Permit <> CIT 1 OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00535
DEVELOPMENT SERVICES DATE ISSUED: 9/22/2006
"f •- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 BA -02000
SITE ADDRESS: 12353 SW GRANT AVE ZONING: R -4.5
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT : 045 JURISDICTION: TIG
Project Description: Temp Power.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ELITE CARE R & R ENERGY RESOURCES
2300 SW 103RD PO BOX 12564
PORTLAND, OR 97225 PORTLAND, OR 97212
Phone: 971- 506 -0151 Contact #: PRI 249 - 7375
FEES
Description Date Amount Reg #: ELE 26 -696C
[ELPRMT] ELC Permit 9/22/2006 $66.85 LIC 71865
[HRTAX] Hourly 8% State 9/22/2006 $5.35 SUP 28975
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 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 rules or direct questions to OUNC at 503 -24 -6699 or
1- 800 - 332 -2344. /
Issued By: imp � Jr� Permittee Signature: / ' � --- - , C-
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.
,. .. _
t ,, „ ...
lectrical Permit Application FUR 01:11( . 1-: l'Sl 0 NI.)
City of Tigard RECEVED Received p/9
Penult No.: • * ) ...,
, 13125 SW Hall Blvd., Tigard, OR 97223
1, Date/B . f A
Plan Revi ,
' • Phone: 503.639.4171 Fax: 503.5916P 1.
Y, 2 2 2006 Date/B . Other Permit:
GA D
Inspection Line: 503.639.4175 Date Ready/By: liMI El See Page 2 for
TIR
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
• - '-'' ' --' '^ , - 1- - . - • -- ' TYPE f 1014toido,k.i• L'. .... . : ,,,-, , ,r, , -, .,.1::-:'1,' 1 , '17' ..:.- i
New construction
• - - • •••• • - - — 0 •• • • •• • - '• • • - • ' - — Addition/alteration/replacement - — '‘ - • •' •• Plea check all that apply (submit 2 Sets wiitems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
.. .- ...,.,„ . ,.... ..,.,....
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
tAtlE061W,0,0,:ediSi4litl#ION',.:3TeAC ;-: , :e. : '
less to ground, or exceeds 14,000 0 Cornmercial-use agricultural
0 1- and 2-family dwelling IX Commercial/industrial 0 Accessory building snips for all other installations. buildings.
0 Multi-family
' ' '''. bli S 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
' ''
0 Emergency system. larger separately derived system.
' • • ••• ''' ' ` ' "'ITeil4iiiRlii
' '-- .: '-' ' •-•`.-':'-' ' .- --. ,'..; :`,4 _-, . ,A71.10.1",i' - , - ' ,...:-!::,.;:,-.,..:- .
0 Addition of new motor load of
100HP or more. occuprmcy.
Job no.: Job site address: / 7 3 ci.c.
.) 5 c 0 ‘0.4.....+ AO e— 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: -- r e - 1 C' r • q 7- "t- 3 0 Health-care facilities. 0 Supply voltage for more than
4
1-e. . 7
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: 0 Service or feeder 600 amps or more.
''..-.FW
Cross street/directions to job site Description • 1 Qty. I Fee. I Total I .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or iess 145.15 4
Ea. addl 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
Limited energy, residential
75.00 2
. ....'.' . : ! "...:' 7 . '- . ` 1 - ‘ : i*,$ . 01.07 - 1)is.10 , ::* * *K":, : :ne"' .. .... . ... . . . . Li m it e d
with above sq. ft)
-------""
.e..40 0 ,
(S) Limited energy, multi-family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
. 200 amps or less 80.30 2
,.._ ,. . ......, ,..... ,
:,....::::-,:: -. .,f 20,1 amps to 400 amps 106.85 2
Name: 401 amps 10 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
.
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 10 400 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
.' • '':" El ''APPLICANT ."'''''' '`''''' 4 :'''''''? - - ;'''El'Ciii■iiA;CT , .PERSOWI.Y . ;: - .'' . ' • above service or feeder fee,
6.65 2
each branch circuit
Business name: B. Fee for branch circuits
• without service or feeder fee,
Contact name: 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E-mail: . Pump or irrigation circle , 53.40 2
: •"::::::':: ,:-. .:'.i . '..-=',':;:' - -:., - / 7- -:.:*;: , :- ,. - :::::::; :,1•t• ...,,.", :.:;!--,.; . - . , - ,7.... , .: . . Sign or outline lighting 53 40 2
Signal circuit(s) or limited-
Business name: 4 ft, V.
g.- 14/1,1 ge...5 0 Li e c+2-5 energy panel, alteration, or
Address: 2i‘b( ,f)t ii,&,t A/vd. extension. Describe: Page 2 2
City/State/ZIP: p r, .4- _ .t • g 7Z 7.—.., Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (5):03 ) zip.— ei4, ?4 Fax: („coS ) -t-el 1 —6 e 37 Investigation per hour (1 hr min) 62.50
CCB Lic.: -.? 1 ..,,,, 6, ( Electrical Lic.:2(,,-616,c, Suprv. Lic.:Za'qs- 5 Industrial plant per hour 73.75 ,
7 A: . ' .3. • ELECTRICAL PERMIT • -- ..
Suprv. Electrician signature, required: . - Subtotal:
, -/--. _ , -di: .........1
Plan review (25% of permit fee):
Print name: , of „ s ct i , e4 „, Date: c i 7 _ t _ e26
State surcharge (8% of permit fee): 536
Authorized signatu -: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: I I 0 Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
i.\ Building\Pennits \ELC-PermitA.p.doc 1./23/06 • 440-4615 (11/05/COM/W.EI
- 7 ( /19 V
CITY OF TIGARD A
BUILDING DIVISION PERMIT #: ELC2006-00536
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/22/2006
Phone: (503) 639-4171 til\
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/25/2006 TIME: 7:01AM PAGE: 32
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Temp Power.
OWNER: ELITE CARE, PHONE #: 971-506-0151
CONTRACTOR: R & R ENERGY RESOURCES PHONE #: 249-7375
Inspection Request Scheduled For: Date: 9/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 037093-01 971-606-0163
et F"Ip
Corrections/Comments/ nstructions:
•
•
•
•
PASS PARTIAL APPROVAL CANCEL El NO ACCESS
111 FAIL pi CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: 6— * 0 '1/4)61.-S Date: 9 7- No Phone #: (503) 718- Di •
, „