, a
Addition/rtuNigep acement Please check all that apply:
` "'� ' " " "l
❑ New construction L
``�� --
❑ Demolition ❑ Oa BV ['Service over 225 amps, comm't ❑Hazardous location
t tt iii 4 u , ,tt t r �(il �' ❑S over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
,t 1 I i 1 •, r U +i r ,1
-= --• _ .._ ....._. o - and 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling t0'Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
El Multi family 12 Master builder El Other: ['Building over three stories :Weeders, 400 amps or more
I , lv ['Occupant load over 99 persons ['Manufactured structures or
' ..::!,:i..:::... ^ .:.... w nli t?I J
... _ m r I0, ,{ v ir�tt ... li9 1 ' �lr) c1t t ill bti�� :. ,y
. _•.. ,...., .._.:_ ,iJ, . ....�.. ❑Egress /lighting plan RV park
Job no.: • 1 Job site address: 1 2 S G-, - - LALE ['Health-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Pp2rt_i\N 9 O ft- el I Z7'3 The above are not applicable to temporary +S conswction service.
Suite/bldg. /apt. no.: Project name; (' .;, i ti,y ll I)p11E� ll a r �` t Acre °i� {'�.
T sz PA = 1c� �,.: lcn.u..'4.n;sa ,1 .. c > s
Description Qty. Fee Total ""
Cross street/directions to job site: 1JT L (TIES New residential single- 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. ft. or portion 33.40 1
Tax map /parcel no.:. Limited energy, residential 75.00 2
"; joy it rt i; a a (flUlgr uu, . p 1{ Limited energy, non - residential 75.00 2
, .., _... ..L_ ,^,, ..... .,.•, J_ 1 ,.,....;;�,.. ,' Each manufactured or modular
Ni �W E C7R -1�V N ATI ON dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation _
200 amps or less Z, 00.30 1(,D .Go 2
u I' 1 dbl:N�� {r 1 E7i'N pit ' � 11 ` I x ,)r tlfai� { a 17t ; ."..'$';:::...:*; 201 amps to 400 amps 106
l ... _:. { ...,_- Sri:, ii.a.. E . 85 2
I 401 amps to 600 amps
Name. � �N4� /---nor-.1 160.60 2
601 amps to 1,000 amps 240.60 2
Address: f •p 1 LA NI A L Over 1,000 amps or volts
L l R CAL E P 454.65 2
City /State/ZIP: Reconnect only 66.85 2
�ILe t��J 0 # 0 03 Temporary services or feeders installation, alteration, and/or
• Phone: (5.9. ) 2 ) 1Ci . o5z Fax: ( ) relocation
200 amps or less 66.85 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. ,_ 2
401 amps to 600 amps 133.75 2
Owner signature: D ate Branch circuits - new alteration or extension, per panel
' �(� .,t 11: �1, ;' A° ,'� J t { , r r+ -1 -, "l t(� ll t 1 r'��Bq r ' f l A. biith
i.' . .7P_. u .__. Y. .......L,.SA,.. ,.v.. ..._J�.u.l JSl.,i. :144tti�c.J .3J_ _,.Ir...'`�?. „F.. ' L�f._.•.I:l
se ic for o fe d er circu feets w
, eac
Business name: branch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee,
•
Address: each branch circuit 46.85 2
Each add'l branch circuit ? 6.65 1 41. 5p 2
City /State/ZIP: Miscellaneous (service or feeder not included)
. Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E Signal circuit(s) or limited -
r . r . +q I "'I' i r5"e '"i''F �i:� -} ; lisp T r x ._,•�•-+.F i 5 - 1 ' -a4 ^es y
Y .5 7 1; "ut1`,nc�l.u,,..J..i::.,:M 1.: ,:.,.,e?Li1tt-..t.y.>ltJ:lei [) L. R i.� x 1, .�"� "11? -1 is ry�a.l :' p,
eT-a �SB�iv". • 1 I' Iw`uY::3.H:i..fa lu,i.u.:.::iSli '+u4:.r7:1 u..J�._u5i:i; .C. 1:
Business name: NEW De scri b e: anelalteration, or
Page 2 2
NEW TECH ELECTRIC, INC
Address: 208 1 1 NW CORNELL RD STE 400 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: H I LL S B ORO OR 97124 Investigation per hour (1 lu min) 62.50
Phone: ( ) 5036481900 Fax ( ) 5 0 3. 6 4 8.31 31 Industrial plant per hour _ 73.75
,, t '�j
i ,.� r 1 µJln u�:'�t i`♦ti (Y D J G •{ritEi w' tl N tC �. ' ��fl'` xJt,,f
CO Lic.: 41868 Electrical Lic.: 2 6 - 41 8 C Suprv. Lic.: 3 8 4 9 S
j Subtotal 3 , (0
Suprv. Electrician signature, required: �, ` / Plan review (25% of permit fee)
Print name: PHIL HANSEN Date: $= q'- (7 S- _ State surcharge (84bof permit fee) 28 _ gp
_ TOTAL PERMIT FEE 3 8 8.10
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: days ailer It has been accepted as complete
Date: * Fee methodology set by Tri- County Building Industry Service Board
*" Number of inspections per permit allowed.
i:\Building P rmits\ELC -Pemut App.doc 12/03 440- 4615T(1 n/02/COtd/WEB
CITY OF TIGARD
BUILDING DIVISION r: PERMIT #: ELC200S -00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2005
Phone: (503) 639 -4171 �i ,m''Hi4nllfi
Inspection Requests (24 Hrs.): (503) 639 -4175 G:_..
INSPECTION WORKSHEET FOR DATE: 5/26/2005 TIME: 7:27AM PAGE: 9
SITE ADDRESS: 12805 SW 77TH PL CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TEREX UTILITIES WEST
DESCRIPTION: (2) 200 arnp, (3) circuits. Job # 7993.
OWNER: B R + G CO LLC, PHONE #:
CONTRACTOR: NEW TECH ELECTRIC PHONE #: 503-648-1900
Inspection Request Scheduled For: Date: 5/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/slab cover 007836 -01 503 -9477 Y
Corrections /Comments /Instructions:
n PASS
ADARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /I - -/ =/ Date, Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION .
PERMIT #: ELC2005`00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2005
Phone: (503) 639 -4171 � 4� �ii�gm
Inspection Requests (24 Hrs.): (503) 639 -4175 ' =� J..
INSPECTION WORKSHEET FOR DATE: 11/8/2005 TIME: 7:OOAM PAGE: 71
SITE ADDRESS: 12805 SW 77TH PL CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TEREX UTILITIES WEST
DESCRIPTION: (2) 200 amp, (3) circuits. Job It 7993.
OWNER: B R + G CO LLC, PHONE #:
CONTRACTOR: NEW TECH ELECTRIC PHONE #: 503-648-1900
Inspection Request Scheduled For: Date: 11/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199'N Electrical final 1 020603-01 503 - 969 -0799 N
Corrections /Comments /Instructions:
C (
il/
,A] PASS L 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: V'^' - 7 // Z--------; Date: / ' A Phone #: (503) 718-