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Permit M Y OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00158 . - � ��� i DE VELOPMENT SERVICES D ATE ISSUED: 3/29/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133CC SITE ADDRESS: 14110 SW BARROWS RD 2 -4 SUBDIVISION: SCHOLLS VILLAGE CONDOMINIUMS ZONING: R-25 BLOCK: LOT : 2 - JURISDICTION: TIG Project Description: Unit #4 Reconnect Only 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: NASRI MASSAAD OWNER 14110 SW BARROWS RD #4 TIGARD, OR 97224 Phone: 503 - 544 -8424 Phone: Reg #: FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/29/04 $66.85 [TAX] 8% State Surcharge 3/29/04 $5.35 Elect'I Final Total $72.20 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. S Issued By`T Permit Signature: All_ i , r � - - ---- -- c 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 639 -4175 by 7:00pm for an inspection the next business day I ` • Electrical Permit Apia FOR OFFICE USE ONLY City of Tigard Received Permit No u Cl 13125 SW Hall Blvd., Tigard, OR 97223 MAR 2 9 2004 DateBy: ` /1/1 �� / g Plan Review/ Phone: 503.639.4171 Fax: 503.598.1960 //H�ry idievec `' Date/By: Other Permit: Inspection Line: 503.639.4175 I CITY OF TIGAR ` - "" ' Date Ready/By: Juris: 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information BUILDING nivj I t Ex OF" WORK I� „ ,1 . `I'X1 ... , ' PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other EService over 225 amps, comm'l EHazardous location ,, r ['Service over 320 amps — rating EBuildng over 10,000 sq. ft., ,, � a I w CATE ❑ GOit, t CONSTii0..r ON , ~4 g t of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2 family dwelling Commcial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family El Master builder ❑ Other: ['Building over three stories EFeeders, 400 amps or more A 'c :,tea, : „ �� i dOB F EOccupant load over 99 persons ❑Manufactured structures or e ISIT ''I TF © R MA ^:��ra., ... s., TION SAND AT EEgress/lighting plan RV park .,, �...... &.. , .�. .4"a..:.� .m ^ .�. ,_�.�...G au"�a�^�s `LOC:. „ .. IO , .N i .. s ?. �' = . : , .. a�,.,e ..?�..::, ❑ gT ess /li g g p Job no.: Job site address: f Lilo soil !2 ie rz ow S R , ❑Health -care facility ❑Other: i\ RA 1 R ii" / Submit 2 sets of plans with any of the above. City /State /ZIP: �, r f'1 o q----, 2,23 The above are not applicable to temporary construction service. S0ltefbidg- /apt -no Projeet- Irmni" , E M. , 'm . FEE* SCHEDULE ■ Description Qty. Fee. Total Cross street/directions to job site: Sc14.o i (S New residential single- or multi - family dwelling unit. Includes attached garage. / j—/_ 1,000 sq. ft. or less 145.15 4 • `� e- 400E of no.: Ea. add'l 500 sq. ft. or portion 33.40 1 fax male n�rrel no Limited energy, residential 75.00 2 k a ry _ imited energy, non-residential 75.00 2 L I ' � 4 , i �A ESCRl<PT CO1� 'ORK t „ fi t, , ,, x Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 � l ( „ NftWM 201 amps to 400 amps 106.85 2 `� RO�PEKT O � �' � �' ` �`' TE "" .. aiii ` 4 ° " " K6 , " ' i et 401 amps to 600 amps 160.60 2 Name: firR S R k NI l<I S SA-A- 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only I 66.85 ‘6,1`J 2 City /State /ZIP: li Temporary services or feeders installation, alteration, and /or relocation Phone: ( sy- et/ a F ax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is eing 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 3 „AdPI'LICANT, t AGA'ONTA `r ' A. Fee for branch circuits with 4 y ....., . a,�, rig art .. r, s. tiu..:�..,t, �as._...am^�:.? „ um ° N al . z.. ��. service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - r ” T" energy � '��, ��'��.?. s� ��i�`.Wi -1 t„ .... � _CON�'RAC�T,�R�„ � E ».. a � .� t� �-' �... , . r,�� ;,� gY P anel, alteration, or extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr nun) 62.50 Industrial plant per hour 73.75 Phone: ( ) Fax ( ) x � �, �- � � �, „ l ; ;„ EI�EGPRJ( L PERM T FEES* _ CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal CP 6 O Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) � TOTAL PERMIT FEE 7a , a 0 • uthorized u ature ' • % `„� = ”, �. L This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete t Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: tto:ENTIAL*O Q: tai e ... .. 4 '. S Fee for all residential systems combined ... $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: 1707i! RC A:; WORt QNLY Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems n B oiler Controls ❑ Clock Systems n D ata Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations iABuilding \Permits\ELC- PermitApp.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING 'inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 4 I BUP Received Date Requested 3 ' 3O 0 4 AM PM BUP Location I \ `O "ahC ov45 R.7 Suite 4` MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC 4 O Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing I / nsulation tP�Rv�J IL, �I N A / By . s� Lv{ Cc Drywall Nailing 0 Fire wall Fire Sprinkler Fire Alarm _ Susp'd Ceiling Roof & o Other: \\( ` Final ` 5 Nee a_OV �L !s \I M -1 (011 PASS PART FAIL 1 u PLUMBING =- ah F a_. W :7�0- sz co i Post &Beam \A P S QC N �� ^ 5 —t� � Under Slab Y o Rough -In Water Service - Sanitary Sewer Rain Drains Catch Basin / Manhole ie Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL ° ` Post & Beam Rough -In Gas Line Smoke Dampers Final FAIL ervice .�N Roug - n _./ UG /Slab row Voltage Fire Alarm Fi I 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. AS PART FAIL SITE -, „ EI Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ( r� p ' ADA Approach /Sidewalk Other: Date �J �l `C Inspe ctor v � �V N bO L 1. Ext 1 Final. DO NOT REMOVE this inspection reord from the job site PASS PART FAIL