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Permit .� CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00749 7 ij') DEVELOPMENT SERVICES DATE ISSUED: 12/31/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126DB-02800 SITE ADDRESS: 09370 SW GREENBURG R '205 SUBDIVISION: PP1991 -018 ZONING: C -P BLOCK: LOT : 001 JURISDICTION: TIG Project Description: Install 4 branch circuits. 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: 3 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: FRANKLIN COMMONS ASSOCIATES HILLSBORO ELECTRIC BY NORRIS + STEVENS 21185 NW EVERGREEN PARKWAY 520 SW 6TH STE 400 HILLSBORO, OR 97124 PORTLAND, OR 97204 Phone: Phone: 503 - 439 - 9666 Reg #: ELE 34 -433C LIC 134481 FEES SUP 4941S Description Date Amount Required Inspections [ELPRMT] ELC Permit 12/31/03 $66.80 [TAX] 8% State Surcharge 12/31/03 $5.34 Rough - Elect'I Final Total $72.14 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) 246 -6699 or 1-800-D2-2344. ��� Issued By: - c j La. e _ a 4(20(A_, Permit Signature: G- �� a / r� i.Z�i j � r)1 • 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: y G / N/ 5 Call 639 -4175 by 7:00pm for an inspection the next business day From :HILLSBOR0 ELECTRIC LLC. 5036013680 12/29/2003 17:51 #602 P.001 z hOR O1■'1�iCE USE, ONLY Elee t h eal Permit Application Received., Electrical Date/B : A,09 o?.? Sail Permit No, :E�4: 3 —49 CitY Of Tigard Planning Approval U ' ' Sign Date/B : Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/13 : Permit No.: Phone: 503 - 639 - 4171 Fax: 503 - 598 - 1960 post - Review Land Use /'' !:'164:111 ' 'dl 's Date/By: Cast No.: Internet: www.ci.tigard.or.us — t s Contact Juris.: � See Page 2 for 24 - hour Inspection Request: 503 639 - 4175 - - Name/Method: Supplemental information. .. TYP.E WORK .. t..,.:':- :'PLAN.REVVEW' Please check ill ■ New construction Demolition ■ Service over 225 amps- ■ Health-care facility commercial ❑ Hazardous location Addition/alteration/replacement Other: Se rvice over 320 amps-rating of Building over 10 000 square feet ❑ P S ❑ g 9 feet, • CATEGORY : OF CONSTRUCTION ' ' ';' '. I & 2 family dwellings four or more residential units in ❑ I & 2- Family dwelling ❑ Commercial/I ddustrial ❑ System over 600 volts nominal one structure ID Building over three stories ❑ Feeders, 400 amps or more ❑ Accessory Building ❑ Multi-Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park El Master Builder © Other: ❑ Egress/lighting plan Q Other: :' .:• i,, :„ , ... J013. SITEINFORMATQN �OC�#,�'x01!F; '�;', ,;:., ,:., Submit sets ofplans with any of the above. :i= ..y. ::.. The above are not applicable to temporary construction service. Job site address l o Su+1 � WkA RA . ; ' :', �. .gi,. : ; . ': �k+'�:;:SG�IDTJLE'.:- :"i:,�i 4 =i Suite #: " • _ J Bld . / /A.t. #: Number of inspections per permit allowed Pro'ect Name: m rI asimft.A�_-aa1. Description I Qty Fee (eel j Totat Cross street/Directions to job site: New residential- single or mull - family per dwelling unit. Includes attached garage. L' -At 1 Y & i' 4 C ` . , J y ,) gt �a , Service Included: — t t ( � � "' 1000 sq. •ft, or leas 145.15 i Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: LOt #: Limited energy, residential 75.00 : Limited energy, non residential 75.00 : Tax map /parcel #: Each manufactured home or modular dwelling a = .7 ; ir: r' •:<<�: t;1,�; ' service and/or feeder 90.90 2 '_ Lr> . : . � . ���bL' SCRIP`tIO�N,iOF..`.'•�?1rld�; d�at''� . ,:.. ..�':" �:',:.�: , t Services or feeders - Installation, alteration or reiocation: 200 amps or leas 80.30 , 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 ,PR.o ,,ER `,OWNER.'„ ...? :i,l <r. ®,TENMi'F "ic;;t'^`':;.; : r: ;l^ - 601 amps to 1000 amps 240.60 2 Over 1000 amps or volts 454.65 2 Name: Reconnect only 66.85 2 Address: Temporary services or feeders - installation, alteration, or relocation: City /State 200 amps or less 66.85 1 Phone: Fax: 201 amps to 400 amps 100.30 2 «, .::;. , 401 to 600 amps lif.75 2 !'l " ;'l. ';Pti0. 1Y:xs; , ; I;CONT.Aer;, 1CSON!-,.;a ; ,: - :, 1 - : Branch circuits -new, alteration, or Name: X1\ t �:t : f l'rr to LL.C. extension per panel; Address: �11_ j (ry r X11) ( i'l A. Fee for branch circuits with purchase of 6.65 2 i l - service or fie, each branch circuit Clty/Statezi r j w - yD l� B. Fee for branch h c ci rcuits without purchase of ��''` `.++ �� � " service or feeder fee, first br anch circuit __ 1 46.85 4"lrt_. 5 2 Sot Phone: gLk.4.p ax: S . Le DI - 310 Bach additional branch circuit a 6.65 19,olP 22 E -mail: Misc.(Service or feeder not included): ..d, , ",i; 5 R:. , j :.�tA 1, j! '�A`'�� ,..,• Y}����''� ^/�r7+'Yi il " . .1. ., . . ti;c:; _ :; 6' Each pump or irrigation circle 53.40 2 ..2s:, .A..iv*: .!::,.;:.s...41 4 L1.. sc.11 N:I.T 1i,; :.: : :. .. f ` ; "; ,' Each line iiRhtln 53 - " � � e a atpn or out & .40 2 Job No: Signal circuit(s) or a limited energy panel, Business Name: HI /1.560,-.0 E t rd-r u . LL.L• , alteration, or extension Page 2 2 Description: Address: 071VR5 ' N I " ENeve cr i-an Pk+N Y • I I ID City/State/Zip: �� t l \Shx�cc� cS? . � �c � Each additional Inspection over the allowable in an,of the above: Per inspection per hour (min. 1 hour) 62.50 Phon . . - X - 0 Investigation fee: CCB Lic. #: 4 a L 1 other y�� 1 '--� I Lie. - shy 1 "« �1G :k,': E'ie. :tiiiia;permierriii '�i ;o: ^to: : ,, - : ;; ' ;•!; + Supervising electrician �'. f:'•:_r. . < •'.,C�' Su p g � - f / ` "' S ubtotal $ (1(.81?!-D— signature required: �V W"L Plan Review (25% of Permit Fee) $ Print Name: 54 \J j ..co I Lie. #: Ary.415 State Surcharge (8% of Permit Fee) $ C 5 , ' , 3+_____ ............_.......—•-----........._.-........._......_.._........_.__.._........-----...._._..._..__._....._...._ ................_..........._...........-'-----....._............._._...,.....__....._......__.-------- ---- -- TOTATRa7!R . MT _ T - FRx' _.. C ____- ......_ '?_.._1/i- Authorizes Notice: This permit application expires if a permit is not obtained Within Signature: Date: 180 days after It.has been accepted as complete. "Fee methodology set, by Tri- County Building Xndustry Service Board. (Please print name) is \D9t9\Permlt Forms\ElcPermitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested Z - /d AM PM BUP Location 6 !r11 dI ��1=! Suite 2 t' MEC Contact Person i . Ph (? 7/ / 7 - 8 70 7 PLM Contractor ---4111-/A4/9 d e C* /c, Ph ( ) SWR BUILDING Tenant/Owner ELC DU 7 7 Footing Foundation ELC Access: Ftg Drain l- �/ �- �- ELR Crawl Drain ` ��/� - Slab Inspection Notes: ei a SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear ( (� I Framing 1 I;� �' 1 1. Insulation Drywall Nailing Firewall �` \ (4 U � Fire Sprinkler - \ Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab nn Low Voltage A/a E L Fire Alarm PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 0 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line Dat q ADA Approach /Sidewalk Other: e Inspector / ' r C/ ✓ o / =L ��/� � � /J Ext (� Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL