Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00252
a DEVELOPMENT SERVICES DATE ISSUED: 5/11/2006
( ' • 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 110AC -00400
SITE ADDRESS: 14741 SW 109TH AVE 1 - ZONING: R -12
SUBDIVISION: TIMBERLINE APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits. Unit 3.
Job #A6705.
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: 0 W /SERVICE OR FEEDER: 0 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:
TIMBERLINE APARTMENTS LLC MCCOY ELECTRIC CO INC
BY WPL ASSOCIATES PO BOX 42428
522 NW 23RD AVE PORTLAND, OR 97242
PORTLAND, OR 97210
Phone: Contact #: PRI 503- 234 -7521
FAX 503 - 234 -9473
FEES
Description Date Amount Reg #: ELE 26 -82C
[ELPRMT] ELC Permit 5/11/2006 $66.80 LIC 8277
[TAX] 8% State Surcharge 5/11/2006 $5.34 SUP 2175S
Total $72.14 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 24.:.99 or
1- 800 - 332 -2344. /� %f f
Issued By: I cl - tAV "v Permittee Signature: / /�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Ap.p°licataon t, , " : FOR OFFICE USE ONLY 1
Cit of Tigard C� Deised — e Pernut No.:
13125 SW Hall Blvd, Tigard, OR 97223 Y � � � r ��
Phone: 503.639.4171 Fax: 503.598.1960 l��� " 1 Dat Ocher Permit:
° =1.I
Inspection Line: 503.639.4175 ,�! U. Date Re ady/By: 2:1 See Page 2 for
Internet: www.ci.tigard.or.us im 113r►i" Za
' Notified/Method: Notified/Method: Supplemental Information
It, CV 9. )k " �
TYPE OF - ORKriP "I 1`° Y ' o : ;",,:_":_ :,: ' :' : PLAN :_REVIEW
❑ New construction ❑ Ad"diiion/$lteration/replacement Please check all that apply:
❑ Demolition Other:
❑ Service over amps, comet Hal rdous location • � " UC over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
' ' CATEGORY OF" CONSTRTION • . • ,; • P` of 1 - and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories OFeeders, 400 amps or more
Multi - family ❑ Master builder ❑ Other:
❑Occupant load over 99 persons OManufactured structures or
JOB SITE INFORMATION :AND LOCATION _ :. :' • ❑E plan RV park
Job noP 6305 Job site address: i it 9. q l _ 1 ()Cd ❑ Health -care facility ❑ Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: *�(,� 1 t Oft—
q 1 4 The above are not applicable to temporary construction service.
•..:: : :i' . ` FEE *•:, SCHEDULE;; . -' .
Suite/bldg. /apt. no.: 3 Project name: 1,$A.P L" i ,..,4 A -lp'rs "''''
„;: .,
(.� _.--:e-- Description J Qty. I Fee. Total
Cross street/directions to job site: CA S i of , ui 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
Limited energy, residential 75.00 2
Tax map /parcel no.: 2 5 1 ( 0 ,4-e (') cr Ye c, Zo Nr(- R--11..._
9
... .:: ....: 75.00 2
;. : : ...` ?' :DE WORK ";:''_ ?, ; :: :;: :i :•
Limited energy, non-residential
• '' � -° " - '- -. ,- :. ,- Each manufactured or modular
r/ C. dwelling, service and/or feeder 90.90 • 2
a nn'' � 2C ��1� 1�-i�� (` —t _ '� Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
::' "' :. :` :1PROPERTY`' OWNER : ; - <vc; • :.' --•: :! : :: ; ' '':.'-' . -":‘'T.'. ; : ,. ;:❑: TENANT :: ;•... 201 amps to 400 amps 106.85 2
- 401 amps to 600 amps 160.60 2
Name: 1 ( 4 4 ( J j , C - 1 2 L IAA E P S L L C J ) P L ) 5 CC 1=r t 5 601 amps to 1,000 amps 240.60 2
Address: G12- f,,-- o ,.i 2' geL, Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: kiL71, 9 j ,. 93 Z. L Temporary services or feeders installation, alteration, and /or
Phone: ( ) 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
.... , , . . . : : : ' : : - ; APPLICANT ;.' ";::,:;•
.; •, : ;;: CONTACT_ ; PERSON-:... : :: _+ -..'-'1,: A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: n'N Cr C � • branch circuit
Contact name: B Fee for branch circuits
t C. L." L t_ without service or feeder fee,
each branch circuit 46.85 4,85 2 J
Address: §
Each add'l branch circuit 3 6.65 39' 2 a '
City/State/ZIP: Miscellaneous (service or feeder not included) •
Phone: ( ) P te:: ( ) 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
Business name: extension. Describe: Page 2 2
1 Co ..-� i��in -i C_
Address: Each additional inspection over allowable in any of the above
Z0,L s- 9 mod
Per inspection " 62.50
City/State/ZIP:
1Qo (2. i C --if) ) Cj� [ t� 42 , i 9 Investigation per hour (1 hr min) 62.50
Phone: ( `i Fax: r ? Industrial plant per hour 73.75
�� ) ry � � �v, ) .v y �J - - ELECTRICAL PERMIT FEES* c,�
CCB Lic.: —q_ Electrical Lic.: � j Suprv. Lic.:�� Subtotal 4s 4, 1 V av
Suprv. Electrician signature, required: 7 _ Plan review (25% of permit fee) fi t ,'
Print name: Date: State surcharge (8% of permit fee) / )
,:..„
R C I -- �_ L � " i TOTAL PERMIT FEE j 3 , 1p q
Authorized signature: This permit application expires if a permit is not obtained within 180 y.'
days after it has been accepted as complete II
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
ss Number of inspections per permit allowed.
i:l Building \Permits\ELC- PennitApp.doc 12/03 440-4615T(10 /02/COM/WEB
CITY OF TIGARD
, . .L.
, BUILDING DIVISION PERMIT #: EI-C2006-00252
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1112006
Phone: (503) 639-4171 :„0091(ii
Inspection Requests (24 Hrs.): (503) 639-4175 ..._-_,. ..—.
INSPECTION WORKSHEET FOR DATE: 6/20/2006 TIME: 7:01AM PAGE: 50
SITE ADDRESS: 14741 SW 109TH AVE 1 - 4 CLASS OF WORK:
SUBDIVISION: TlivIBERLINE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: TIMBERLINE AP r - NTS
DESCRIPTION: (4) branch circuitsM
Job #A6705.
OWNER: 'TIMBERLINE APARTMENTS LLC, PHONE #:
CONTRACTOR: MCCOY ELECTRIC CO INC PHONE #: 503-2347521
Inspection Request Scheduled For: Date: 6(20/2006 Pour Time:
C. ee # Inspection Description Confirm # Contact # Message
alb Electrical final
031984-01 503-730-2005 Y
Corrections /Comments/ Instructions:
i \¼ 5 7
2 .PASS 0 PARTIAL APPROVAL r7 CANCEL El NO ACCESS
0 FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: WS II (..,----- Date: 1 7--6i66 Phone #: (503) 718- OtilCi
, .