Permit CITY OF TIGARD ELECTRICAL PERMIT
r
AI° PERMIT #: ELC2006 -10079
DEVELOPMENT SERVICES DATE ISSUED: 3/27/2006
- I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 110AC -00400
SITE ADDRESS: 14741 SW 109TH AVE 1 -4 ZONING: R -12
SUBDIVISION: TIMBERLINE APARTMENTS LOT : JURISDICTION: TIG
Project Description: Reconnect Only. UNIT 3. Job #A6431.
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: 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: 1 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 4/6/2006 $66.85 LIC 8277
[TAX] 8% State Surcharge 4/6/2006 $5.35 SUP 2175S
Total $72.20 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: 7d u ) Permittee Signature: �P .2 Q5\
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.
Mar, 27. 2006 1:45PM , MC COY ELECTRIC No. 8919 P. 2
metrical relrnur .A n 110 1 c)l; t)1 F,c . I_l
A
. Ty of Tigard Re -6 ceived J j ‘ ,P Permit No.: 7
e�
I IL -1 4 �Y ~ �d ®l q
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503,639.4171 Fax: 503.598.1960 p r ') r r { Date/By. Other Permit:
Inspection Line: 503.639,4175 �' r "� :I ....... Date Ready/0y; luthy 0 Scc Paget for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
0 New construction 1� �'tbn Please check all that apply:
Demolition �[ Other: Service over 27-5 amps, corrlrn ! Hazardous location
T . ❑Service over 320 amps - rating ❑Buetdng over 10,000 sq. ft.,
... CATEGORY OF CONSTRUCTION °! : of 1 • and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling geommercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
El Multi- family ❑Master builder ❑Other ❑Building over three stories ['Feeders, 400 amps or more
, ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION :. • ❑Egress/lighting plan RV park
Job no.A (p�3` Job site address: j l(3-CI 1 5,414 , (d _ ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State/ZIP: ` ,6 a(1.0 nil-. The above are not applicable to temporary construction service.
Suite/bldgJapc no.: rrojectnatne: T 1 yn 6 c, ft - , C - . ° '; . ` : '` . ,Flay SCIICEDULI�: ..
D I QV. I Fee I - row
Cross street/directions to job site: li K'rC 0 E 6,t C 6 Otto S 5 New residential single - or multi- family dwelling unit.
/r Includes attached garage.
CA A hl i R-6CA(�( Qi ° j`C1ll } 1,000 sq. R or less 145.15 4
Subdivision: Lot no.: Ea. add'! 500 sq, ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
• Limited energy, non - residential 75,00 2
'' DESCRIPTION OF WORK , .. .. Each manufactured or modular •
Q ! ' �ft('i � vim( (A t S 3
dwelling, service rs ins feeder 90.9a 2
- 1( -� � . d Vl N Services or feeders installation, alteration, and/or relocation
Li . 200 snaps or levy 80.30 2
' 201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER:.,:: , C� TENANT:''' ..
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 2
Recomicet only f 66.85 �2
City/State/ZIP: Temporary services or feeders installation, a teration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 I
Owner installlation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 44.9, 670, and 701. 401 amps to 600 amps I 133.75 - 2
Owner signature: - Date: Branch circuits - new, alteration, or extension, per panel
1 A. Fee for branch circuits With
❑ APPLICANT (�' CONfi,A.CT..PERF,ON w � %'
service or feeder fee, each 6.65 2
Business name: lMC 6::)......i. - L.-CTru..c_ branch circuit
B. Fee for branch circuits
Contact name: a 1 L L L LI S without service or feeder fee, 46.85 2
Address: each branch circuit
. - Each add'l branch circuit 6.65 2
City /State/ZIP: Iijiscefaneons (service or feeder not included)
Pump or irrigation circle 53,40 2
Phone: ( .
) . 34- 9-c ? i I Fax: : ( )
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
Address: Co , y s_ _ ��t Il _ �`G Each additional i a spcerion over allowable In any of th above
Per inspection 62.50
City /State/ZIP: ? j (mi l— 9 - t V r Investigation per hour (1 hr min) 62.50
Phone: (% ,g54-.3,;-, I Fax: 15o3) „ (l(- 3 Industrial plant per hour _ 7175
ELECTRICA PERMIT FEES'"
CCB Lic.: 8 a3 1- I Electrical Lie.: ,9(0 43 (Z I Suprv. Lie.: a l +S ,C(. Subtotal 1
Suprv. Electrician signature, required: c t — w /& 2,��C,(__ Plan review (25% of permit fee)
{ !� C — Date: ) 3_5 State surcharge (8% of permit fee)
Print name:
'� ` l`- � �'` � ' a ° - Z. 6 TOTAL PERMIT FEE vy Lt ()
Authorized signature: + 'This permit apptientiop empties if a permit Is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- Country Building Industry Service Board
• •• I./umber of inspections per permit allowed,
1: \nuildinnpcmliSM-C- PmnitApp.doc 12/03 VISA 440461ST(t0/02/COM/WEB
CITY OF TIGARD t-q-C-
BUILDING DIVISION PERMIT #: 2 06‘ -WO 7`�
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 / , r�utmypuppl� ii ` \
Inspection Requests (24 Hrs.): (503) 639 -4175 ..._,..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / t 7 ql it' 9 Q ' - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ,,,
DESCRIPTION: T ",,,, u Jt ,6_ A ci -
OWNER: PHONE #:
CONTRACTOR: } PHONE #:
Inspection Request Scheduled For: Date: 3— 2 ?"- 0 c Pour Time:
Code # Inspection Description Confirm # Contact # Message 0 O
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Corrections /Comments /Instructions: (51,n/
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PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: al 2., l Phone #: (503) 718- li'