Permit ,'. FR
CIT OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00232
COMM DEVELOPMENT DATE ISSUED: 4/12/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135BC-00201
SITE ADDR ESS: 1 0763 SW GREENBURG RD 100 ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: 7-11
Project Description: 5 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: 4 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:
BELANICH, ROGER M BECK ELECTRIC INC
BY SOUTHLAND CORP 15600 SE FOR MOR CT #8
PO BOX 711 CLACKAMAS, OR 97015
DALLAS, TX 75221
Phone: Contact #: PRI 503 - 656 - 7396
FAX 503 - 656 -4397
FEES
Description Date Amount Reg #: ELE 3 -5C
[ELPRMT] ELC Permit 4/12/2007 $73.45 LIC 2629
[TAX] 8% State Surcharge 4/12/2007 $5.87 SUP 5024S
Total $79.32 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 503.246.6699 or 1.800.332.2344.
Issued By: j i d . ! ■ / / ` ? ? Permittee Signature: /j��/J -�,Q
' r
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.
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1107 1 1 : 2 2 a p . 2
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Bran Review
?,, Electrical Permit Applicatral,., : .,. - . '-:.:.., ' :FOR OFFICE USE ONLY
V ' , . • '
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City of Tigard
" 13125 SW Hall Blvd., Tigard,
I
11 , . 5009982 ULI IIP It Mel to ?
,
Date/By: Pennit Not _ iii - 7 -... ezy 2,3
r Phone: 503.6394171 Fax: .5
Other Permit:
, TIGAREi Inspection Line: 503.639.4175 APR i 1 2007 6,2„. Date Ready/By: Jurigi■ 10 See Page 2 for
• Internet: www,tigard NoLified/Method: I Supplemental Information
,.... -. -- .:•1. -. 1: ::.. • ' '-''':,- - • ' :,• : ...:. TYPE Cli, F - 2. :' .. :. " :"...' ''' - -:. - ' : :' - . - : - '1:...'' . :: ;'':3 :- :"';,',.' !."...'.......:,•,•:.:..]:,.:: -
[1] New construction IX AddiRMT-Viy,Ftkcp4VONe Please check all that apply (submit , sets of plans w/iterns checked below).
/ I " l 1 frtinVIIIN • 9 Service or feeder 400 amps or more 0 Building over three stories.
C.I Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
-' • '.:-. '''''-''''''''':'..: -.,;':- '':: eAti6611V: ;ONSTIcI.IjeffO14•. ''' ':'" ''. exceeds 10,000 amps at 150 volts or 0 Floating buildini, .
less to ground, or exceeds 14,000 0 Comrnercial-use agricultural
0 I - and 2-family dwelling 0 Commercial/industrial EI Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder El Other: 0 Fire pump. 0 Installation of 75 KVA or 0 Emergency system. larger separately derived system.
‘• . -.. •.: ‘....:' 1:! . .,J013 SITE :'1.1 Asi.j .,. ,::::.: .::::.,.::.,:::::.,..-- ' ..' 0 Addition of new motor load of
IODHP or more, occupancy.
Job no.: izgi I Job site address: I Di t 31A) G r ent\ 6,,o(c., J 1:1 Six or more residential units. 0 Recreational vehicle parks.
• City/State/Z1P: .- click 0 l e__ 11223 D Health-care facilities. El Supply voltage for more than
El Httzardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 1 name: - 7- ( t - -.-6ive_.- 0 Service or feeder 600 amps or more.
.
Cross street/directions to job site: Description r Qty. l Fee. I Torn! I
New residential single or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. addl 500 sq. It. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
... .- 75.00 2
.- T:;:ii::::;::.;:t:'g (with above sq. ft)
Limited energy, multi-family
;- 6 1 K-e-• -R.12... 1:MOCiaL-- residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 I 2
'..•::;- :,!:: ty,mcii,Ekr*.ow/4R:::. ::::::.:;-;;;,.,.::::::=A;:::.,::.1: ci; TENANT .: : 201 amps to 400 amps 106.85 2
_
Name: • 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps . 240.60 2
Address: Over 1,000 amps or volts 454.65 . 2
Ci /State/ZIP: Temporary services or feeders installation, alteration, and/or
ty
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 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
Branch circuits - new, alteration, or extension, per panel •
Owner signature: Date: A. Fee for branch circuits with
LF.AfttiteAt■it::::::::i1:::: :.1 q , cis: r',: above service or feeder fee,
. . ... .. . ... . ... .... ..
..... .. ... . ... 6.65 2
..
each branch circuit
Business name: B. Fee for branch circuits
c ,,,--
without service or feeder fee I 46.85 Lila - 6‘ 5 2
Contact name: first branch circuit
Address: Each add'I branch circuit . - 1 - _ 6.65 21 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 • 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
tONT1Ael'.0Tngt-nit'a:):::4.!:!•.-1';;;;;!,:il . Sign or outline lighting 53.40 2
Business name: ' a e,C*-: 1 -- --7 - L eC A YI (--' Signal circuit(s) or limited-
energy panel, alteration, or
Address: y5 00 SE. Po a. imo- cr '*-.. extension. Describe: Page 2 2
City/State/ZIP: C1 C.4..C.... WI Ci_S 0 k... 9 70 l S , Each additional inspection over allowable in any of the above
, 1 Per inspection 62.50 _ _
Phone: (52)3) I --/ .C. Fax: ( .) ) i Si 1 investigation per hour (1 hr min) 62.50
CCB Lie.: i Electrical . c.: 3--S,CL,.. _ Suprv. Lic.: 507-i-C. Industrial plant per hour 73.75
'.. ii,
Suprv. Electrician signature, required: Subtotal: -- . 45:
1 . , , ..... Plan review (25% of permit fee): • .
Print name: 0_,Iick r - Itc 0040'A I. Date: ti. i t j 6
/ AM State surcharge (8% of permit fee): 3 cc 1
Authorized signature.i
)e./e, I . TOTAL PERMIT FEE: 79 . 3 2_
. i This permit application expires if a permit is not obtained within 180
Print name: CIAC:r ---e:iCtVVf\‘'S Date: Lt. i I 01
days after it has been accepted as complete.
•
• Number of inspections allowed per permit.
I: \Building \ Permits \ ELC-Pcrmit App.doc 05/23/06 440-4615T( I 1/05/COM/WEB - •
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00232
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41/2/2007
Phone: (503) 639 -4171 Am�ulwgulp
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7 :00AM PAGE: 60
SITE ADDRESS: 10763 SW GREENBURG RD 100 • CLASS OF WORK:
SUBDIVISION: LOT #: _ TYPE OF USE:
PROJECT NAME: 7 -
DESCRIPTION: 5 branch circuits.
•
OWNER: BELANICH, ROGER M, PHONE #:
CONTRACTOR: BECK ELECTRIC INC PHONE #: 503 - 666-7396
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Co ' irm # Contact # Message
100 Electrical final 046670 -01 503- 312 -7380 \ Y
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANC ❑ NO ACCESS
AIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector,: Q Date: '1. (1/09 Phone #: (503) 718- Tilik)