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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00013 l DEVELOPMENT o (03) 639 -4171 DATE ISSUED: 1/11/2005 13125 SW I PARCEL: 2S 109DD -00100 SITE ADDRESS: 12635 SW BEEF BEND RD SUBDIVISION: ZONING. R - BLOCK: LOT : JURISDICTION: TIG Project Description: FUTURE TRACT "E ". Private street lighting. SW 127th and Beef Bend. Direction: Beef Bend, Rt.at 127th., Rt. at Davinci, Rt. to Tract E. 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: 1 W /SERVICE OR FEEDER: 2 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: RIVERSIDE HOMES TODDS LIGHTING & ELECTRICAL 15455 NW GREENBRIER PKWY #140 19579 SW KARI ANN CT. BEAVERTON, OR 97006 OREGON CITY, OR 97045 Phone: 645 -0986 Phone: 503 -742 -1899 Reg #: ELE 3 -510C LIC 146666 FEES SUP 4434S Description Date Amount • Required Inspections [ELPRMT] ELC Permit 1/11/2005 $93.60 [TAX] 8% State Surcharge 1 /11 /2005 $7,49 Rough -in Elect'I Service Total $101.09 Elect'I Final 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- 332344. Issued By: Vb.' Permit Signature: dyt ��j� � °7cJ 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 D,2005 09:55A 5037421900 page 2 Electrical .Penult Application Received Electrical CC Date/13 : I FOR OFFICE USE ONLY - 10 -0 5 u3 Permit. No.: ` 0 0 ;�j- _ Planning Approval Sign City of Tigard Test / y 15 . List ] , i ?ale:42 :__, �. . Permit No.: „ �C0Q °2 --,•• • `T' 13125 SW Hall Blvd. � Plan Review Tigard, Oregon 97223 fe e! ® �f Date/B : r- F it Nn.: Phone: 503-639-4171 Fax: 503- 598-1960 Post- Review Land Ilse 2 Internet: www.ci.tifard.or.us A� N 1 Q 2 1 I alevili. { ii Date /13 : No.- - - ('awe :x i. ''. Contact Juris CI Scc Page 2 for CA- 21 -hour Inspection Request: 503 -639 -4175 Name/Method: 77 C Supplemental information. II.. C►ry OF TIGARD S\ 1?9- 00 / OU lr�° DIVISIO _ - - 1 till _ a TYPE U RT< _ • • PLAN REV (Please check all that a pply) rL New •construction 1')ei olition C0 Service over 225 amps - 0 Hcalth -care facility ., Add ition /altetation/replacement Other: commercial (, [iararduus location c _ Q Service over 320 amps- rating of 0 nuilJing over 10,000 square feet, fit _ CATEGORY OF CONSTRUCTION . •' 1 & 2 family dwellings Lour or more residential unite in 1 I & 2- Family dwelling Commercial/Industrial Q S over 600 volts nominal one slructurc 0 Building over three stories 0 Veedcrs, 400 amps or more, Accessory Building • Multi-Family C • / El Occupant load over 99 persons [� Manufactured structures or f( V park ❑ Master (Buil der (T' Ot ____i_e ______ ! �rtw�]i, �1 Egress /lighting plan 0 Other; JOB SITE INFORMATION and L H Job site addle,. , f 2 7 4- c e . r"� OCATION it Submit sets of pious with nay ul'the above, _ ,. -- The n _ above arc not applicable lcable to Ien1rurary construction service, Mitt it:- Bldg, /Apl, //: Q4 t i FEE* SCHEDULE ' - - - °'•- ° • -- Number of inspections per permit a lioK•c<1 • � ro Name: % a P c l r /: _ I) eseelplinn Qty Fee (ea.) T in rOSti S1TCC /l�tfLGttonti to �(1. 51tC ( New rastdeatial -single or is utti.1'umily per kA,, ' dwalinti unit includes attached garage. 1 /2 7 � • j / Service included: C C s• (/ 1 5 paw a h•e t 1L.at,„e 2 I t . . r . - -t• ' . 1000 sq. ft. or Less �� 145.15 ; / 5•fr t To � ( ' C 1 Each additi ,. onal SOU sq. ft or tx�ninn thereof ,. 3 i.4t) 1 Li energy, residential Subdivislun: 1( vi -xX._ 75.00 - .- Z S - Limited enemy, non residential 7S AU 2 Tax ma, /parcel Ii: _ Each manufactured home or modular dwelling DESCRIPTION OF WORK - - serviceand/orfceder 90.90 2 a t Service% or feeders - insbdtalion, - - _.T Fit fill _1-4 . J . Qy ; Alteration or relocation: 200 amps or Ices. / _ 80.30 r S 4' 2 -..... .. ....._ - -._ 201 amps to 400 sna ps 106.}15 7 401 amps to 600 amps 160.60 R ' ' OWNER 0 TENANT ... bpi amps to 1000 a s 2 - Ui I:R TY ps p zan -h0 z Name: rr --- Over 1000 amps or volts 454.45 2 4�. e-S /ele ._.;1- 'G171R -j Reconnect only - 66.85 2 Address: Temporary services or feeders - installation, Lit /State/ZI 7: -. Alteration, or relocation: _ 200 amps or Ices 66.85 I - Phone: 6 b6 Fax: _ 201 amps to 400 amps 100.3o 2 N APPT,TCANT T P ON ' - 401 to Goo amps 133.75 2 Name: Branch circuits - new, alteration, or !. - eiel 1O aSe extension per panel: Address: - A. Fee fur hnanch circuits With purchase of c/vice or fe fcc, each branch circuit 6.65 /3.•yea 2 City /State /Zip: . li e Fee for branch circuits without purchase of - -' -" — service or feeder fee, first branch circuit Phone: Fax - -� _ 46.85 Bach additional branch circuit w - G.AS 2 -mail: Miac.(Service or feeder not i ncluded): �' CONTRACTOR Each pump or irrigation circle 53,40 2 Job NU: Each sign or outline lighting 53.40 2 -- ( Signal cireuit(s) or a limited energy panel, Business Name: T s L ` L L ! ! /GaK�! '/ ` S� t GRI alteration or extension* _ 75.00 2 ... I f ! ✓L/ '- �^' *Description: - - ti. Addre of N_e} - CitZ /State /Zip: o a C i - . ©ie t 7 _,Each additional i over er tine allowable In any of the above; ' / _Per inspectio hour - Alin. 1 hour) Phone: -o ?- 413 - 2/ yy Fax: 54:1'3 5� Z 9, estipat ice: I I I — 7 -/ 0 n Inv . . �2. SO i • WI Lie. #: r � 6e, Lie,. #: oth «: ‘IN St3;�C 7 / — .. : � - :Electrical Permit Fees* M Supervising electrician signature required: c mil F ttai $ Q � Print Nannc: ^f Lie. #: �� � — ^ Plan Review (25% of Permit f cc) $ 7 q _ V f-S _ -_, State Surcharge (8% of Permit Fee) $ /0 — / -- TOTAL PERMIT FEE , $ j d/. e r V Authorized No tice: Th is permit application ex ires If a permit is not obtained within Signature: tax Date: 00/05 r pn p _- — ..... ._ 180 days after it has been accepted as eoueprete. *Fee methodology Set by Tr) County Building Industry Service Board, (Plcusc pnnt name) ! CITY OF TIGARD Al 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received // Date Requested ! AM PM BUP Location /d– 40 3 5 _j (Se-n4 Ra Suite MEC Contact Person Ph ( ) i ll 3 ' PLM Contractor Ph ( ) (� SWR BUILDING Tenant/Owner raa '! -��LC ,.?04 S -- 13 Footing , r -c ' go° t lid 7 Foundation Access: Ftg Drain ELR Crawl Drain Slab frJL s: � ! t ,, SIT Post & Beam \ lv `� � Shear Anchors Ext Sheath/Shear Int Sheath/Shear • Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In LE Water Service Sanitary Sewer Rain Drains - Catch Basin / Manhole Storm Drain - Shower Pan Other: - Final • PASS PART FAIL MECHANICAL Post. & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL E__IZQTRICAL f V Rough -In UG/Slab Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. FAIL SI ❑ Please call for reinspection RE: LI Unable to inspect — no access Fire Supply Line tt t � ADA ct Approach/Sidewalk Date — — Inspector "t 5 �a L CM' YY Ext Other: Final DO NOT REMOVE this inspection record fro the job site. PASS PART FAIL