Permit CITY OF TIGARD " , - Vc\'- ELECTRICAL PERMIT PERMIT #:
Ai I , DEVELOPMENT SERVICES ���'
�`� DATEISSUED: 2 /1/2005 2 00818
--�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102BD -00800
SITE ADDRESS: 12630 SW GRANT AVE
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: 200amp serv.10 branch circuits. 2/2/05: Added (1) temp service.
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: 1 W /SERVICE OR FEEDER: 10 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:
ROMAN CATHOLIC ARCHBISHOP OF WRIGHT 1 ELECTRIC INC
PORTLAND I N OREGON 5618 SE 135TH AVE
2838 E BURNSIDE PORTLAND, OR 97236
PORTLAND, OR 97214
Phone: Phone: 503 - 760 - 8522
Reg #: LIC 97757
SUP 3398S
FEES ELE 3 -332C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/1/2005 $146.80
[TAX] 8% State Surcharge 2/1/2005 $11.74 Elect'I Service
[ELPRMT] ELC Permit 2/2/2005 $66.85 Rough -in
(additional fees not listed here) Elect'I Final
Total $230.74
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 NC at (503)
246 -6699 or 1-800- 332 -2344
Issued By: � Permit 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 639 -4175 by 7:00pm for an inspection the next business day
C ITY OF TIGARD ELECTRICAL PERMIT
K PERMIT #: ELC2004 -00818
mil'' DEVELOPMENT SERVICES DATE ISSUED: 2/1/2005
-`-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102BD -00800
SITE ADDRESS: 12630 SW GRANT AVE
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R-12
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: 200amp serv.10 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: 1 W /SERVICE OR FEEDER: 10 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:
ROMAN CATHOLIC ARCHBISHOP OF WRIGHT 1 ELECTRIC INC
PORTLAND IN OREGON 5618 SE 135TH AVE
2838 E BURNSIDE PORTLAND, OR 97236
PORTLAND, OR 97214
Phone: Phone: 503 760 - 8522
Reg #: LIC 97757
SUP 3398S
FEES ELE 3 -332C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/1/2005 $146.80
[TAX] 8% State Surcharge 2/1/2005 $11.74 Elect'I Service
Rough -in
Total $158.54 Elect'I Final
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- 332 -2344.
Issued By: Permit Signature:
OWNER INSTALLATION 0 '
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 639 -4175 by 7:00pm for an inspection the next business day
i� ;
Electr ''ermit Ap 1 FIVE® * ,1 .„- .. „ �, ' ' . , r.*' F OR OF FICE U SE ONL Y it �+4 ; 1 q
C of T ed Reeerved y� hemtit \t, ��� ���j �j�
Date /Bv ��,,)4 4 7 JS.� u/t/ / - 06/�
13125 SV 01 d , Tigard, OR 97223 DEC LUu P lan Re.ie,s / /
Phone 503 639"4171 Fax 503 598 1960 ��� + _eli'ii Date/By Ocher Feiner .N)9 r/ .0O -2-
Inspection One 503 639 4175 CITY O Ilafp � ,1�.;i �� Date Reudy'Be 0 See Pat, e 2 er'
Internet www Cr tigard or us BUILDING DIVISION Notified /Method / <- Supplemental Inio, illation 1
TYPE OF WORK a (I PLAN REVIEW
New construction ❑ Addition /alteration /replacement Please check all that apply
t
❑ Demolition ❑ Other ❑Service over 225 amps, conn'I ❑I lazarduus lu aeon
EService over 320 amps - rating ❑Builcing over 10,000 sy it -
CATEGORY OF CONSTRUCTION of I- and 2- tamely dvvellntgs 4 or more mess residential
El 1 - and 2- family dwelling ❑ Commercial /industrial — '10 Accessory building ❑System over 600 volts nominal units in one structure
❑Buildin over three stories ❑Feeders• 400 amps or more
❑ M ulti- family ❑Master builder ❑ Other.
❑Occupant load over 99 persons ❑ Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no Job site address ['Health-care facility ❑Other
( 03 b SVNj COQ Kr Ate Submit 2 sets of plans is Mt any of the above
City /State /ZIP' - 1 — FG, A lax„ ces ' 2`L3 The above are not applicable to temporal consu ut.mon scr vise
J FEE* SCHEDULE
Suite /bldg /apt no Project name l _ n
N/ 1 °z+SUJ Descnpnon I Qt, l Ise total f
Cross street/directions to job site. S \\/ q j t I I x^101•1 New residential single - or multi - family dwelling unit.
Includes attached garage. ___--,- !!Z
..y 5\v cr) c-- .14, 1-c... 1,000 sy tt or less 145 1 .
Subdivision Lot no 43CAD Ea add'I 500 sy It or portion 33 4u 1
Limited energy, residential 75 00 2
Tax map /parcel no. 2 S I ., oz_ gD Limited energy, non - residential 75 00 - '
DESCRIPTION OF WORK Each manufactured or modular
ST d welling, service and /or feeder 90 90 2
�hl 2 ' � 00 r ) �� �"I p..„5%-6 t ix., Services or teeders installation, alteration, and /ot relocation
200 amps or less / 80 30 ,90 2
--- PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85
401 amps to 600 amps 100 60 I 2
Name �C Talowc... digl SHmc , e ) F r t ,o t4 ('1„� _ l 601 amps to 1,000 amps 240 60 2
Address - ' 3 8 E S I �� ���Q Over 1,000 amps or volts 451 65
Reconnect only 66 85 2
City /State /ZIP `P� LL .,, KO ^s C a) '72l 1-- Temporary services or feeders installation, alteration, and /or
Phone: ('Q3) c....3,0) -4( 7°) Fax ($5 ) G1:1 4 ^2.3cc, relocation
200 amps or less 66 85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 30 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 401 amps to 600 amps 133 75 I
Owner signature: Date Branch circuits - new, alteration, or extension, per panel
- "ill APPLICANT --- CONTACT PERSON A Fee for branch circuits midi ,
service or feeder fee, each
Business name: s.T. IN\ KrWOCy--P FA branch circuit / 0- 6 65 A 57
B Fee for branch circuits
Contact name
�n13 . KLASS pH 5 3 - 6 o - 71 C without service or feeder tee, 46 85
°,�Q S \V MC. .y(-5ti =1 Each a branch branch chc
Address it
� � E ach add'I branch circuit 6 GS _
City /State /ZIP - 17c04y+2a 9 C)_ 'D' 223 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53 40 I )
Phone: (.563) c.,3°) - -4-1 Fax (50' ) e.02g- 2 3Gq - ,
Sign or outline lighting 53 40 2
L E - mail Signal encuit(s) or limited
F D �
cwxid r � - energy panel. alteration, or
T�d l�p1'� �� - -�- - extension Describe Page 2 2
l ., . _.� _— __.._....... Each additional inspection over allowable in ant of the abosc
I_ Cl t y.'s?ita/ZIPt pA x . R ..., ~ ��� - _,_.._,. .... .. Per inspection 62 I I
Phalle ) Fi x: -- 6 \ c6 Investigation per hour (1 hr min) 62 50 I
^ l • Industrial plant per hour 73 75
I (tt'c 1��� I ElcuttWi Lrc.. $e>ifi • ELECTRICAL PERMIT FEES*
Sl :lynv;, @ Ieetfl r{4tt Zt�lltti3 4.444& Subtotal 1446" - 6,D
p°■ �G :• P'
Q. ry T . � I 4o• \g ;p. )-61 (0A/07 Plan ieviev, (23 of permit fee)
sv 1
--- State surcharge (S'% of permit fee) �1
■
1C'41106etFurc, TOTAL PERMIT FEE /6 5
i Qfiin� e i This permit application expires if a permit is not obtained , tuhnr i SO
---- , "'—_.— ^ dass after it has been accepted as eomplete
. hvdo nu I'.,rmovIl scoop Joc i_m, r. ' : ' •• i I ' Fee methodoioe> ,et by Tri-County Building Indu,trs Sen. rte Boat2
' -- Number of rn,pecuon_, per permit allo,sed
3
I
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning
System*
f .Vacuum Systems*
Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
[1 Boiler Controls
[ I Clock Systems
n Data Telecommunication Installation
P1 Fire Alarm Installation
HVAC
P1 Instrumentation
n Intercom and Paging Systems
Landscape Irrigation Control*
n Medical
I I Nurse Calls
Outdoor Landscape Lighting*
I Protective Signaling
Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I ABuddingVPermus' EEC -Pen nut App doi 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2004 -00818 .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2006
Phone: (503) 639 -4171 �mne4P�u�pfil`�\
Inspection Requests (24 Hrs.): (503) 639 -4175 _�.'
INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:08AM PAGE: 106
SITE ADDRESS: 12630 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 009 TYPE OF USE:
PROJECT NAME: ST ANTHONY
DESCRIPTION: 200amp serv.10 branch circuits. 212/05: Added (1) temp service.
OWNER: ROMAN CATHOLIC ARCHBISHOP OF, PHONE #:
CONTRACTOR: WRIGHT 1 ELECTRIC INC PHONE #: 760 -8622
Inspection Request Scheduled For: Date: 3/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002479 -03 603 - 700 -8837 N
Corrections /Comments /Instructions:
I JA
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: AL/IA- 1- t/o
/ Date - :0 --C7 Phone #: (503) 718-
6