Permit CIT OF TIGAR® ELECTRICAL PERMIT
�' PERMIT #: ELC2005 -00268
DEVELOPMENT lrSERVICES 503 - 639 - 4171 DATE ISSUED: 5/11/2005
PARCEL: 2S102AD -01203
SITE ADDRESS: 08800 SW COMMERCIAL ST ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Upgrade panel 200A to 400Am wire /connect (3) HVAC split system. Job #22552.
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: 7 PER INSPECTION:
201 - 400 amp: 1 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:
HUMPHRIES, RICHARD B AND 3D ELECTRICAL SERVICES INC
THELMA MAGNO PO BOX 173
PO BOX 230626 OREGON CITY, OR 97045
TIGARD, OR 97223
Phone: Phone: 503 - 657 - 9173
FEES Reg #: ELE 3 - 460C
Description Date Amount SUP 135234
444 7278S4
SU5
[ELPRMT] ELC Permit 5/11/2005 $153.40
[ELPLCK] ELC Pln Rev 5/11/2005 $38.35 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 5/11/2005 $12.27
Total $204.02
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 4! 0 -332- 344.
Issued By: OIL a 0/ Permittee Signature: I :10. s s
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.
trical Permit iApp14ca • ° ° e • e• • • -(:C- r _ r < -77-r- F OR - OFFICE- USE-ONLY _.._
•
City of Tigard ,� @ ° e nat� y; ,L" } - I� �1 I - Pemit No.: (-- L c', p� 3 _ ,.Z.� �`
13125 SW Hail Blvd., Tigard, OR 972 Plan Review Other permit:
Phone: 503.639.4171 Fax: 503.598.1960 '04 4 ' f lir Date/By
Inspection Line: 503.639.4175 ® P ►e 2, IA V • l . -`I 1 - Dere Ready!). • • • ! fit See Page 2 for
Internet www.ci.tigard.or.us ° ' • • • • lo�fieil iv thgd: • • d ( Supplemental Information
• � • • ° - -.e. ° , ,.,,w .. -•i , •:•m � -tom :'�' ik= ;��,«��:}�_;..,.,;c
t�. ` > ":.r�� "• •ru' �' r; ... ✓ :.R. �:. . �. ?��" ':,PI:e1N'�RE�?I ^ � ; ,:; t ` � : ,, .- :x�:. „ ; . s't�
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S. z� €. a� s. - r.:.j... ..r_... .... ,... _x..1 7,......:.- ...- �i ��������1�. . i°= dr:_:�'�_� � �. e.�7.C°�YJ �a .Y2 :iYiL,,.. �.J. -.r 4. S -• n • -.s=_'
in New construction ❑ Addi sa R on/replacement Please check all that apply:
❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑Other. • • • • • • • • • • • • ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft_,
%r" . ;R; ° ..s °�; t CA`T GO riti JCiNST CCMaIV =`.-' "'` ea ; • �'7 dwellings 4 or more new residential
� `� ''"` •.�� � �• -�=• • of 1 - and 2 dw
,�l i;:w��.,•",.:��" i ''"rx:H��::.r�: s.�s, .- r_ rvav_ naR: w.,.; w:.. m4�. T,._.,.,:. •:i ?i»� �•;,�.Y .'Cit. • Y
1- an d 2-family dwell' J Commercial/industrial ssay i
buldIng .• : • • ❑system over 600 volts nominal units in one structure
❑ y fl o ceders, 400 am
Multi-family ❑ Master b uilder ❑Building over duce 99 s or more
persons es P
❑ y 0 _ _ ❑o�upant load over 99 p ❑Mantrfacttrred structetres or
°. r;.r 6�. , 4 .�_,, - -� .< a rm = a;.':.c ' ra- ti = l -, - ∎ " RV park
�" ` ! :ilgin::;. ` 4 9, :, ,; T,.k9 ,AN Gt1PON: .:i � � .,, ".AW OE❑Egress/lighting plan p
•. a•:.,>:- L- s-__ u a.<,. 13:,.. xa- ��,. �.. w,._._.,.,.-: � ... . .._. ,�r..esk.,�..� .. ,..�..,...,„ . °:. ,r..r�aa- �.::. ;•- •.�, h
❑Health -care facility 00t her
Job no.: 2 ZS S 2 Job site address: 8 Su) ChM t�qe, gt Submit 2 sets of plans with any of the above.
City / State/ZIP: 7":16-1911.1) $ui ld1Al #1.-- The above are not applicable to temporary construction service.
r 'i, . iISt i , ;:, I?I71:E4-s -`t'' `.: n 'fig= •'' =.'-?u ; '+`c`-;:� -:'
Suite/bldg./apt. no.: Project /v146/Va - f/v�'4 I 1 -' :� FEE, :. x r .H ...... t.
•
Pro ect name: nexriptio• � Qt ( Fee. 1 Total
' Cross street/directions to job site: AL(„... New residential single - • or taulti- family dwelling unit.
Includes attached garage.
' 1,000 sq. ft or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
:.r., ° D O F O.- > : :: ; modular
� R' > '" °�`"c.�i `d�:��;,. �T � V � _t �. -z • , �' �7•z . Each NaDU�detfiflCd or : e"' n' i '"n.,,:t €.. " _ai�„'�,.¢TS :r, i., s.3:'�?: s�i:.�:. <_ - _ - �.i.•�t�- ,.. �.. �:.. n„ �..:... �.. �� #vA:`�1w.r..J.'',..."�.,,r_ r�_"., +'._.
U pctOig De � CS�} 1"' 1_ 10P _ _ IS / �{� '' dwelling, service and/or feeder 90.90 , 2
t J •!'IC� f Services or feeders installation, alteration, and/or relocation
- it lltC /CC»t Vied (S) 64 C S 4-t r St's 3P 200 amps or less 80.30 / 05- 2
i€_:,. _ .. „.., - _ ::;' s ue i ' - ti; _ - t x:.t> :- 201 amps to 400 amps i 106.85 /0( 2
�SOR$T'i'DA "vr �,*EWA�yi sr -
_- ....- _,...,. �..,.._.,.,..... _s.._,...;` �:-- �"�':cr- �• -s:. __..._..a. <.._..._ ..__ 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
n' v °:� __-??t r =.- :j �K ` _ - "_`'-�.; A Fee for branch circuits with
rP - `'�"�-- ° - �CONTA�x��iLS01Y ;,= '�`c',�s „�
a yc' G� API iCt11!I': ....r._,''t��`
. - ' � ° - - service or feeder fee, each ���JJJ 6 65 �� 2
Business name: branch circuit /
B. Fee for branch circuits /
Contact name: without service or feeder fee,
each branch circuit 85 2
Address:
Each add'1 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 -
..u. ..,.... -- Us:>> _:,;- x_ - .- panel, alteratio
,r.,, :,,.�r. .,� -�. - �.-rGO1VT�2AC�'O F; 1 <� i ^` _ ; :at "� -�,< ': energYp � or
...nr...- z o^i_,._.:. .,»:.^ -••,.a ^''k;"'''::•'�u �,�,. - . -� ,.. ,... ,.�-- ...,..Y.c`- ...-� ".- .eyi: L ,.- ..;:..•ezc�u.>ii ' :„
���� 3 �� extension. Describe: Page 2 2
Business name: - - t ( s c 12 ,.. v ( ces
Address: po (&53C /7 3 Each additional inspection over allowable in any of the above
Per inspection 62.50 _
City /State /ZIP: it O rj(j -04) Li r-V 1 0 le 9 7, CL5 Investigation per hour p hr min) 62.50
Phone: 3 / F ax L� Industrial plant per hour 73.75
i. ( ) , per) t 7 dl0_I� ' .- -.,1'v''et ELtelVO ;L`;i'ERN/Att SEES .11- ± V24
12 l - CCB Lic.: 13.5234 Electrical Lic.: L/ � Suprv. Lic.: s/L/ 78� Subtotal /53 40
6 Suprv. Electrician signature, required: iii L
Print name: y Date: [ Plan review (25% of permit fee) 321.3 / 3S-
State surcharge (8% of permit fee) 1 2 . 27
OZ-
Li he TOTAL PERMIT FEE
Authorized Slgn ! 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
i:t Building \Permits \Fr C- Pemitppp.doc 12/03 440-4615T(10/02/COM/WEB
CITY . TIGARD a _ .,-
B UILDING DIVISION P ERMIT #:
r
� ) EL C2005,00268
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2005
Phone: (503) 639 -4171 avil P4puyp ,i 1` j liT\ .
Inspection Requests (24 Hrs.): (503) 639 -4175 -._1I_..
INSPECTION WORKSHEET FOR DATE: 7/25/2005 TIME: 7 :12AM PAGE: 90
SITE ADDRESS: 08800 SW COMMERCIAL ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAGNO
DESCRIPTION: Upgrade panel 200A to 400Am wire/connect (3) HVAC split system. Job #22552.
OWNER: HUMPHRIES, RICHARD B AND, PHONE #:
CONTRACTOR: 3D ELECTRICAL SERVICES INC PHONE #: 503.657 -9173
Inspection Request Scheduled For: Date: 7/25/2005 Pour Time:
Code # Inspection Description on it • Contact # Message
199 Electrical final 0 50.01 971- 150 -6856 N
Corrections /Comments /Instructions:
F N ) 0 , \ . ? 1 ,- - a a , NQ \.. b , L- Seib - Es.14 ► IJ -
, NtS pkNSt m O.. 10 dipre Ra.a.■)ia.A))
PASS ❑ PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -- (' ' 'a.." 1 .-7 V ' Date: 7 1 IgiCr.
Phone #: (503) 718- 2 411.0 ,