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Permit CI TY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00537 �., DEVELOPMENT SERVICES DATE ISSUED: 9/22/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101AC -00900 SITE ADDRESS: 07128 SW GONZAGA ST 230 ZONING: MUE SUBDIVISION: PAHLISCH /GONZAGA PROFESSIONAL LOT : 015 JURISDICTION: TIG Project Description: 1 branch circuit. 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: 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: PHIL GENTEMANN DEXHEIMER ELECTRIC INC 7128 SW GONZAGA SUITE 100 10639 SE FULLER ROAD TIGARD, OR 97223 PORTLAND, OR 97222 Phone: 503 - 620 -2047 Contact #: PRI 503 - 786 -0886 FAX 503- 786 -2040 FEES Description Date Amount Reg #: ELE 26 -32IC [ELPRMT] ELC Permit 9/22/2006 $46.85 LIC 43935 [TAX] 8% State Surcharge 9/22/2006 $3.75 SUP 25145 Total $50.60 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 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 -1010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: / Permittee Signature• `���, ;'t 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) E C E NE D Received - FOR OFFICE USE ONLY • . City of Tigard s� Date/B . �� a 06 Permit Noia4)0) +0 4 14 q 13125 SW Hall Blvd., Tigard, OR 97223 E P 2 2 2006 Plan Review G ' ' Phone: 503.639.4171 Fax: 503.598.1 Date/B - Other Permit: T7 G A It D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: IIIM ® See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information . TYPE OF WORK • PLAN REVIEW • ❑ New construction . Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I - and 2- family dwelling cErCommercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or . ❑ Emergency system. larger separately derived system. JOB SITE. INFORMATION AND LOCATION ❑Addition of new motor load of ❑ "A ", `T ", "1 - ", "1 -3 ", • Job no.: Job site address: ' . , 100HP or more. occupancy. _ 1O > ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: / ) p� ) ?' 4; 4; ' w 60 ❑ Health -care facilities. ❑ Supply voltage for more than •(1 ( V t - /�� ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: S Project name: Go,,, . Tr' ❑ Service or feeder 600 amps or more. FEE. SCHEDULE • Cross street/directions to job site: �2 ^6 S-{ , Description I on. I Fee. I Total I / New residential single - or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 • .DESCRIPTION OF WORK (with above sq. ft.) ,^ 1 Limited energy, multi- family 75.00 2 • 7. ,,-....1 .- S residential (with above sq. ft.) 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 Name: pt„ r I G L/1. �„.., A . n/.1 401 amps to 600 amps 160.60 2 / 601 amps to 1,000 amps 240.60 2 Address: ' ' S (n/ / et) n - tar St , 5 ft- /U i) Over 1,000 amps or volts 454.65 2 City / State/ZIP: 'j , v-' / 6 (e- q 71-23 Temporary services or feeders installation, alteration, and/or relocation . • Phone: (tti3) �) 10 3- Fax: ( 91) C. - Z�% .3" 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 599 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with '0 APPLICANT CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 • Business name: - n a ) f I �r (4 /t vL B. Fee for branch circuits L j�/ Contact name: without service or feeder fee, 46.85 �( A 2 (hr' „1/4_ / u y. (Gat first branch circuit Address: SL✓ Gl)v\ S /s- �fi - S�./ Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: A 7 o r` age v \ X 1 7. ZZ 3 Each manufactured or modular 90.90 2 dwelling, service and/or feeder . Phone: (c1)3) 6 , -Zd F a x : : ( ) ( C 2_0 - Z Z g .a- Reconnect only 66.85 2 E -mail: A 6 n w e..-#1 - f l^/7AA C%/In.< - -S . "V.-'1' Pump or irrigation circle 53.40 2 CONTRACTOR -, Sign or outline lighting 53.40 2 Business name: 6 (/ >,,,, j� r ei or li or � v "� L / r L energy panel, alteration, or Address: (0 6 ? S C7 Fn ! I.l.✓' extension. Describe: Page 2 2 . • City/State/ZIP: - 7 8 / ' G , - 01. 4j 7-2:7_/-2-- Each additional inspection over allowable in any of the above O 1 6 VV Fax: (' 3 ) - 9-8 6 - Z © e! 7 Per inspection 62.50 (ev . T p (. Phone: `a � Investigation per hour (1 hr min) 62.50 • CCB Lie.: Electrical Lie.: ? Suprv. Lie.: Industrial plant per hour 73.75 �� ` ) 4 p �/ �� ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: L( ( - 3 } Print name: Date: Plan review (25% of permit fee): State surcharge (8% of permit fee): 5.1s Authorized signature: TOTAL PERMIT FEE: 50, t'Ov • This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05/COM/WEB /0 /..PL, Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: FRESIDENTIAL _ 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 $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ C lock Systems ❑ Data Telecommunication Installation . . • ❑ F ire 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\Pe nits\ELC- PertnitApp.doc 0323/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC200G -00537 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9//22320Ce Phone: (503) 639 -4171 pu �j Inspection Requests (24 Hrs.): (503) 639 -4175 ...'� '. INSPECTION WORKSHEET FOR DATE: 10/2E12006 TIME: 7:03AM PAGE: 34 SITE ADDRESS: 07128 SW GONZAGA ST 230 CLASS OF WORK: SUBDIVISION: PAHLISCH /GONZAGA PROFESSIONAL LOT #: 015 TYPE OF USE: . PROJECT NAME: EMPLOYEE BENEFITS DESCRIPTION: 1 branch circuit. OWNER: GENTEMANN, PHIL PHONE #: 50:3 -620- 2047 CONTRACTOR: DEXHEIMER ELECTRIC INC PHONE #: 603 -7136 -08186 Inspection Request Scheduled For: Date: /0/2512006 Pour Time: Code # Inspection Description Confirm # Contact # Message ' 199 Elec:t.rical final 038812-02 503-754-6001 Y (2,..- • Corrections /Comments /Instr .tions: AM x PASS PARTIAL APPROVAL n CANCEL I NO ACCESS I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ° N66(.. Date: 143 0 6 Phone #: (503) 718 2 4. 0- CITY OF TIGARD BUILDING DIVISION A PERMIT #: ELC2006-00537 _ . 13125 SW Hall Blvd., Tigard, OR 97223 DATE (SSUED: 9/22/2006 Phone: (503) 639-4171 havidtp0 1 it Inspection Requests (24 Hrs.): (503) 639-4175 _481- 4 1 _- INSPECTION WORKSHEET FOR DATE: 10/5/2006 TIME: 7:00AM PAGE: 40 SITE ADDRESS: 07128 SW GONZAGA ST 230 CLASS OF WORK: SUBDIVISION: PAHLISCH/GONZAGA PROFESSIONAL LOT #: 015 TYPE OF USE: PROJECT NAME: EMPLOYEE BENEFITS DESCRIPTION: 1 branch circuit. OWNER: GENTEMANN, PHIL PHONE #: 503-620-2047 CONTRACTOR: DDOIEIMER ELECTRIC INC PHONE #: 803486-0886 Inspection Request Scheduled For: Date: 10/5/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 037736-02 503-754-6001 N Corrections/Comments/Instructions: 4Z I PM• 1 3‘•) 1 Zia S ox 6 N APASS PARTIAL APPROVAL CANCEL I I NO ACCESS EI FAIL 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G .-- . N tse k.-1 , Date: 0151 0 Phone #: (503) 718- 1 44k) _ . . . CITY OF TIGARD - BUILDING DIVISION PERMIT #: ELC2006.00637 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2005 Phone: (503) 639 -4171 , /oi�itomgt l- Inspection Requests (24 Hrs.): (503) 639 -4175 ':' �. INSPECTION WORKSHEET FOR DATE: 9/29/2006 TIME: 7r.O6AM PAGE: 64 SITE ADDRESS: 07128 SW GONZAGA ST 230 CLASS OF WORK: SUBDIVISION: PAHLISCHIGONZAGA PROFESSIONAL LOT #: 015 TYPE OF USE: PROJECT NAME: EMPLOYEE BENEFITS DESCRIPTION: 1 branch circuit. OWNER: GENTEMANN, PHIL PHONE #: 503-620-2047 CONTRACTOR: DEXHEIMER ELECTRIC INC PHONE #: 503.,785 --0886 Inspection Request Scheduled For: Date: 9/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 037375.04 503.754 -5001 Y Corrections /Comments /Instructions: 9 At i 12 4 OoJ ''i1D {J, I Cif �A N w6 CAS h( A1,L.e WA e f •oSsD PAY 334.,12. 0)Q0 , PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS >21' FAIL A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G-. 036 6 La. Date: 9' • 6 6 Phone #: (503) 718- 2400