Permit • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -10080
DEVELOPMENT SERVICES DATE ISSUED: 3/27/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110AC -00400
SITE ADDRESS: 14741 SW 109TH AVE 1 -4 ZONING: R -12
SUBDIVISION: TIMBERLINE APARTMENTS LOT : JURISDICTION: TIG
Project Description: Reconnect Only. UNIT 4. 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 21755
[TAX] 8% State Surcharge 4/6/2006 $5.35
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $144.40
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: Ty) f j O ;7 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.
ma r, L/, 1U06 1:45PM . MC COY ELECTRIC No. 8919 P 2
Liiecrlricaii rermir A -rl a ,
FOR tlFFlc- • ' _ . 1.1'
City of Tigard , Received f
13125 SW Hall Blvd -, Tigard, OR 97223 D /B . " _ 7 `f 0 • , . Permit No : & ' •7 A .
/ Phone: 503.639,4171 Fax: 503.598 -1960 a r , Flan Review .
Inspection Line: 5 03.639,4175 :�_ .s , i +'�1 Li„ Date�B , Other Permit
fnternet: www -ci. +� ' Date y
gerd .or.us Ju ne:
v Notified/Method; Scc Pago2for Supplemental Infornranon
I 'tlVR
jj : .
.,. , .. • ' � " ,.PLAN`.REV,I;EW ,: ' , .. .
o New construction 0 tntaiter'abion/replaccment Please check all that apply:
1:3 Demolition .Other: ❑ SCtviceover225 am co 1
: . .. CATEGblil OP' CONSTRt1CfloN :T ; ` : .
['Service over 320 amps - tati g ❑pu� g overr 10, 00 sq. it.,
of ! •and 2- titrtitly dwcUings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi-family ❑ Master builder [] Other:
JOB SITE INFORMATION AND LOCATION; - D Oocupant load over 99 persons ilMavufaetured structures or
•
❑Egress/lighting plan RV park
Job no.1401- Job site address: 1 41..L, I S W , l 0 ❑Health -care facility ❑Other•
City /State/ZIP: ' G ° J
(. .�1 IZ Submit 2 sets of plans with any ofthe above,
Y The above are not applicable to temporary construction service
Suite/bldg. /apt fie.: Project t?Atiie ` • : ; ;;4 ti :.x ; ,' ME *. SCHEDULE: E: '
T I yr 6 <44, t tV (- rg „ Descripve r ..
Cross street/direetit> is to job site: 6� S— G 6 1 QV. l F� f Total 1
e S 5 New residential single - or multi - family dwelling unit.
h jam- n � � ` , O f � � � 1,000 es attaehedsara5c.
d�i " -- rT 1,000 sq, R or less
�A 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq, ft. or portion 33.40
I
Tax map/parcel Ro.: Limited energy, residential 75,00 2
D$SCRII'ThON OF WORK _
- tmited ease y, non - residential 75,00 2
g
Each manufactured or modular
EM (.ft(-1 6\((1�� Q� J� f N � ' ' j dwelling, service and/or feeder 90 2
�N`, ` Vl Services or feeders installation, aioerat(oa, and/or relocation
200 amps or less
2
.❑ PROPERTY: •OWNER . :, :: ' 201 a 80.30
2 -
T ENANT: ":`..; psto40 0amps 106
Name: 401 amps to 600 amps 160.60 2
•
Address: 601 amps to 1,000 amps 240,60 2
Over 1,000 amps or volts 4 5 2
City /State/ZIP: .----- Reconnect only 1 66.83" 2
Tempora y services or feeders installatio , ration, and /or
Phone: ( ) I Fax: ( ) relocation
Owner installation: [tiffs installation is beiR m ade tiff r 200 amps or loss 66.85 1
g P S 44 , 44 I own wl d 7 01. is mot 201 amps to 400 maps 10030 - b . ge, according to ORS X147, 449, 670, acid 7 2
intended for sale, lease, rent, or exchan
Owner signature: _ 401 amps to 600 amps 133.75 2
Date:
Branch circuit7s - new, alteration, or extenema, per panel
❑ APPLICANT
:' :`• ' p CONucr..PF,RSQ,N.. r ; °: A. Fee for branch circuits with
Business name: ► l C::, L service or feeder fee, each
e branch circuit 6.65 2
Contact name: a I LL LL S ;3. F� for breath circuits •
without service or feeder fee,
Address: each branch circuit 46.85 2
City /StatelZlP: Each add'! branch circuit 6.65 2
_ Miscellaneous (service or feeder hot included) •
Phone: ( j) 3 " 2 ( I F ( ) Pump or irrigation circle 53.40 2
E -mail: / Sign or outline lighting 53.40 2
Signal ciieui s) or limited-
CONTfiACTOR energy panel, alteration, or
Business Ratite: CO� g - C/ _` extension. Describe; Paget 2
Address: C y s^ r � ��` - a (� Each additional inspection over allowable in any of the above
" `L Per inspection 62.50
City /Stste/ZIP ` f t
Por �' AID) ark- 9 �-. Z 1 7 Investigation per hour (I lir r in) 62.50
Phone: ( )�3 � , 4 Fax: G ) a3 4 4 Industrial plant per hour 73,75
PERMIT FEES"
�tECT
CCB Llc.: 8 a Electrical I.ic.: v?Cc�3 aL° rv. Lie.: Su Rt
p a 1 a ,(� K � Subtotal
Suprv. Electrician signature, required: f J / ,l',, . v 140 1`
Plan review (25% of permit fee)
Print rune; Bate 3",,) Sta surcharge ( of permit fee)
�rr� -n t 2 - 4 , � 3 — 4 _ a 4
Authorised signature: ?..2 _ Z''6) TOTAL PERMIT FEE
•
--
This permit application etplres if a permit Is not obtain ed within 180
Print name: }Date: days after it has been accepted as complete
-
Fee methodology set by T6 - cauety Building Industry Service Board
islBuitdinawermitalt ;LC,permitApp.d°c 12/03 R �Nutnberpfipspectiansperpetmital lowed,
t 5 A 440.461i7(!NOyCOM/WES
CITY OF TIGARD _ _ EZ..
BUILDING DIVISION PERMIT #:2_00 (_ / d 6 g6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 � 'q���I�
Inspection Requests (24 Hrs.): (503) 639 -4175 '! L
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: I � — 1 / CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: I PHONE #:
Inspection Request Scheduled For: Date: 3 " z0- 0 Pour Time:
ode # Inspection Description Confirm # Contact # Message
' 936 - F3 /
Correc • • - - • ments /In ctions: -/� �
L ,60 1 ±'`
�
V• ts*L rt■SWIN fwt.,
e • Po -Eck_ Ip r ca -
S stASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • ' Date: lAC O Phone #: (503) 718- *4
• -