Permit •
ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2006 -00229
,,;, °R.' DEVELOPMENT SERVICES DATE ISSUED: 4/28/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102CB - 03400
SITE ADDRESS: 10055 SW GARRETT ST 14 ZONING: R -12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
Project Description: Electrical reconnect.
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:
ALEX & LOT FINKE
PO BOX 23562
PORTLAND, OR 97223
Phone: 503 - 244 - 5824 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 4/28/2006 $66.85
[TAX] 8% State Surcharge 4/28/2006 $5.35
Total $72.20 REQUIRED ITEMS AND REPORTS
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 mor an 180 . ATTEN N: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth i OAR 952 - 001 -0010 thr gh OAR 952 -001 -0100. You may obtain copies of these rules or direct questio - e - - at 503 - 246 -6699 or
1 -800 332 -2344.
Issue B 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.
Electrical Permit Application FoR 0FTICl usE.0NIA
f#.
u Received
City of Tigard Date/By: Permit No.: r- ° r • , / q
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
1 ®: Phone: 503.639.4171 Fax: 503.598.1960 • Daze /B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard- or.gov 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'I ❑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 0 Feeders, 400 amps or more
❑Occupant load over 99 persons OManufactured structures or
JOB SITE ❑E
: Egress/lighting p
'INFORMATION ' AND LOCATION ° RV park
J
6 Job no.: ,4 Job site address: /1.00-6 /1.00-6 lei 6 { ( � ❑Health -care facility ❑Other:
!!!! Submit 2 sets of plans with any of the above.
CitylState/ZIP: t 1 ' yn� ,� The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Pro name: CG�� , ' w/ ° �2 e F EE* SCHEDULE'
Description I Qty. I Fee. I Total
Cross Street directions to job site: r - �� ( f New residential single- or multi - family dwelling unit.
�' v v 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 I
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
,PROPERTY OWNER . - - ❑ TENANT 201 amps to 400 amps 106.85 2
1 ' 401 amps to 600 amps 160.60 2
Name: / - / 'A �C 601 amps to 1,000 amps 240.60 2 -
Address: / 6 C'7 /7- /��Z L �_%
,9 2 5 3 J d/ � / Over 1,000 amps or volts 454.65 G
/ Reconnect only -- 66.85/ (9 v 5 2
City /State /ZIP: i /' (2 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (5-63) 0 2 -- 5 - e j / � Fax: ( ) 200 amps or less 66.85 1
Owner installation: This inst lation is / / / bei • II •. e on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, r , r ch. _. • -, • 4.rding to • RS 447, 449, 670, d 7 1. / 401 amps to 600 amps 133.75 2
Owner signature: i Date: � J!/ Branch circuits — new, alteration, or extension, per panel
' APP - ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: n ' branch circuit
/ y /1 - 55—,/ B. Fee for branch circuits
Contact name: `^' t/ 1 v / without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 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
extension. Describe: Page 2 2
Business name:
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Investigation per hour (I hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES *•,,
CCB Lic.: Electrical Lic.: Suprv. Subtotal: �j i, )
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Date: State surcharge (8% of permit fee): 5 . ✓J
TOTAL PERMIT FEE '7 ,aC)
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
rr Number of inspections per permit allowed.
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 440- 4615T(t t/05 /COM /WEB
•
Electrical Permit Application - ('ity of Tigard
Page 2 - Supplemental Information ~ �'
LIMITED ENERGY PERMIT FEES:
RESID 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 WORB.ONLY:
Fee for each commercial $75.00
system
(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
1:\ Building \Permiu\ELC- PeimitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #:'Fa,LZ opt. 00229
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 41714l��ii�k�t��I�
Inspection Requests (24 Hrs.): (503) 639 -4175 =� — :_.. •
INSPECTION WORKSHEET FOR DATE: S.- l - ( TIME: PAGE:
SITE ADDRESS:IO 55 SW GNctaz• t1 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: S 1, -6b Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructio :
Jj,PASS ❑ PARTIAL APPROVAL P CANCEL ❑ NO ACCESS
'❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NiWt L Date: S / J 6v Phone #: (503) 718 - Vi Lit