Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00102
, DEVELOPMENT SERVICES DATE ISSUED: 3/3/03
If
:4.1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112BD-00100
SITE ADDRESS: 07520 SW BONITA RD 001 ZONING: R-12
SUBDIVISION: TIFFANY COURT APT.
BLOCK: LOT : 065 JURISDICTION: TIG
Project Description: Apts. #1 and #11. Install (10) branch circuits. Add bath plug, smoke detectors and 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: 9 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 $106.70
[TAX] 8% State Tax 3/3/03 $8.54 Rough -
Rough -in
Total $115.24 Elect'l Final
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 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 -33 2344.
Issued By: AI !i �i -/ Permit Signature:
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: k S
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application FOR OFFICE USE ONLY
DateeiByd _3 –0 Permit No.:
Date/By: �C d o � -
tBy: –0') � � Permit
Cit of Tl and Planning Approval Sign
Y 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 Post-Review Land Use
�0,'/er l � Date/By: Case No.:
Internet: www.ci.tigard.or.us ■ �, o f l i Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
1~ ,�. �. �`�'�.l�T t:' �.. ::T�X,PE ®F WO,RK�, `:, � 2t. �:ik � „ fie „3L?L�AN: REVIEW, (Please;clieckrall;that�tiPP1Y) , f�.,�,; :._;�.�� a
111 m ew construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
ddition/alteration/replacement 111 Other ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
- "V ' nCA ,CONSTRaUCTION; L Z i ,., ,t, 1 & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
El Building over three stories ❑ 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:
„ J • O -� F: i 7 Submit _ sets of plans with any of the above.
t� . � , JOB= SITEINFORIVIAT *IQN:andLOCAT�ION”- ; . The above are not applicable to temporary construction service.
Job site address: 75:267 r f-y--,,_ votaimitm , SEE *'SCHEDULEa ?„ e
Suite #: Bldg. /Apt. #: / sit I 1 Number of inspections per permit allowed
Project Name: Description Qty Fee (ea.) Total i
New residential - single or multi - family per
Cross street/Directions to job site: 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
„zu service and/or feeder 90.90 2
: � DESCR RTION OF:W®RI( i4 , ..
G55t p - rI X70 � / 1 Services or feeders - installation,
alteration or relocation:
n/ I �� ew 200 amps less 80.30 2
N 201 1 to amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
g Ho ,,b E
�RT�Y OWNER " " _ ` TENT' : li 601 amps to 1000 amps 240.60 2
PROP �<<u .. >z� .
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 _ 100.30 2
401 to 600 amps 133.75 2
El AI' ._ to :' C ONTACT KItSONz_.� , -- ,nb 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 7 //LL
�.J 2
Phone: Fax: Each additional branch circuit ? 6.65 , 5 9 -SVS 2
E-mail: (s rv� feeder included):
Misc. a ce or eder not incl ed
W r I , - t ... g Each pump or irrigation circle 53.40 2
m `,, -a ` Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
Business - r _, �' alteration or extension Page 2 2
usiness Name: ,
1 De scription:
Address: J A3ow 2--.3//s
, » 2 p Each additional inspection over the allowable in any of the above:
City /State /Zip: 77 L ? �k Per inspection per hour (min. 1 hour) 62.50
Phone:. ,'3 -6 zo– /906, Fax: Investigation fee:
Other
AIf6, , ' =,01tNi, W 6Mectncal, PermifFees __ 6 „m., . _ _ IAA:it:_
Supervising electrician ] Subtotal $ /Oaa •7
signature required: 777 I J� Plan Review (25% of Permit Fee) $
u
Print Name: M LJ PS P r Lic. #: 40 2-4S-7,S State Surcharge (8% of Permit Fee) $ fS, 5
TOTAL PERMIT FEE $ J / S , at"
Authorized / Notice: This permit application expires if a permit is not obtained within
Signature: ..e•i-, _ _ Date: ,3 - 3 -G7.3 180 days after it has been accepted as complete.
*Fee methodology set.by Tri- County Building Industry Service Board.
/ 1 ttt k‘-e/''' 0
(Please print name)
I: \Dsts\Permit Forms \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
• 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:
n 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
n Landscape Irrigation Control
IT Medical
n Nurse Calls
n Outdoor Landscape Lighting
❑ 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 •
ease Activity Listing 11/:07AM
A 11:16:07AM
TIDEMARK Case #: ELC2003 -00102
COMPUTER SYSTEMS, INC.
�' .i� , ., -14v f.5i s ue, ie . ,�;�. ,.:` e. ,, ' ..m�<fb �,u,,' ".,�",':
IliYi•i, v : ; ' " , . n%: :x " ry: / d,;;� y a ■ .r e6e'r t>IVn � �:, a � „a� . fat r3 v ii >ts ,�;�
.
ELCD001 Application received 3/3/2003 None DONE BB 3/
BLD
ELCD003 Permit created 3/3/2003 None DONE BB 3/3/2003
BLD
ELCD700 Rough in 3/11/2003 None PASS HFY 12/31/2003 unit # 1 rough in passed. 2. unit # 11
HFY final passed.
None 3/3/2003
ELCD700 Rough -in
BLD
ELCD799 Elect'l Final 3/11/2003 None PASS HFY 12/31/2003
HFY
None 3/3/2003
ELCD799 Elect'l Final
BLD
ELCD400 (F)Ready to issue 3/3/2003 None DONE BB 3/3/2003
BLD
ELCD500 (F)Issue permit 3/3/2003 None DONE BB 3/3/2003
BB
ELCA800 Case Finaled 12/31/2003 None DONE HFY 12/31/2003
HFY
Page 1 of 1 CaseActivity..rpt
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
•
Received t Date Re nested 3 /' AM PM BUP
Location J Oa-e) Sui MEC
Contact Person Ph ( ) O f q - 71r,30 PLM
Contractor Ph ( ) SWR 3 BUILDING Tenant/Owner ELC 3 - 66 ' /
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 \�� ,( ,n
Drywall Nailing
Firewall
Fire Sprinkler 11 f
Fire Alarm
Susp'd Ceiling
Roof
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:
Final
PASS PART FAIL
MECHANICAL
Pos & Beam
Rou
Gas Line
Smoke Dampers
Final �.
PASS PART FAIL
ELECTRICAL
/
Service
Hugh =ln ' l O
Low Voltage
Fire Alar
in ' 1 l Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Date - a � Inspector id - � - �� Ext
Approach/Sidewalk
4 Other:
Final DO NOT REMOVE this inspection record from _ tlai job site.
PASS PART FAIL