Permit '" t
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00067
p DEVELOPMENT SERVICES DATE ISSUED: 2/8(2005
� l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 AB -01604
SITE ADDRESS: 07307 SW BEVELAND RD
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT : 016 JURISDICTION: TIG
Project Description: Underground, (6) branch circuits. Job No. 6037
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: 5 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:
PAT GILROY JARMER ELECTRIC INC
5100 SW MACADAM AVE SUITE 240 5105 SW45TH AVE
PORTLAND, OR 97239 PORTLAND, OR 97221
Phone: 503 - 225 -5559 Phone: 246 -5381
Reg #: LIC 6924
SUP 4044S
FEES ELE 26 -144C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/8/2005 $80.10
[TAX] 8% State Surcharge 2/8/2005 $6.41
Total $86.51
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 - • •AR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6 9 or 1 -800 -332 -' 44. ,
Iss ed By: � :� Permit Signature: f - ♦
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
J'ical Permit Application volt onsiCi:-usi :()NIA' .
City of Tigard Received . QD l �i _ ii •I
13125 SW Hall Blvd., Tigard OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �y ` . ' I </ �wg , Other Permit: r � �� a ./....
Inspection Line: 503.639.4175 -i 1 L. Date Ready/By: brie fa See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental informadon
'Y : :v _ - ' 'i`- ;:1� cfir`, : : :e . fi re - vh .:+
�,TYYE OF: WORK; :.��..,� :,v- _,�•,: �`�•� 1.:4;i :ra �aa�.�`•�' -'{ .. .. ,._ �.�_..Rl'►,a:4s: %4t::. .�5���".�` -:
)5]
, ...: . ) . ',U . ".:' .
New construction u 4 ❑ Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other ['Service over 225 amps, comm'I ❑Hazardous location
�. ,tea Other ..�, . �„..�� .
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft,
i t . :i ; `' wi °z °t< sr , M , � : s.,, " - ; .,;
t { , D' • -,1:f tirox R?r;0. dottgro iktoy 0 f . , ' : of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, , 400 amps or more
El Multi-family 0 Master builder 0 Other
['Occupant load over 99 persons ❑Manufactured structures or
`l# : :' •`:'JOB'S ORMATIOM' ' L j F "yt:i" :'•?0= is • 1[r I)R? ft: -. , - , �r. gt ❑Egress(lighting plan RV park
Job no.: 6. G 3 7 Job site address: 7 30 7 $ cJ .t (../e_i_yg-,t,4 ❑Health -care facility ❑Other.
Submit 2 sets of plans with any of the above.
City/State/ZIP: T9 0 - /1 �4 The above are not applicable to temporary construction service.
Suite/bldg./apt. Y . . FEE!LSCHEDULE; :• _ ,. ` t r;':
g apt no.• Project name 6,1 !e. 0 L A (�
• n«r+pn,m (Qty. � Fee. �' :. ` . , • T � h
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
_ Limited energy, non - residential 75.00 2
.' ., ...-•••-:-:.::',.' - - DESCRIPTION OE WORK•, . :. - '',",
.., _ .._ . .. ... .'Y= f: t' �`.`. .. ..... ^�� :�- Each manufactured or modular
Lea , 4,Z . _ �� �.t � � dwelling, service and/or feeder _ 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 _ 2
;,,,,,,..::. ,. ... _. ..:.: _.. _._.... -. :_: I _ _ ,.�;� _ 201 a s to 400 s 106.85 2
Cl. PROPERTY, OWNER?: z` :.;' , _:•. ❑; •'TENANT :. i ' h.; YA M 1 mP
- 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 454.65 _ 2
Reconnect only 66.85 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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
t' i. ; . APPLICANI':`:w''`': " `r ; . ❑' CONTACT: P#1400,0n* A. Fee for branch circuits with
service or feeder fee, each 6.65 3 2
Business name: branch circuit
B. Fee for branch circuits
without service or feeder fee, 46.85 y�j
Contact name: 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) F :: ( )
Sign or outline lighting 53.40 2
E -mail: _ Signal circuit(s) or limited -
i 1 : :'-I = yx: : g4 : ;;:; ; •" energy el, alteration, or
extension. RYA . _... .. ....... _ .:.... C'1'OR :'. . <_` i4w -:a.? .: ....... ,......, . s ion. Describe: Page 2 2
Business name: Tt}2 et.-' EEL' T _i , Sow
Address: Sj p c�w [� S ST 2-0 0 Each additional inspection over allowable in any of the above
/� e Per inspection 62.50
City/State/ZIP: 6 o--2 7 A.) 4 Q 2 ' 7 2 2 / Investigation per hour (I hr min) 62.50
Phone: (S63) Z L/ c - e6�3 c / Fax: (,503) 24/y- ,f-c) 3 7 Industrial plant per hour 73.75
r ql~ ? :: : :: ELEGTittel PE I�`l ' )� le
CCB Lic.: /p y ( Electrical Lic.: 2(o- /41/4- S Lic.: goty5 Subtotal crf 0v
Suprv. Electrician signature, required: -' <' Plan review (25% of permit fee)
Print name: �j 7,I 4 /2 j Ai e ' ate: ,-1K—() State surcharge (8% of permit fee) ee, y/
TOTAL PERMIT FEE f& S7
Authorized Signature: This permit appticadon expires if a permit is not obtained within I80
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
•• Number of inspections per permit allowed.
i.\ Building\Pamiu\ELC- Pmrritwpp.doc 12/03 440 -451 ST( lw02/COMM'EB
CITY OF TIGARD __..„ . ..
BUILDING DIVISION PERMIT #:
ELC200.5-00067
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
2
Phone: (503) 639-4171
. 141114 . 11 til \
Inspection Requests (24 Hrs.): (503) 639-4175 02005
,......_,w • -...
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/2912005 7:08AM 80
SITE ADDRESS: CLASS OF WORK:
07307 SW BEVELAND RD
SUBDIVISION: LOT #: TYPE OF USE:
GILROY BUILDING 016
PROJECT NAME:
GILROY OFFICE BUILDING
DESCRIPTION:
Underground, (6) branch circuits. Job No. 6037
OWNER: PHONE #:
GILROY, PAT 503-225-5659
CONTRACTOR: PHONE #: I
JARIvIER ELECTRIC INC 246-5381
Inspection Request Scheduled For: Date: 9/29/2005 Pour Time:
Co e # Inspection Description Confirm # Contact # Message
199
Electrical final 016976-01 603-246-6381 N
Corrections/Comments/Instructions:
C (
( ,), k
_j-PASS 0 PARTIAL APPROVAL fl CANCEL 0 NO ACCESS
0 FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
. ,