Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00337
..� DEVELOPM ERV 503 - 639 -4171 DATE ISSUED: 6/14/2005
13125 SW Hall PARCEL: 2S115AA-OTOOA
SITE ADDRESS: 16105 SW 108TH AVE BLDG B ZONING: R -25
SUBDIVISION: OAK TREE APARTMENTS LOT : OOA JURISDICTION: TIG
Project Description: Rough -in & service for (24) units.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 1.00 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 1 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 23 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 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:
OT2 LLC SPECTRUM ELECTRIC
5437 ROSALIA WAY SUITE 100 2050 VISTA AVE. SE #100
LAKE OSWEGO, OR 97035 SALEM, OR 97302
Phone: 503 - 620 -4373 Phone: 503 - 361 -1256
FEES Reg #: ELE 24 -353C
LIC 116453
Description Date Amount SUP 2223S
[ELPRMT] ELC Permit 6/14/2005 $2,312.29
[ELPLCK] ELC Pln Rev 6/14/2005 $578.07 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 6/14/2005 $184.98
Total $3,075.34
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Code d 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 o f issuance or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Or-' n Utility N • ' rc -tion Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rule- •r ..rect qu�i s to OUNC at
503 - 246 -6699 or 1-800
Issued By: "":17 Permittee Signature: �� / t��.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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard R E CEI VE Received L) r/ p ermit N '
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: / ��) � -- 1 24% 27033 /
Phone: 503.639.4171 Fax: 503.598.1960 t..,1,:, Plan Review
/ / pit h� r � '� Date/By: Other Perrnit:"SlJ`� DD 47/60.2._ Inspection Line: 503.639.4175 A -s C L1 7 _r Date Ready /By: Juris: H See Page 2 for t+
Internet: www.ci.tigard.or.us Notified/Method: --j (. Supplemental Information
T! Ti_ t
• , ew construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other OService over 225 amps, comm'l ❑Hazardous location
� �{ % t �� : i mil ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
� x-, < ' �f of 1- and 2- family dwellings 4 or more new residential •
❑ Commercial/industrial ❑ Accessory building DSystem over 600 volts nominal units in one structure
;� ulh family ❑ Master builder ❑ Other: ❑Buildin over three stories ❑Feeders, 400 amps or more
_ p ❑Occupant load over 99 persons ❑Manufactured structures or
_ � a - . _< � ® ° t e , � ❑ Egress/lighting plan RV park
Job no.: Job site address: 5 722/ ❑Health - care facility ❑Other:
�U „iU Submit 2 sets of plans with any of the above.
City/State/ZIP: , - The above are not applicable licable to temporary t3' s(.1/ ,D��i4�i9/IJI /�U/9G/ PP P rY construction service.
Suite/bldg. /apt. no.: Project name: �� ' , '.MAk'"
Description I Qty. I Fee. ( Total I ""
Cross street/directions to job site: i I = ■ bi 1 y ' New residential single- or multi- family dwelling unit.
Includes attached garage.
��:C , Z /� �, 1,000 sq. ft. or less / 145.15 / O 4
Subdivision: V Lot no.: Ea. add'l 500 sq. ft. or portion ) 33.40 53 � 1
Tax map /parcel no
Limited energy, residential 75.00 2
, * r4 „ �� _� Li •ted energy, non - residential 75.00
' ` h � s � „ x. e w .P t , 9A 3z n U i ' '` ...... - ,r a J �”
k.a. � ?4 �.n..n � ,. , R , „ rte$ ..� .mss x:C _ .. `. i ..� _ �� a' �' • i r . ♦ i I\� 2
ZZEr i'1G / .-OU -� fiV c2 4,Cf. rI ed , : �.9Q NNIrI
Services or feeders insta lotion, alteration, and/or relocitity
200 amps or less / 80.30 31) 2
- i o- ; s Y '�” : A 201 amps to 400 amps 106.85 2
" � ' .1 "" ' " 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 /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) I Fax: ( ) relocation
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
). i �� l.g ' TM a : d ' � , T' , ;; f a 4.1) � a `" •A t/ : a . ''1 A. Fee for branch circuits with
� s s s ,� � � ..-., � �.,...,�.. �; � ..,�,.� s� . , ., ��� service or feeder fee, each
6.65 2
Business name: 5 c 7' /��G/Y)? F,Gft!' r /(^; branch circuit / _
B. Fee for branch circuits
Contact name: r te' /��C /f _z7GtivoN / 4Ut 2 without service or feeder fee, 46.85 2
Address: �6 �U U S7 .A �Uf s / f ' � 2 .1 each branch circuit
L �`/� v Each add'l branch circuit 6.65 2
City /State /ZIP: .5;9:e 0/2 97,3e • Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (So 3 )36 / 54 I Fax: : (SGt3) J6/ 7/ Sign or outline lighting 53.40 2
E -mail:
Signal circuit(s) or limited -
51 °, 7- %ts a l y ' �t � � i n I: t xK , i a energy panel, alteration, or
Business name: extension. Describe: Page 2 2
_.../..y"../ �s �9
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
N •' City /State /ZIP: Investigation per hour (1 hr min) 62.50
, . Phone: ( ) F ax: ( ) - Industrial plant per hour 73.75
i" n l ? L*D �� i9t, i ; � r, `'xir°R'" _ . °, 1
CCB Lic. _3 I � - /
: Electrical Lic • Su ^� •� �� ¢ � ,, 1. ��
� �/ - �� p rv. Lic.: �or 3 5 Subtotal
Suprv. Electrician signature, required X ' 7 _. ,, _0., Plan review (25% of permit fee) vv
/ „_ I �JL • ' t a '
State surcharge (8% of permit fee) / &J
Print name: w U/v / ' � Date: G 4. TOTAL PERMIT FEE ( ,Vip3
`- � j �
Authorized signature: This permit application expires if a permit is not ob within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \Pemits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD t�
BUILDING DIVISION PERMIT #:E TOO 6 -Wan
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 : " "Uitii ii
Inspection Requests (24 Hrs.): (503) 639 -4175 „'
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS :1, S W � CLASS OF WORK:
SUBDIVISION: 'tIQ- LOT #: TYPE OF USE:
PROJECT NAME: R
DESCRIPTION: a J I L -b% 0 o, v
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
icltk Code # .•t sp Descript Confirm # Contact # Message :.............
F- sl..c,`C cAL,..'.,,.
Correctio omments / .
No t SSvE6_
Ifi ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NOg L Date: t 14105 Phone #: (503) 718- 244