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Permit CITY OF TIGARD ELECTRICAL PERMIT • ¢ 4 PERMIT #: ELC2005 -00009 DEVELOPMENT swail Blvd.. Tigard, OR 97 DATE ISSUED: 1/6/2005 13125 97223 (503) 639 -4171 PARCEL: 1 S135BB -00600 • SITE ADDRESS: 10380 SW CASCADE AVE ZONING: I - SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: 2 branch circuits: Furnace and lighting. 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: 1 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: FOURIER, GEORGE PER ACCESS ELECTRIC AND CONST. FOURIER, JAN JACOB 17509 NW AUTUMN RIDGE LARSON, ALAN W BEAVERTON, OR 97006 PORTLAND, OR 97217 Phone: Phone: 503 - 372 - 5770 Reg #: ELE 34 -675C LIC 158680 FEES SUP 4931S Description Date Amount Required Inspections [ELPRMT] ELC Permit 1/6/2005 $53.50 [TAX] 8% State Surcharge 1/6/2005 $4.28 Rough -in Elect'I Final Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 -33 344. Issued By: Permit Si nature: Y �� is 9 1' 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 Electrical Permit AppliB> t n E1VED l oI . b FIicr USE ONl City of Tigard p p n ^00� Date/B . Received i Q , y b Permit No.: 14_ -- r3125 SW Hall Blvd., Tigard, OR 97223 JAN v L Plan Review ✓ Phone: 503.639.4171 Fax: 503.598.1960 Qe. r,, ± 1 Date/B Other Permit: Inspection Line: 503.639.4175 ITY OF TIGA .3j.l = - Date Ready/By: 11 � . H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information tin n1NG niulsinw E OF WORK PLAN REVIEW ❑ New construction Addition/alteration /replacement Please check all that apply: ID Demolition ❑ Other: 0 Service over 225 amps, comm'I ['Hazardous location ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEG OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure El Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑ Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: 0 ' o SLi 61.6c CMJ6 13tL.Vd, ❑He 2 -care facility fp ay ❑ abov e. Submit 2 sets of plans with any of the above. City /State/ZIP: 1 q A. „.1 K g - 1 ZZ 3 The above are not applicable to temporary construction service. ) Suite/bldg. /apt. no.: Project name:s�ghfGrylAi>� C t' FEE *, SCHEDULE' Desc ription I Qty. I Fee. I Total Cross street/directions to job site: 21'7 I ,.. /! r A _ New residential single- or multi - family dwelling unit. `� ��"� Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular n t } 1 F0 rG dwelling, service and/or feeder 90.90 2 Al /k l■ -� — Services or feeders installation, alteration, and /or relocation SZ x'413 e Ltiy v; 200 amps or less 80.30 2 ❑ PROPERTY OWNER 1 ❑ TENANT 201 amps to 400 amps 106.85 2 401 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 Phone: ( ) I Fax: ( ) relocation 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 • 0 APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit Contact name: B. Fee for branch circuits without service or feeder fee, I 46.85 2 Address: each branch circuit Each add'I branch circuit ' 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I_ Fax: • ( ) Sign or outline lighting 53.40 2 E -mail: , Signal circuit(s) or limited - CONTRACTOR . energy panel, alteration, or extension. Describe: Page 2 2 Business name: ALCC. s eI ant.tL 4D e t?vJS Address: (? S� N (� _ Each additional inspection over allowable in any of the above ��'� �( ti( Jtk Per inspection 62.50 � t 9 City /State/ZIP: te 9 �� Investigation per hour (1 hr min) 62.50 Phone: 37z S7 D q 73.75 �6 ) Fax: 1ogO + � , t Industrial plant per hour ELECTRICAL PERMIT FEES* . / CCB Lic.: ls�l'oso ]Electrical L . vi s d I Suprv. Lic.: yg31 5 Subtotal S3 5{) Suprv. Electrician signature, required: V \►rte Plan review (25% of permit fee) // / J Print name: Z ` I A& � � Date: 1 1 (e(Oc State surcharge (8% of permit fee) `f' `d' yeltir f TOTAL PERMIT FEE �� 7g Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: 7 Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Building \Pennits\E1.C- PennitApp.doc 12/03 440.4615T(10/02/COM/WFB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information r LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: ret WORK ONLY Fee for each commercial system $75.00 • (SEE OAR 918- 260 -260) • Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC • ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Pemtits\ELC- PennitApp.doc 04/03 Cr'TY OFTIGARD BUILDING DIVISION PERMIT #: ELC2005-00009 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/6/2005 Phone: (503) 639 -4171 /n�v1 " I t b 1 � Inspection Requests (24 Hrs.): (503) 639 -4175 '- INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 97 SITE ADDRESS: 10380 SW CASCADE AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: HONDA DESCRIPTION: 2 branch circuits: Furnace and lighting. OWNER: FOURIER, GEORGE PER, PHONE #: CONTRACTOR: ACCESS ELECTRIC AND CONST. PHONE #: 503 -372 -5770 Inspection Request Scheduled For: Date: 6/30/2005 Pour Time: Code # Inspe .• • • - scription Confirm # Contact # Message 199 Electrical final 010500.01 971 - 645.8152 Y Corrections /Comments - - ..ns: ll G f .4) • • • ZE}ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � / / Date: • Phone #: (503) 718-