Permit i CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00104
a � t DEVELOPMENT SERVICES DATE ISSUED: 3/3/03
4 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 1126 D -00100
SITE ADDRESS: 07540 SW BONITA RD 017
SUBDIVISION: TIFFANY COURT APT. ZONING. R-12
BLOCK: LOT : 065 JURISDICTION: TIG
Project Description: Apartments #17,18,19,21. Install (5) branch circuits in each apartment for a total of 20. Add bath plug,
smoke detectors, replace heaters.
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: •
WASHINGTON CO. HOUSING AUTHORITY WEBER ELECTRIC INC
111 NE LINCOLN ST PO BOX 231154
#200 -L, MS63 TIGARD, OR 97281
HILLSBORO, OR 97124 -3082
Phone: 503 - 846 -4794 Phone: 620 -1906
Reg #: LIC 44087
SUP 4028S
FEES ELE 34 -442c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/3/03 $173.20
[TAX] 8% State Tax 3/3/03 $13.86 Rough -
Rough -in
Total $187.06 Rough - in
Rough -in
Elect'l Final
Elect'l Final
ciect l i-lnai
Elect'l 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 wodc 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 -33 344. //��
Issued By: &r p Permit Signature: ,4 pQ elf /A re
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: 1 5
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application FOR OFFICE USE ONLY -
- -_ Received Electrical
Date/By: , " Permit No. 0 ,X10 3 -en :2 /of/
Cl of Ti and Planning Approval Sign
,7 g Date /By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Avdi & Post- Review Land Use
� l�'
Internet: www.ci.tigard.or.us 0 � 1 6. 1 I I I Date /By: Case No.:
Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 ` " " ' Name /Method: _ Supplemental Information.
�a✓ Ya. .1r "#• €- - .'M�.: ;,' ,. :k. i t i M�,`;C 'W ii e+ t a:thit a:. l r: ..,
�...�., .. `�.�.� `�'��� ._.� <.ETI' =P -�. ;,��.�:�rw :sv,�'`�z� ��., .�.�f.;e',A� ._(>E'1 a "s...�� . i ll .. �_.PP.Y)..:,:�,�u:� :��:;
❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial 1:1 Hazardous location
G� -^ lacement ❑ Other:
ddition/altti/re on
era h = 4 �, v,, _ ❑ Service over 320 amps- rating of ❑Building over 10,000 square feet,
tt:- `,,; , LeATEGORIYIOI e-ONS1IRUCTION 1 „_, , 1 & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories El Feeders, 400 amps or more
❑ Accessory Building ®= Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
; ,, ,„ „ 0B SIT , =E;,INFOI2IVIATIONnd m OCAT;ION �; Submit sets of plans with any of the above.
; L
The above are not applicable to temporary construction service.
Job site address: 7Sy0 SGJ -. - o. � �J
.. k ' :` ��. k FEE S`C1001LE 5 viii vM
Suite #: Bldg. /Apt. #: /7, /g, /9 , Z I Number of inspections per permit allowed
Project Name: 80,,, V ite. /9/on Description Qty Fee (ea.) Total
Cross street/Directions to job site: New residential - single or multi - family per 1
dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
tiM I ` iDESCRIPTIO WO , „ - ,, ; , " , ; ' service and/or feeder 90.90 2
/ L * - e / /- Services or feeders - installation,
4d ✓e" X pLe� �e 10 t� o �e r� �i Q.rS alteration or relocation:
200 amps or less 80.30 2
P./64-G r s =AA 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
E ,_ _ -... I .m 601 amps to 1000 amps
240.60 •
7] PROPERTI'OWNER „„ T EN AN T ; . . ... P P
Over 1000 amps or volts 454.65 2
Name: Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: 200 amps or less 66.85 1
Phone: Fax: 201 amps to 400 amps 10030 2
401 to 600 amps 133.75 2
�M CONTFAC'0 "— $ -:O,Ni ' p
. � =tAP,PLICAN -��� _�,� ...n � Branch circuits - new, alteration, or
Name: extension per panel:
• A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit ( 46.85 A i .g5 2
Phone: Fax: Each additional branch circuit / Q 6.65 /2(,.35 2
E-mail: Misc.(Service or feeder not included):
• Each pump or irrigation circle 53.40 2
��, n; b ...� ... ..___ , .�.4 .. _ Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
i^ alteration, or extension Page 2 2
Business Name:
G� /' �� / �' c �r7L Description:
Address: pp Ee.,4 23 / /S4- /
City/State/Zip: / 5 )/ Z / 7 Each additional inspection over the allowable in any of the above:
/ / Per inspection per hour (min. I hour) 62.50
Phone: 5b3-6 2- (90(0 Fax: Investigation fee:
Other
CCB Lip. #: 4 4o9 7 Lic. #: 34 -14 2-C__ - ,, - -- —�
. . ,`. `.._.. _. ketrttal:Permxt °Fees* 3: .ter •- . .f .: : �.,.,, k
Supervising electrician ] Subtotal $ / 7 3 , 20
, %��� �
signature required: --, --, - Plan Review (25% of Permit Fee) $
Print Name: rh ), Lie. #: Zio 241,-S State Surcharge (8% of Permit Fee) $ / 3, S' 6
TOTAL PERMIT FEE $ / $ 7, o(e,
Authorized Notice: This permit application expires if a permit is not obtained within
^ /
Signature: ! / . ��'e ... D ate: 3 — 3 --cY 180 days after it has been accepted as complete.
*Fee methodology set. by Tri- County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Fortis \ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information `'!
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
n Audio and Stereo Systems
n Burglar Alarm
n Garage Door Opener
Heating, Ventilation and Air Conditioning System
n Vacuum Systems
n Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
0 Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
F - 7 Instrumentation
n Intercom and Paging Systems
1 - 7 Landscape Irrigation Control
n Medical
n Nurse Calls
n Outdoor Landscape Lighting
n Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line (503) 639 -4171
' BUP
Received Date Requested 3 AM PM BUP •
Location 7 S YO r2 .( J Suite 4 MEC
Contact Person Ph ( ) �S ` ? — 73 g d PLM
Contractor Ph ( ) I SWR
BUILDING Tenant/Owner ELC 3-66M
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm Q\L-- 1Wistz.J 2 an p � A n ' Sel .�
Susp'd Ceiling
Roof 1I �� O C .�
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: /)(177 Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
•
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
=!) PART FAIL
SI ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dat ' �--� 3 Inspector ' Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL