Permit •
k' CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00831
-'''� DEVELOPMENT SERVICES DATE ISSUED: 10/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DA 01200
SITE ADDRESS: 07165 SW FIR LP 200 ZONING: C -
SUBDIVISION: 72ND BUSINESS CTR PARK LOT : 014 JURISDICTION: TIG
Project Description: Electrical TI
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: 2 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:
AMERICAN PROPERTY MANAGEMENT ALOHA ELECTRIC INC
2154 NE BROADWAY SUITE 200 1741 N JANTZEN AVE
PORTLAND, OR 97232 PORTLAND, OR 97217
Phone: 503 - 281 -7779 Phone: 503- 289 -7060
FEES Reg #: ELE 34 -224C
Description Date Amount LIP 24265
SUP 2426S
[ELPRMT] ELC Permit 10/25/200`. $60.15
[TAX] 8% State Surcharge 10/25/200`. $4.80 REQUIRED ITEMS AND REPORTS
Total $64.95
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 wo • • e .. - '• accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
s :.ended for more than , :0 da ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
les are set forth in OAR 95 :- 001 -00 • • hrough OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503-246-6699 or 1 80033 4./ / ,1� ,a
sued By: L _ �,, ��/ , 1 �./ _j/ / Permittee Signature: C / L J z �`1,/,,
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: '"i >' 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.
Electrical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard Date/B . a6 i Permit No.: ZG St'J
C- '.O
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639 4171 Fax: 503.598.1960 44 !�Y *a. ' (• % . D . Other Permit:
Inspection Line: 503.639.4175 " f_1 ., Date Ready/By: M 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK • PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps— rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION ' . of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder
0 Building over three stories ❑ Feeders, 400 amps or more
❑ Other:
❑Occupant load over 99 persons ❑Manufactured structures or
.i JOB SITE INFORMATION AND LOCATION ❑Egress/lighting RV park
Job no.: Job site address 7/66 jc,� F1A Z�� ❑Health -care facility ❑Other.
Submit 2 sets of plans with any of the above. '
\ /-7 SU 1 - 1 -& - , The above a re not applicable to temporary City/State/ZIP: �l , � • 2-Z3 PP � P Y construction service.
FEE*. SCHEDULE
Suite/bldg. /apt. no.: Project name: M/9c /P C j ( /Q---S'( Description I Qtr. I Pee Total I "
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: 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
, DESCRIPTION OF WORK - Each manufactured or modular
O �6 Ca 0IPq TE2 - L -- - `� dwelling service and/or feeder 90.90 2
/` ! Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
*PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: fi C9 ) pp , HA.//' tH f T 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
( 52) ) tJ V J- 7 7 7 G ( ) relocation
Phone: D l / 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
❑: APPLICANT ❑ CONTACT 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, .1 46.85 l / / , ' _ 5 2
Address: each branch circuit 1
Each add'l branch circuit 2- 6.65 13,3 V 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 -
CONTRACTOR - energy panel, alteration, or
Business name: A 0 E— r C �} extension. Describe: Page 2 2
Address: / 7 4 ( , J�! z�� /! v G Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: p(% . ! 7,2, (7 Investigation per hour (1 hr min) 62.50
Phone: (67)3 ) 2 Fc?' 7,o 60 Fax: (53 ) 231 76 6 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 3---y, 71 Electrical Lie.: 3 / 224 (1, Suprv. Lie.: 24/Z6S Subtotal 6 . /„-
Suprv. Electrician signature, required: 4_44 - f,___- / Plan review (25% of permit fee)
Print name: i an t_ b F-� L c Date: j» - 2 S —C3 S State surcharge (8% of permit fee) y• g�
TOTAL PERMIT FEE 6 y • 9
Authorized signature: 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:\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM/WEB
Electrical Permit Application - City of Tigard ' •'
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
iiiiiDEiyfiAL 'WORK (man? .__ _. _ i
Fee for all residential systems combined........ $75.00
•
Check Type of Work Involved:
El Audio an Systems*
❑ Burglar Alar
❑ Garage Door Ope er*
❑ Heating, Ventilation a d Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
FCOMM RCIAL WORK ONLY: . •
Fee for each commercial system • .00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Ins . . ion
❑ Fire Alarm Installatio
El HVAC
El Instrum - - . tion
•
.❑ I ercom and Paging Systems
`' Landscape Irrigation Control*
El M edical
❑ Nurse Calls
El Outdoor Landscape Lighting* .
❑ Protective Signaling
El Other .
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\ Building \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00831
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/25/2005
Phone: (503) 639 -4171 Jilliell �li..
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WO RKSHEET FOR DATE: 12/16/2005 TIME: 7 :06AM PAGE: 17
SITE ADDRESS: 07165 SW FIR LP 200 CLASS OF WORK:
SUBDIVISION: 72ND BUSINESS C "TR - VARNS PARK LOT #: 01 TYPE OF USE:
PROJECT NAME: PACIFIC COAST RESTAURANT
DESCRIPTION: Electrical TI 12/15/05 added 4 branch circuit.s.(for power pole.)
OWNER: AMERICAN PROPERTY MANAGEMENT, PHONE #: 503-281-7779
CONTRACTOR: ALOHA ELECTRIC INC PHONE #: 503- 289.7060
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Co e # Inspection Description Confirm # Contact # Message
199 Elect.iical final 023627 -01 503-289-7065 N
Corrections /Comments/ Instructions:
.
A---
C. .
•
•
0
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: idwi «—/ Date/ rO Phone #: (503) 718 -02.