Permit CITY TIGARD .t ELECTRICAL PERMIT
PERMIT #: ELC2005 -00694
DEVELOPMENT SERVICES DATE ISSUED: 9/19/2005
13125 SW Hall Blvd., Tigard, OR 97223 503639 -4171 PARCEL: 2S102CB 03400
SITE ADDRESS: 09850 SW FREWING ST 45 ZONING: R - 12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
Project Description: Reconnect service.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Phone:
FEES Reg #:
Description Date Amount
[ELPRMT] ELC Permit 9/19/2005 $66.85
[TAX] 8% State Surcharge 9/19/2005 $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. 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 e or dir- :. -s io . to OUNC at
503 - 246 -6699 or 1 -800 -3 2344.
Issued By: J Q X1_ Permittee Signatur . °
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.
• Electrical Permit Application ti F OR O FF IC E US ONL
Received / CN a;t0
City of Tigard RECEIVE'! Date . (7,,...., a�� , PermitNo.: G (, 0 ,f'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / �ir., a ✓f ;r; Other Permit:
Inspection Line: 503.639.4175 SEP 19 20 �r c �' "` Date /B ,_ . -,' Date Ready/By: mil . See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TY1 'O
I ciF apARD PLAN REVIEW '
❑ New construction ❑ Ac ') io %i KAent 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 ❑System over 600 volts nominal units in one structure
Multi family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
• 3°�
DOccupant load over 99 persons ❑ Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
1 ° ❑Health -care facility ❑Other:
Job no.: Job site address: 9 �� so r / C--,
Submit 2 sets of plans with any of the above.
City/State/ZIP: /'Q r C'OZ — td / 'L7 q 7 ,,7-. 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 4 Project name: Cet 6.44 D �! / , , FEE* SCHEDULE
Description I Qty. I Fee. Total I **
Cross street/directions to job site: , •ti i • New residential single- or multi - family dwelling unit.
5, t , ri , e_ . / �� 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
Tax map /parcel no.: / > Limited energy, residential 75.00 2
. Limited energy, non - residential 75.00 2
. DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
Ai ROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 1 60.60 2
. Name: A--(., (_�, / 'NI 601 amps to 1,000 amps 240.60 2
Address: F b, `',e 3 5'L __ Over 1,000 amps or volts 454.65 2
Reconnect only . I 66.85 2
City /State/ZIP: --7--, ' 6,),I) ,/ , e ,;2_e / Temporary services or feeders installation, alteration, and /or
/�
Phone: (S-63 � --� g c jib Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This • stallation is • . • ....e on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, leas t r exc . e accon ing t , 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
p service or feeder fee, each
Business name: e-- l_ (3..{�p i. 7� S , branch circuit 6.65 2
Contact name: /� L B Fee for branch circuits
�j /� _ without service or feeder fee, 46.85 2
Address: each branch circuit
CC/0 (�.12---- 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: (67,8 — --- ax:: ( ) 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:
Address: v / 4_' Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Investigation per hour (1 hr min) 62.50
. Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL' PER MIT FEES* . •
CCB Lie.: Electrical Lie.: Suprv. Lie.: Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: -) Date: State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1,2 ()
• Authorized signatur . This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: A - r =, ;v j, Date: 9//?/2 * Fee methodology set by Tri- County Building Industry Service Board
*' Number of inspections per permit allowed.
is \ Building \Perm its\ELC- PermitApp.doc 12/03 4404615 OM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
r 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:
[COMMERCIAL 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 \Pennits\ELC- PennitApp.doc 04/03
� OF TIGARD A it
� .. _ INGkDIVISION PERMIT #: ELC2005 -0Q694
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -417v1 V iii� � Inspection Requests (24\Hrs.): (503) 639 -4175 .:_..
INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7 :07AM PAGE: 48
SITE ADDRESS: 09850 SW FR&1NG ST 45 CLASS OF WORK:
SUBDIVISION: CHARLOTTENNOF APARTMENTS LOT #: 009 TYPE OF USE:
PROJECT NAME: CHARLOTTENHO APTS
DESCRIPTION: Reconnect service.
OWNER: FINKE, ALEX AND LO I 1, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 900/2QQ5 Pour Time:
Code # Inspection Description onfirm # Contact # Message
115 ervice __ !k.143-01 503 244 -5824 N
Corrections/Co - .cents /Instr tions: C.A_P5'EA
-\) .
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A PASS n PARTIAL APPROVAL ❑ CANCEL l NO ACCESS
n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: A '08 1 Date: 2
2 GT
Phone #: (503) 718 - 2.4*