Permit 1 TOF TIGARD ELECTRICAL PERMIT
• CIT
PERMIT #: ELC2005 -00708
e � l � l DEVELOPMENT SERVICES DATE ISSUED: 9/22/2005
`-' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102CA -00301
SITE ADDRESS: 09870 SW FREWING ST 060 ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 018 JURISDICTION: TIG
Project Description: Reconnect only.
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 TRUSTEE OWNER
FINKE, LOTTE I TRUSTEE
PO BOX 23562
PORTLAND, OR 97281
Phone: Phone:
FEES Reg #:
Description Date Amount
[ELPRMT] ELC Permit 9/22/2005 $66.85
[TAX] 8% State Surcharge 9/22/2005 $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 Utilit u- Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rule direct q estions to OUNC
503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature:
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.
•
L' lectrical Permit Application . , . :
. , FOR Ol 1 lCE USE ONLY
City of Tigard Received - 0 .5--- Permit No.: / 0 - a ) 7/ 1 1
13125 SW Hall Blvd., Tigard, OR 972. :
�° 4 Plan Review Other Permit:
'
Phone: 503.639.4171 Fax: 503.598.1'6; +ieja;;jl1' °�" Date/By
Inspection Line: 503.639.4175 J : ` -' f J„ Date Ready/By: MI M See Paget for
Internet: www.ci.tigard.or.us SEP 2 2 2005 Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Adigli6X/SiltrillAWacement Please check all that apply:
❑ Demolition }fit{ ayp_DING DIVISION 0 Service over 225 amps, comm'l ❑Hazardous location
T` ❑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 OSystem over 600 volts nominal units in one structure
El Multi - family El Master builder Other: ❑Building over three stories ❑Feeders, 400 amps or more
JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑Ma park
tured structures or
❑Egress/lighting plan p
Job no.: I Job site add ess: 7i94--/ 60 ❑Heaith -care facility ❑other:
Submit 2 sets of plans with any of the above.
City/State/ZIP. / i' 0 v �, ' ? 7- / The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE
Description I Qty. I Fee. I Total I .
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
r , P Includes attached garage.
V`� -7 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
f� 1 C dwelling, service and/or feeder 90.90 2
� Services or feeders installation, alteration, and/or relocation
/ 4.11_____--- 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: �7 �( 601 amps to 1,000 amps 240.60 2
Address: f Or y * p . 3 �p 7 Over 1,000 amps or volts 454.65 2
t Reconnect only ,.----AN 66.85 2
City / State/ZIP: r f ice' /t -7e-) 0 e� 7 � 0 ' Temporary services or feeders installation, alteration, and/or
Phone: ( - 6j3 tt - - Fax: ( ) .,------- relocation
200 amps or less 66.85 1
Owner installation: This instal . on is being made, on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, I:: %r or gxcharag` according to ORS 447, 449, 670, d70j'. 401 amps to 600 amps 133.75 2
Owner signature / ' Dat e: / p Z ` d � Branch circuits - new, alteration, or extension, per panel
•APPLICANT I 4(CONTACT PERSON A. Fee for branch circuits with
/ service or feeder fee, each 6.65 2
Business name: A.. s c !/ branch circuit
B. Fee for branch circuits
Contact name: / without service or feeder fee, 46.85 2
Address: !/,J a6-- 0-
IL— each branch circuit
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: ( ) Fax :: ( ) 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: A/ 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 PERMIT 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 22 Q
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.
is \Building\Permits\ELC- PennitApp doc 12/03 440- 4615T(10 /02/COM/WEB /�
G'/ 6
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
VRESIDENTIAL WORK ONLY : —
Fee for all residential systems combined $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
El Vacuum Systems*
• ❑ Other:
CONIlVIERCIAL 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
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
El 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 CIF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ELC 2OS15 pQ7Q8
Phone: (503) 639 -4171 / / a i lp u b'I��I� 'n( 1 9�17I2005
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' W'!
INSPECTION WORKSHEET FOR DATE: 9/23/2005 TIME: 7: PAGE: 82
SITE ADDRESS: 09t370 FRElMNG ST 060 CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 018 TYPE OF USE:
• PROJECT NAME: CHARLOTTEN HOF APARTMENTS
DESCRIPTION: Reconnect only.
OWNER: FINKE, ALEX TRUSTEE, PHONE #:
CONTRACTOR:
OWNER PHONE #:
Inspection Request Scheduled For: Date: 3 / Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 ; Electrical final 016411 -01 503 - 244 -5824 N
Corrections /Comments /Instructions: •
h
PASS , ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 1 4- ") ---1 Date: �J s � Phone #: (503) 718-
/