Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00768
All DEVELOPMENT SERVICES DATE ISSUED: 10/11/2005
`� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102AA -03900
SITE ADDRESS: 08915 SW COMMERCIAL ST 23 ZONING: CBD
SUBDIVISION: CASCADE MOBILE VILLA LOT : JURISDICTION: TIG
Project Description: MH service. Job #05 16103.
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: 1 • 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:
DAVIDSON'S CONSOLIDATED PARKIN ELECTRIC INC
8915 SW COMMERCIAL ST • 14001 FIR STREET
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 - 639 - 4650 • Phone: 503 - 657 - 4958
FEES Reg #: SUP 4241S
Description Date Amount
LIC 35151
ELE 34 -4C
[ELPRMT] ELC Permit 10/11/200' $90.90
[TAX] 8% State Surcharge 10/11/200: $7.27 REQUIRED ITEMS AND REPORTS
Total $98.17
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 - 332 -2344.
Issued By: � £. t _ Permittee Signature: 0
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.
10/11/2005 TUE 14:52 FAX 503 557 1059 Parkin Electric City of Tigard 12001 /002
g
Electrical Permit App •c _ tjwil FOR OFFICE USE ONLY
City of Tigard tGEIVE I' Received / permit No I p
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
OCT
Phone: 503.639.4171 Fax: 503.598.1960 !', „.rry c\ . Other Permit
Ready/By: Inspection Line: 503.639.4175 a e �� Date
20 � � -_� n _ _ adyBy: ]uric: ! 0 See Page 2 for
Internet: www.ci.tigard.or.uS yj - -- :- _ Notified/Method: .1
', (- Supplemental Information
k ,,, , 4'+� .,,r, ., ro t , "' ,r, ,� „ , ' �iii ri J ;; 5 tt . . � . .. v
.1.t 522 ) xi J F i O t t 4 t ; i ,mss a .11,44"'..,1' " •
_.___.5. _ .� - c�_ - >t.. _ ... ,..- ,..��tt ..r_ ..:. ' _... _ �� � : �s'.�.t ? �e � ' �?� 7,r- • �' r !��a r � eyta Lt� 1'4'4%140 s.
.� •'!__�•:'� ^ -
❑ New construction :, Addition/alteration/replacen ent Please check all that apply:
❑ Demolition Other; ❑Service over 225 amps, comm'l ❑Hazardous location
over 1 OService oer 320 amps -rating Buildn over 10,000 sq. ft.,
Li'H „+r w t . m'G2r_p r t}, 4e2;: rvs -ir; yxF�c�.a.V4 v-”' p 8 g ve . Q
: x 1 .ri Ys d ```am j � 1 � z � " 9 .. °ct - ,' +, ';e`'``' in T of t- and 2-family dwellings 4 or more new residential
►: - and 2 family dwelling 0 Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder OBuilding over three stories OFeeders, 400 amps or more
❑Other 0Occupant load over 99 persons DManufactured structures or
: i: i._� .: is >y -' ti`,�Eah '°J' � 3 rf d ; t 'J , s cO J G ,'r
;e
�*_�;._ .�'` , _����t- c � -�• ` ?t' < r ,� ❑ E ess/li htin Ian RV park
• ..._. 8r g 8 P
Job no.: ( � - I �i ? Job site address:i�t 15 5 pp��� v_
OHealth -care facility ❑Other:
`3JV�fi i P /C ;c Submit 2 sets of plans with any of the above.
City /State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg./apt. o.: : 3 ` ,, `'' 3 y« ',y�3" G gre4 V ' 'tn:�.F :
; ^ .S
no.: 1 Project name: Qty. Fee. Total ._� _ : = r,•> :. '. ,
'� l 'O✓l S0 (J k T�-� Dusceiption Y •"
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: I Lot no.:' 2.3 Ea. add'l 500 sq. ft. or portion 33.40 • 1
Tax map/parcel no.: Limited energy, residential 75.00 2
. ` $=t¢ par a x , ;C ^� t , , , , >; Limited energy, non - residential 75.00 • 2
c., w _ -s,,, ,e.,. `:�i:: .,." �i'g' , : a,. -tit •:= ti `' h .t
M ...� _. v �. Each manufactured or modular
nn + ' �� �� dwelling, service and/or feeder ( Q 90.90 "(O ( 0 2
' 1 lT Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
a 1 j� i 3 3 4 tF? a t i t - ``1�. ; i, t '4" ' g jAIR t 201 amps to 400 amps 106.85 2
�"' "' "" �' ' ' 401 amps to 600 amps 160.60 2
Name: � � v /�C��S C 1 ,sO \ll � , OL - 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts • 454.65 - 2
City /State/ZIP: Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: (5 g) . h " v( 5-() I F ax: ( ) 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
._ S r'-` "` 3— ,- :.'. 7 7 7 - 71 - 2 ,i-,..; , f-1 C'S -s. w ^I' a ' t • , r , 7 y . . � y , • Y .,,,.. t
c s.�. . � >_ :. . f i � t-a"—. !v 6.. [: 2 . % 4 �.V .a � i `il,c,..1... A. Fee for branch circuits with
Business name: service or feeder fee, each 6.65 2
branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City/State/Z1P: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) l Fax:: ( ) .
Sign or outline lighting 53.40 2
E
Signal circuit(s) or limited-
" ' , i`� .t ,, ,.._r ;m. �- ,. , . r.; h ?: . .� - :.. - . . ', ; ,a energy panel, alteration, or
"Parkin Electric; Inc. 14001 Fir street -- _. , ,
Oregon City, OR 97045 503 657 - 4958 fax: 557 - 1059 extension. Describe: Page 2 2
` Contractors License #: 34 exp. 07 - - Each additional inspection over allowable in any of the above
i Supervisor: 4241 -S exp. 07 -01 -06 Per inspection 62.50
Contractors Board Reg #: 35151 exp. 10 -12 -08 Investigation per hour (1 hr rnin) 62.50
Metro # 2416 exp 11 - - Industrial plant per hour 73.75
Owner: t3- gamey t RieW- 4EdV�t fl � -- y; " • id:t.r :£>:.14 ''7.- ` -
_ -
Subtotal tCtD
Suprv. Electrician signature, required: Plan review (25% of permit fee)
- Print name: / Date: State surcharge (8% of permit fee) 7 ,L 7
� TOTAL PERMIT FEE
a/
Authorized signature: This permit application expires if a permit is not obtained within P 180
-
days after it has been accepted as complete
- Print name: 4l(ie' 0 - / / � �� IAf Date: • Fee methodology set by Tri -County Building Industry service Boar
"• Number of inspections per permit allowed. 9`k
is! Building \Petmims\SLC.PerrmtApp.dnc 12/03 440-4615T(I0 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00768
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/005
Phone: (503) 639 -4171 Attifi0
Inspection Requests (24 Hrs.): (503) 639 -4175 ._':
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 27
SITE ADDRESS: 08915 SW COMMERCIAL ST 23 CLASS OF WORK:
SUBDIVISION: CASCADE MOBILE VILLA LOT #: TYPE OF USE:
PROJECT NAME: CASCADE MOBILE VILLA
DESCRIPTION: MH service. Job #05. 16103. .., G
OWNER: DAVIDSON'S CONSOLIDATED, PHONE #: 503 - 639 -4650
CONTRACTOR: PARKIN ELECTRIC INC PHONE #: 503 - 657 - 4958
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 018843 -01 503.657 -4958 N
Corrections /Comments /Instructions:
C
\
t Z S n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTI '4 N In ADDITIONAL FEES ASSESSED
1
A „ <<4 kL
Inspector: i - i Date/O . Phone #: (503) 718-