Permit ,r
CITY CITY OF e
01 1 T I�/'�RD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00705
DEVELOPMENT SERVICES DATE ISSUED: 9/21/2005
� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133AD-02200
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE ZONING: R - 7
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: TI
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 19 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:
WESTGATE BAPTIST CHURCH KELSO ELECTRIC INC
12930 SW SCHOLLS FERRY RD 545 SE 3RD
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: Phone: 503 - 648 - 6360
FEES Reg #: LIC 116254
SUP 4270s
Description Date Amount
ELE 34 -43-43
3c
[ELPRMT] ELC Permit 9/21/2005 $173.20
[TAX] 8% State Surcharge 9/21/2005 $13.85 REQUIRED ITEMS AND REPORTS
Total $187.05
• 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 -8 332- 4.
Issued By: , , 1) - Permittee Signature ;x � �,./f�
C am/ > �
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.
•
4
Electrical Permit ApplicatiE��l��= ® FOR Ol FICE uSL ONLY ... s :r
A i l Received i , PermltNo C� ew p'' -", t,
13125 SW Hall Blvd., Ti
City of Tigard Received . ! /
Tigard, OR 97223 Plan Review Other Permit:
g SP 21 � I � �
Phone: 503.639.4171 Fax: 503.598.1960 tP�� Juris: • � 61 See Page 2 for
Inspection Line: 503.639.4175 CITY Date Read Su Information
; )
Internet: www.ci.tigard.or.us Notifed/Method
ard.ocus ,, a v� ,r �:- •
g BUS/ nII w,......._ `�,;, �;;
w y r Yr �' °. 3° PLANGRE'IE:�.t. r� e' 6
�� 2a"' u r r n b "'�'i3? 1 Y ., u.,w.vw•, �. env. , � � i7 , `"� . �l_ Pt ��W
,i�>r„ "' � rr °'� st y.o ,ySF"'' TYEE�•OF, ° i:" "��`'
i r�... ` w te 1 ....bk '�'� i. du: ' � r an` rf•" �' 4 '. i .�,.,b.•+.a�r .s,.�i'K e: '}r�».�
Please check all that apply: ,u, y
❑ New construction Addition/alteration/replacement ❑Service over 225 amps, comm'l ❑Hazardous location ' ,II
❑ Demolition Other: OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft., ‘i
_� r _ , * „ r �,, •;, I �:. �s 4 or more new residential :i°
t �` u MO / �' h � .A A Rl'• OF"CON$TRiJ @TIUN " ;. ' , r of l - and 2- family dwellings ; :p
r ..s >,,z Ff�,.�..... w -;n ,w r�x, _ ways units in one structure
❑System over 600 volts nominal { 4.
El 1 -and 2- family dwelling Commercial/industrial ❑ Accessory building OBuilding over three stories ❑Feeders, 400 amps or more i',11 Master builder 0 Other: DOccupant load over 99 persons ❑Manufactured structures or
El Multi family ❑ �.: RV park
_ �, �• ��; �•,.:.,,.,,, .;��,���:�.,�;�'�r`.,t °,»�:,�:a ,zy�-. �'� �a 0 ghtingplan
r JOBSICEIIYFQRMATIONANDs ❑Other:
Job no.: I Job site address: /
K= ��'� J ❑Health -care facility
2936 s 1 Scsioc� ' ' Submit 2 sets of plans w any of the above.
Ci ty / S tate/Z I P :
�4 A 20 vR 172 The above are not applicable to temporary construction service.
`' "' ,fg::
� � °��a : ' , ' � �' ;� u,' FEE$' SCHED,LII4.Ej� " "��'� �;`,' 1"';#b.� r��.
Suite/bldg. /apt. no.: I Project name: %p/($1 4 a, ions. Description J Qty. I Fee Total
New residential single- or multi - family dwelling unit. ..,
Cross street/directions to job site: Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.:
Ea. add'I 500 sq. ft. or portion 33.40
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2 •
r ` i ' . `.;:E ("gt sg F VVORIC` ` y "�� t ` ' t Each manufactured odular
or m
._.;r 3�.. , ; - _ y. es.;.. w�Yr.••:. t:, an ,.,,....FL•e>'DESCRIP�TION'O.,, r..`i it ` 2
- � dwelling, service and/or feeder 90.90
"M • 7. e [ 4/200M Services or feeders installation, alteration, and/or relocation
rY '� 200 amps or less 80.30 2
_ 201 amps to 400 amps 106.85 2
s -1 '; }"4 - ' _''R(QP•EItT O WNE R � , . '2 tG ',r. ®A'T 'tT M '" 9k 160.60 2
aF�� � s t • , . ,. ; i , .�`� � -- � a 401 amps to 600 amps
601 amps to 1,000 amps 240.60 2
Name:
Over 1,000 amps or volts
454.65 2
Address: Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 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.•i NMI I t oCONTACTc PERSON,'� A. Fee for branch circuits with
".:!:15,45. tii _ Y; .4.: ... �. lk"`" service or feeder fee, each
„�P;.w;��? ®s,APPI:ICAIVT,_, .._ a ., ., 6.65 2
branch circuit
Business name: B. Fee for branch circuits u
Contact name: without service or feeder fee, 1 46.85 L AO* v� 2
each branch circuit
Address: Each add'I branch circuit , t9 , 6.65 1 Pdo.S6 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: 2
Pump or irrigation circle 53.40 2
Phone: ( ) , Fax: : ( ) Sign or outline lighting
53.40
E -mail: Signal circuit(s) or limited -
r a r v ener gy panel, alteration, or
;4,.> #, r :40p. x u aF ;~`CONI IWI OR� 4tARS h.,•. OMagai? �1' Page 2 2
extension. Describe: Pa
Business name: f7/2LSo £Li.€ GT/Z/c 22 c
Each additional inspection over allowable in any of the above
Address: Sy d /� ~ s r Per inspection 62.50
City / State/ZIP: / / /GL 5/3o/lo d n `7 71Z 3 Investigation per hour (1 hr min) 62.50
Fax: (5 6 tie- ea.,/ I ndustrial plant per hour 73.75
Phone: (�p3) 6'6/ f - (p3(® I h ria(U ELECTRICAL: PERMT iiF,EES a; .44 f=
CCB Lic.: / /6 I Electrical Lie.: 3 — H 12,......1/1/_ 3�Gl Suprv. Lie.: 9Z7r/S Subtotal / X3.)4,
, 7 0 9 Plan review (25% of permit fee)
Suprv. Elecr gn ature, required: f,,L
State surcharge (8% of permit fee) �3.$G
Print name: c 7 - 0 ` / .i i �j /Cz. I Date: 7 /, 9/a S.'” TOTAL PERMIT FEE l $ 7
Authorized signature: A._ �� This p ermit a expires if a permit is not obtained within 180
days after it has been accepted as complete
• Fee methodology set by Tri- County Building Industry Service Board
VPrint name: d ■, /� i��vi,, I Dat '����o •* Number of inspections per permit allowed.
I\ Build mg\Permits\ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM/W EB '
CITY OF TIGARD
BUILDING DIVISION PERMIT #:S42003:1)010
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 u >nNt � 1\
I
Inspection Requests (24 Hrs.): (503) 639 -4175 `�' I..
INSPECTION WORKSHEET FOR DATE: 1 41 I s-IOb TIME: PAGE:
SITE ADDRESS: `®130 6 W I $ V P1V ° CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 2.61 e14, Pour Time:
Code # Inspection Description Confirm # Contact # Message
ko! coNi A L,
Corrections /Comments /Instructions:
A PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Yv L Date: 4 2S( Phone #: (503) 718 - 2i-Vi`
E. CITY OF TIGAR®
BUILDING DIVISION PERMIT #: E 200 00706
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9'21/201)f;
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: • 1/f12006 TIME: 7 :00AM PAGE: 40
SITE ADDRESS: 10730 SW 130TH AVf=. IAL LTI bRPOSE' CLASS OF WORK:
SUBDIVISION: �" - LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST
DESCRIPTION: pyi(o6grZif
OWNER: wE:STC BAPTIST CHURCH, PHONE #:
CONTRACTOR: KELSO ELECTRIC INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
19 Electrical final 02 503-572 -7392 N
Corrections /Comments /Instruction`'
p 06\ 103 1 -kkv>4 C,U fit$ I ,3 ) I kl
S I ° R' G T s 7i 1 4k
V �R ft
•
P ASS PARTIAL APPROV n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Ins'ector: 1 Date" C ' Phone #: (503) 718 -2 q
.y
_Aso f ,
r
y ,
N\ \/
1
f �
CIRCUIT DIRECTORY
1/5/2006
Bath /Elevator Lights
1 R. 103 & 107 2 R. 107
Bath GFI Outlet
3 R. 103 & 107 4 R. 105
5 T.V. 6 R.103
7_Elevator-Gutlet 8 North Parking Lot Light
El`evator Pit-Sump
9 10 Hall Outlet
11 Spare 12 Spare
Bath GFI Outlet
13 R. 111 & 114 14 Spare
15 Bath Lights 16 Quad Library
R. 111, 113, 114
17 Drinking Fountain 18 Quad Library
19 R. 114 20 Counter Library
21 22 Counter Library
•
23 24 R. 108 Library
25 26 R. 121
27 28 R11,9 170 1=2 -1F Ql or
29 30 Spare
31 32
33 34
35 36
37 38
39 40
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00705
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/31/2005
Phone: (503) 639-4171 AA
al lifr
Inspection Requests (24 Hrs.): (503) 639-4175 'LL
INSPECTION WORKSHEET FOR DATE: 1/5/2006 TIME: 7: 00AIVI PAGE: 46
SITE ADDRESS: - 10730 SW 130TH AVE MULTI .
CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST
DESCRIPTION: TI
OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: KELSO ELECTRIC INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
19N Electrical final 024421-01 503-572-7392 N
Corrections/Comments/Instructions
p 0 io 1 0'3 --- r\-kkQ \ `1 - Ai.4 * c,o M, t 5- 31 PI I ) -I
5 G Lx PI 11-6,% 7
i
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PASS ril PARTIAL APPROV A 0 CANCEL fl NO ACCESS
1
FAIL [ CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
i }
Le:
Ins ector: 6t4/}-r ' (:)
Date:kr t Phone #: (503) 718-2 c-M
1 _ ,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00705
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/21/2005
Phone: (503) 639 -4171 - IN��ypi lfill?�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/7/2005 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 10730 SW 130TH AVE MULTI PURPOSE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST
DESCRIPTION: TI
OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: KELSO ELECTRIC INC PHONE #: 503- 648 -8360
Inspection Request Scheduled For: Date: 12E/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 0230B5.01 503-572-7392 N
Corrections/Comments/Instructions:
__PCk.av i0 YWEPAS 1 ( • 4i R. c,, fs, 0 61566 f -R-oM.
'v 'EA GASSb'E &l•L■ P41.1tr 6Qcl It G5 t 4 1'�
J
ta 6 1).Ni b ■1
CLAStila\41■1 ‘it Y.S 60 Ildi Or'
1L A) &3`��� r ■\ -L peg' NZ
it.-W a1.0.6L, 1‘ in c N o‘ 1 1S.0 i s.
<A -1 i tre7 4 t We-4 644 41 s i7.3,.41, XIV
rs - ` "'1
--- 6 'io\-11,a__, --*0-tv PI, tg FlAL C-OeCC%
1. ._. C. �O0 i
•
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ALL tf\A C. c.> NW 4 k c 6a1P 6100417i .
S(t Ott N4 Cat, MT ,l..A
oN - 1L�
PASS )4/PARTIAL APPR AL ❑ CANCEL (l NO ACCESS
I I FAIL A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • -1•'' Date: I 1-(1,W Phone #: (503) 718 - •
•
CITY OF TIGARD ,.
BUILDING DIVISION PERMIT #:
ELC2005-00705
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9!2112005
Phone: (503) 639- 4171r �
Inspection Requests (24 Hrs.): (503) 639 -4175 =' i I ..
INSPECTION WORKSHEET FOR DATE: 9/27/2005 TIME: 7:05AM PAGE: 86
SITE ADDRESS: 10730 SW 130TH AVE MULTI PURPOSE CLASS OF WORK:
"' , SUBDIVISION: LOT #: TYPE OF USE
PROJECT NAME: WESTGATE BAPTIST
DESCRIPTION: TI
OWNER: VVESTG ATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: KELSO ELECTRIC INC PHONE # : 503- 648 -6360
1
Inspection Request Scheduled For: Date: 9/27{2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 016651 -01 503- 793 -3276 N
Corrections /Comments /Instructions:
vQ ►—\ cb \ GC-- A0 Q.. -vim ► N Pia M6 • .
11t1 J' III 3 1)5, )41), \0"1 0(0 \53 lo) �d0S
\h� 121 toy• I > >
1 v Lb.i (\\1 cs kl OR, 7 0 cC,■i3 INN c., -
s 0 CI ,M.►` ' E 1.'Z1 C Cf-L--- p \€ s FL
P\..o. v %. % aML., coj i u (• .
i
.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 6-M N NO LT Date: il 2 7( OJ Phone #: (503) 718- 24 •