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Permit CITY OF TIGARD ELECTRICAL PERMIT • PERMIT #: ELC2005 - 00829 P DEVELOPMENT SERVICES DATE ISSUED: 10/24/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103AD - 00404 SITE ADDRESS: 10960 SW ERROL ST ZONING: R - 4 5 SUBDIVISION: LOT : 012 JURISDICTION. TIG Project Description: Temporary power RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp• 1 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: 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: ENGLERT, TERRY VANGUARD ELECTRIC 10960 SW ERROL 3800 MORRIS TIGARD, OR 97223 NEWBERG, OR 97132 Phone: 503 - 639 -5176 Phone: 503 - 537 -5006 FEES Reg #: LIC 164865 ELE 36 -104C Description Date Amount SUP 4880S [ELPRMT] ELC Permit 10/24/200' $66 85 [TAX] 8% State Surcharge 10/24/200' $5 35 REQUIRED ITEMS AND REPORTS Total $72.20 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Speaalty 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 -8 - 332 -2344 Issued By: „/ , , Permittee Signature: C-j (2To,,14 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. Oct 21 05 02:35p Chris Strange (503)537 -5019 p.2 • Elec.'_ricak Permit Application FOR OFFICE IISE ONLY City of Ti ard DWe/B l'�o �r;� Perim' No ��o5_on�� 13125 SW Hall Ivd, Tigard, Oy2 EI Plan Remo Phone 503 639 171 Fax: 50 (V V - Date/By Ocher Permit Inspection Line. 503.639 4175 /_JL Dale Ready /By 1= ® See Page for Internet. www of tigard or us n^T [) i 2005 Nonfied/Method / / C f Supplemental Information t -EYPE OE WORK PLAN REVIEW ❑ Nev constrtetion [gllAcldi(i i/lI�f'r`dtl C lacement Please check all that apply ❑Demolition CitgbfigN l�y+�l ['Service over 225 amps, comm'I ❑Hazardous location /' -�� <� ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft, CATEGORY OF CONSTRUCTION of I- 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 ID Multi - family ❑ Master builder aQther: ❑Building over three stones ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park /�, ❑Heal h -care facility pother Job no. 5 - 1 0 (9 1 Job Site address / 6 / q 1,0 .R.goL ST Submit 2 sets of plans with any of the above City /State/ZIP: so � /5 l " - The above are not applicable to temporary construction service 7 i j I FEE. SCHEDULE Suite/bldg. /apt. no. I Project name: /tk E_UT� a ereopoo o I I on. I Fee I Total 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: Lot no.: Ea add'I 500 sq ft or portion 33 40 1 Limited energy, residential 75 00 2 Tax map /parcel no.: Limned energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90 90 2 ' ` -S -02 Cc Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 E1 P OPERTY OWNER ❑ TENANT 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 relocation Phone: ( ) Fax- ( ) 200 amps or less / 66 85 tv 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 ] 37 75 2 Owner signature: Date Branch circuits - new, alteration, or extension, per panel 4 APPLICANT ❑ CO\ - TALC PERSON A Fee for branch circuits with service or feeder fee, each 6 65 2 Business name branch circuit B. Fee for branch circuits Contact name' without service or feeder fee, 46.85 2 each branch circuit Address: Each add'] branch circuit 6 65 2 City/ StateZIP: I Miscellaneous (service or feeder not included) t� Phone: ( )I Fax ( ) Pump or irrigation circle 53 40 2 1 \ Sign or outline lighting 53 40 2 4 E - mail' I Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension Describe Page 2 2 `(`1yt{ Business name / ;:titt gr, =G i✓G 1 1 Address' 1 LY�. s � 4e ., J ' , 5 ✓/'�' Each additional inspection over allowable in any of the above ,'tf Sc -L� J ' -` r�� v—✓ ,(� Per inspection 62 50 City / State/ZIP: W / �� 7/3� U Investf anon ( _ g per hour l hr min) 62 50 L Phone ,3 ) .557500 i 'J ) S,3 ^f ,5 /9 � Industrial plant per hour 73 75 / E LECTRICAL PERMIT ILES* ' r CCB Lic: Electncal Lic.: '/ Su pry. Lie.. /6�l/3hh - �as�e p yee05 Subtotal ‘7, Supry EleciiitIan signature, requtred:�r / Plan review (25% of permit fee) ,5, 3.5 - m - //��JJ .0 r State surcharge (8% of permit fee) L - " 0 � Print name: ( a e/ uired fV_,G a te, i� �/7 O,� r - ?'t ^ �� TOTAL PERMIT FEE 77 .26 Authonzed signature: - This penult application expires d a permit is oat obtained within 180 days after it has been accepted as complete Print name: I Date: • Fee methodology set by Tn- Count) Building Industry Service Board Number ofmsceetions net oermu allowed CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE VANGUARD ELECTRIC INC 3800 MORRIS NEWBERG, OR 97132 Electrical Signature Form Permit #' MST2005 -00320 Date Issued 9/21/2005 Parcel 2S103AD -00404 Site Address 10960 SW ERROL ST Subdivision. Block Lot: 012 Jurisdiction' TIG Zoning: R-4.5 Remarks Shop. 10/10/05: Added (1) lay, (1) water closet, (1) shower. (1) vent fan. Your company has been indicated as the electrical contractor for the permit indicated above In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN Building Division No electrical inspections will be authorized until this completed form is received OWNER ELECTRICAL CONTRACTOR. ENGLERT, TERRY VANGUARD ELECTRIC INC 10960 SW ERROL 3800 MORRIS TIGARD, OR 97223 NEWBERG, OR 97132 Phone # 503 - 639 -5176 Phone #: 503 - 537 -5006 Reg # LIC 164865 ELE 36 -104C SUP 4880S AN INK SIGNATURE IS REQUIRED ON THIS FORM • tri•; . - r /1A . , ;. Electrician If you have any questions, please call 503 718 2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE VANGUARD ELECTRIC INC 3800 MORRIS NEWBERG, OR 97132 Electrical Signature Form Permit # MST2005 -00182 Date Issued 9/21/2005 Parcel: 2S 103AD -00404 Site Address 10960 SW ERROL ST Subdivision Block: Lot: 012 Jurisdiction TIG Zoning R-4.5 Remarks New SF Your company has been indicated as the electrical contractor for the permit indicated above In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN Building Division. No electrical inspections will be authorized until this completed form is received OWNER. ELECTRICAL CONTRACTOR: ENGLERT, TERRY VANGUARD ELECTRIC INC 10960 SW ERROL 3800 MORRIS TIGARD, OR 97223 NEWBERG, OR 97132 Phone #: 503 - 639 -5176 Phone #: 503 - 537 -5006 Reg #: LIC 164865 ELE 36 -104C SUP 4880S AN INK SIGNATURE IS REQUIRED ON THIS FORM _ -a - ure o Electrician If you have any questions, please call 503.718 2433. CITY OF TIGARD BUILDING DIVISION APERMIT # ELC2005 00829 13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 10/24/2005 Phone (503) 639 -4171 7 ill Inspection Requests (24 Hrs) (503) 639 -4175 ^'I �., INSPECTION WORKSHEET FOR DATE 10/27/2005 TIME 7:16AM PAGE 16 SITE ADDRESS 10960 SW ERROL ST CLASS OF WORK SUBDIVISION LOT # 012 TYPE OF USE PROJECT NAME ENGLERT DESCRIPTION Temporary power OWNER ENGLERT, _RRY, PHONE # 503. 639-5176 CONTRACTOR VANGUARD ' ECTRIC PHONE #. 503- 537 -5006 Inspection Request Scheduled For: Date. 10127/2005 Pour Time Code # Inspection Description Confirm # Contact # Message 110 Temporary - ' . ., • ' e 019534 -01 503. 793-2673 N VCS CL. L o5d Corrections /Comments -. uctions: ^PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL ❑ CALL F FOR RI INSPECTION El ADDITIONAL FEES ASSESSED Inspector ` ( _.5 1 \1 ' Date: I Z1 \lb Phone #: (503) 718 - 1•144'C7 (-