Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00498
6 DEVELOPMENT SERVICES DATE ISSUED: 7/12/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S109DA -12800
SITE ADDRESS: 12956 SW BIRCH HILL LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT : 117 JURISDICTION: URB
Project Description: Temporary 200amp service.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
•
CITY ELECTRIC & SUPPLY CO
8900 SW BURNHAM ST. F -27
TIGARD, OR 97223
Phone: Phone: 503 - 443 - 1092
FEES Reg #: SUP 3592S
LIC 42422
Description Date Amount ELE 26 - 289C
[ELPRMT] ELC Permit 7/12/2005 $66.85
[TAX] 8% State Surcharge 7/12/2005 $5.35 REQUIRED ITEMS AND REPORTS
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 1 440- 332 -2344.
Issued By: _ ! AP ` Permittee Signature: ,x
•
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.
EIectriCal Permit Application FOR OFFICE USE ONLY
Received r / S)
13125 S W Hall Blvd., Tigard, OR 972
City Of Tigard - � • E DateB : 2 l Pem _00 n N M' t� P a n Revie Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 ,1 0v l i j i y.
Inspection Line: 503. Date Ready /By: luris: ® See Page 2 for
Internet: www.ci.tigard.or.us JUL . 2005 Notified/Method: Supplemental Information
;U:r3
, .... .. ... .'r act,,..,. .,.. >.., ... , .
. .: r , w..n:..- ,,:.;�4�.; <,..;- :a , , R, +s::�,"`: `a, ":�•' i {'s,.,.u. w9 �' :. ' p,;.
• �.. ,,..._w .. . ... ^ -.. ,t.,, ._ -,,:i � -:t... _;P,LAN >� REVIEWWri;:,�°. ,�.. _
, .,•,.. F>,. a..,-<,._ n�>,,.. Y....,.. rx,.-.•, �m:: n,::.-,. � ,e:,..::.,.E- ,r,t._..�:», . <`E _.a ...,., �ixi ���'t4• . .......:..:....�. .... - . - ,...
' ' V "H Please check all that apply:
4
New construction ❑ Addition %alteration /replacement �
t:33UILUIN(a DIVISION ['Service over 225 amps, comm'I ['Hazardous location
❑ ❑ Other:
Demolition
Service over 320 amps rating ❑ Buildng over 10,000 sq. ft.,
= '`CATEGORY :OIi' °GONSTRTJC'PION- 'i's': ?�``r� ° <_^ of 1 and 2 famil dwellings 4 or more new residential
;�. __.. , s ' : a='^:,-_::,:,.,..-;<_': �,.. n. � �. , ..::, �,, ,,,, >;•..•.~r:.�.:.;::�,, - +a
1 -and 2- family dwelling ❑ Commercial /industrial ❑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:
r -„ ; x:: x,,, <:,,:k;, _ ❑Occupant load over 99 persons ['Manufactured structures or • "i RV park
�'�'� '�B�,'' I411E sINFO 'A�'c IO - ''ANI).,LO:GATIONs '�•n >
,:;_ ::���JO .S R1VI,11 .1!I', .�,.;,,xi� = "drz�a,., ❑E Egress/lighting htin plan
P
.. ........ .....� .�. -n.. �e:,1 �. .. � crs... �.. ....xs ., :;:Sid':.:,- ;.u,,.r i._,x..... „ , i.y f.:Sk?i:r`v: :,:Kw.::.F:SS.r h,[ .. •......i.«.. ,.. ..., ._ ,. -. ': s: -',
Job no.: Job site address: s , ❑Health -care facility ['Other: C. !t IT, C. 4 . Z( Z -..,,, Submit 2 sets of plans with any of the above.
City /State /ZIP: `"h GLAr6 Of/ The above are not applicable to temporary construction service.
i „ .' ::1,'i;: �..O. �.. ' ::tt,... ..........:,SC, �,HEDUL - : ' _
S uite /bldg. /apt. no.: Project name: M;,,,;,,;,,,;;_ �.,.. 1... a , �,,^,.., �...,...,..: ....,,::._.....;,. .,,..
Description I Qty. I Fee. Total I ..
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'1 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
,,; 4,_„ „,,;_ ,,, . , fii , Limited energy, non - residential 75.00 2
'fl;�`a :;4.�•�` `�.” 'di?"�+;' :: � „R:., ".�'autii :'ri;, m ks s
- i:;,_ �::p::; ,,� ;.,tt .8., , '. %:,iii;k .. ,:fir •�- 'fM:.:.r .d
,��DES' ,TIONu. OF:': ,URIC,•: yzv �;,.- ,�..;.'r, :+ -... ��'.:, - �
���,: -:r -`4 , 4,7:.;i.v_ '''��, taw. {.,�.. 4�x�>~ :�:�',, �
isar�:..'i.i:....,,o- �:m<��:., ..,.4„ ,. , .�.m... , .,, <- �,•��, : �.u,. �, :�: �F•,,..... � ...,,,.,, ='a,: >.�...r,c „� �w ,..., ,M: ��,e.,�:~. �:':�C�,�. 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
' ; ; - . , > _.,, ' ^w :, _ : *, y::,, ; ca`c .� ' t, 'a; =ac a ; , t :xi,.xa...:: :gf _, , D- 201 amps to 400 amps 106.85 2
i %a ", �. ' `_', . . ,, � % li; F' �p � . e �,. d �^.. S , � - >'s °��' tt.a.�t iil�` � ,•.T: ; P P
:.x ;r :i g :PROFFrR+I 1 Y, ; OW1SE3 , �;i. , r„ ...,, :�': :.r' ; t .^>r, p „ ,.ig .r: t ,
s
. rf; ..1. _`a A: .r�ane<6ran, >rn,f m:r.:t:M, six +sr�X.4,v > vti, ,. a °.�3 't,om `iA.:n< ,( ,:. ,rw•,,. -.:s, ncl ^:,i1. .1'.,?r.,5:_..T_ "s.5::2,,; --
401 amps to 600 amps 160.60 . 2
Name: ) OY \ On e, '_ VV IJ'' P 601 amps to 1,000 amps 240.60 2
1� Address: —. W vY�l,'�Fi w �� Ix Over 1,000 amps or volts 454.65 2
/�) /� Reconnect only 66,85 2
� City /State /ZIP: (, ' () q 1V Temporary services or feeders installation, alteration, and /or
Phone: ) ` •_^! � r--7 Fax: l .J [ I �) '7 - .7 5 relocation
� J 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
:.N:• ..., _ x :4 ^: Nte.`ii.'F^�k..v,:,�,,V :�i; - . uYii __ _ - _ _ ^;a .o,�,.;, i,.,e�. �:, .,,tq+,� A. Fee for branch circuits with
;t ; , .I � 1: ,.,x8r'atu" rt'” u,:• rl ', tr
: -A• P P I'IC '. tT' - ;., , z g '.l, z� : i,at't. O1VI'ACT;B_ERS ,,,,,, .,, ;i
- "� " ❑ <, � ,i,. ' :e .F.ur., • t . ;;ha: ?t'n ❑ " r n ... e ...,,.., .F . _Sr,l
t•.
,: ,:...._ ..:......::.. . . ... .. <,..,,s.,.'::..r ,, >. ...,.,.:,....,....,... r ,.,.- „;,•tr
service or fee, h
feeder f
Business name: branch circuit each
6.65 2
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-
- - - - ^'gr.^ ys> i_4= :.c'. ...... 'n1 ;>! ,::
•::rte •.r �.�:- ;l >= ,�” ^;:t'•;
"e ,,,..; =� s:; energy panel, alteration or
- >`'� =�: -� ..ai {; ,YGON'IIRAC`TO &.. •.r = =. max. ,i..�•�. •„f,,.,�- g P
- ^ -`:',. ,,..�q.. ,.:- ,....:: , y ..�.p,::e::, y ...,,y, p .,. t., 3 t:'ti`57iti (•c, . _`.�' }i'r �.r. . ........
extension. Describe: Page 2 2
Business name: CA 0 J (^ ` r /
?)9(i)
Address: s �'l tc L_ - , - Each additional inspection over allowable in any of the above
� ^/ `J Per inspection 62.50
City /State /ZIP: • l t4 4A ("r q'� Jd- Investigation per hour (1 hr min) 62.50
Phone: ( b 2.4,2 ;(c t D._ Fax: ( ) Industrial plant per hour 73.75
,c%i i -
t : teal RIG AEI; rP_ERIVIIT�:
CCB Lie.: 1-11 -0,2— Electrical Lic.4 Suprv. Lie.:.. 5 Subtotal (4 , 575
Suprv. Electrician signature, required: - Plan'review (25% of permit fee)
�.► State surcharge (8% of permit fee)
Print name: �1�u L ' �/ I Date: -
TOTAL PERMIT FEE � d , , -O '
Authorized signature: This permit application expires if a permit is not obtained within 180
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.
Nn,diA6,o\P.r • USI r.v.,,nbno:.A.,,' th,m nnn ec, crnnm -I,cn.en,mn
?i Y OF TIGARD
BUILDING DIVISION PERMIT #: ELC200S- 00498
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1202005
Phone: (503) 639 -4171 Ailltb @li,ii
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' =__�
INSPECTION WORKSHEET FOR DATE: 7/19/2005 TIME: 7 :08AM PAGE: 84
SITE ADDRESS: 12956 SW BIRCH HILL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 117 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE SALES TRAILER
DESCRIPTION: Temporary 200amp service.
OWNER: DON MORISSEI IE COMMUNITIES LLC, PHONE #: 503_.387 -7538
CONTRACTOR: CITY ELECTRIC & SUPPLY CO PHONE #: 503-443-1092
Inspection Request Scheduled For: Date: 7/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 011668 -01 503 - 519-6452 N
Corrections /Comments / Instructions:
•
E PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I NNU 'ISt Date: l I 66 Phone #: (503) 718-
F TIGARD
ING DIVISION PERMIT #: ELC2005 -00498
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1212005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,J
INSPECTION WORKSHEET FOR DATE: 7/15/2005 TIME: 7 :11AM PAGE: 50
SITE ADDRESS: 12956 SW BIRCH HILL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 117 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE SALES TRAILER
DESCRIPTION: Temporary 200amp service.
. OWNER: PHONE #:
CONTRACTOR: CITY ELECTRIC & SUPPLY CO PHONE #: 503- 443 -1092
Inspection Request Scheduled For: Date: 7/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 011505-01 503-209.4637 N
Corrections /Comments / Instructions:
9 NO C ct`S ■41h(t + 5 Ci foci 5 w' L.� eyz YAM■r)t AT
PLIk6"E bcvvE. 1 Wo .RP trlitt6 ft0.b
c6 0 Ivy (->z ooNOI t cs5t\).' 6:4(.
(t\) i k G 1 ) (If3bF 6t 2 -n >5 (L.
' % . 25 c o \
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
)FAIL X CALL FOR INSPECTION NI ADDITIONAL FEES ASSESSED
Inspector: Date: bl Phone #: (503) 718- 2 -_1 L\
s •
` .
CI F TIGARD -
BUILDING DIVISION PERMIT #: ELC2005 -00498
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1212005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' £::—
INSPECTION WORKSHEET FOR DATE: 7/14/2005 TIME: 7:11AM PAGE: 52
SITE ADDRESS: 12956 SW BIRCH HILL LW CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 117 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE SALES TRAILER
DESCRIPTION: Temporary 200amp service.
OWNER: PHONE #:
•
CONTRACTOR: CITY ELECTRIC & SUPPLY CO PHONE #: 503 -443 -1092
Inspection Request Scheduled For: Date: 7/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 011414 -01 503 - 209 -4037 N
Corrections /Comments / Instructions:
-- rwso (-2) G--(zt C-teL
s,.;% S■L,..s 6 FR
•
'TIC'• 5 3 (iv + 5 Coots i cL t R. ti ;
■th F 1 Vkr P■.) %6 c-- 1 N5 e v cAk u LL
Nei N.yEz.cs (3 1J cZo ∎) V
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL gkCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: oe Date: if N 05 Phone #: (503) 718- 2'14