Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00272
T.� DEVELOPMENT SERVIC DATE ISSUED: 4/22/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
OULU. PARCEL: 1 S135DC -00500
SITE ADDRESS: 11775 SW GREENBURG RD ZONING: C - P
SUBDIVISION: TIGARDVILLE PARK LOT : 008 JURISDICTION: TIG
Project Description: (8) 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: 7 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:
PENNY, JUDY COCHRAN TICE ELECTRIC
17305 GUSS WAY PO BOX 15009
BEND, OR 97707 PORTLAND, OR 97293 -5009
Phone: Phone: 503 - 233 - 8801
FEES Reg #: LIC 166
Description Date Amount SUP 2586S
ELE 26 -126C
[ELPRMT] ELC Permit 4/22/2005 $93.40
[TAX] 8% State Surcharge 4/22/2005 $7.47 REQUIRED ITEMS AND REPORTS
Total $100.87
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: , CL Permittee 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 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.
04/21/2005 09:24 503 -872 -8290 TICE ELECT.SERV.DEPT PAGE 01
S
Electrical Permit: Application / FOR. OFFICE USE ONLY
City of Tigard R CEI' Y ED R r ed .- / Pamitrro.: ,LQ O0� �L
pates : ' 13125 SW Hall Blvd., Tigard,. OR 97223 Plan Review Other Permit InInspection Line: 503.639,4175 , ,..� t
Phone; 503.639.4171 FaX 503.598.1960 , ; , .9,'. a : : l ` Date/13
APR 21 200 �s :�i pp'' • ` k :_.. Date Beady/By: Fl See Page 7 Car
Internet: www.ci.tigard.or.us , . • • Notified/Method: Supplementallatormation
4?: J;'rRti' •L PLAN REVIEW
1 1 M P 'a s . i r • ' w • Please check all that apply: .
• . ] New constt'1lcdon �, A• it 1• a t • x ,tlor>/rep acelllent
OService over 225 amps, comm'1 OFlazsrdwa location
0 Demolition (0 Other: ' ❑ Service over 320 amps - rating ❑Buildng over 10,000 sq. ft.,
CATEGORY 01? ',CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
• 11:1 1 and 2-family dwellixig 10 Coramercixl/industlial (] Accessory building
0 System over 600 volts nominal units in one structure •
[Building over three stories (]Feeders, 400 'amps or more
❑ Multi-family 0 Master builder. ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or
. JOB SITE INFORMATION "AND LOCATION ❑Egress/lighting plan RV park
❑Health care fatality ['Other: no.; 99. 98.40. lob site address:. '.'11775 SW Greenberg lid Submit 1„ sets of plans with. any of the above.
•
.City /State/ZIP: Tigard' OR • 97223 The above are not applicable to temporary construction service.
6 ' 1C :1 3.e-O Eice ., FEE* SCHEDULE
• Suite/bldg. /apt. no.: Project ltae: buwtguoa qty. f F,, Total I "
• Cross street/directions to job•site: New residential single- or multi - family dwelling dpi..
Includes attached garage.
1,000 s.. R. or less 145.15 . 4
. Subdivision: • • • • • • Lot no.: Ea- add'l 500 sq. ft. or portion 33.40 1
' Limited energy. residential 75.00 2
•
Tax map /parcel no.: . ' Limited energy, non-residential 75.00 2
• DESCRIPTION WORK Each manufactured or modular 1
•
. Remodel office . ' ' dwelling, service and/or feeder '• ' 90.90 • •2
Services or feeders inatallatjmt, alteration, and /or relocation
200 amps or less 80.30 2
20l ant -s to 400am■a 106.85 2
. ❑PROPERTY OWNtR . ' . 0 TENANT 401 amps to 600 amps 160.60 2
• Name: Derrick Hillie .. 601 amps to 1,000 amps 240.60 2
Address! . over 1,000 amps or volts • 454.65 2 • 7i e3- =,- s • s + • Reconnect only 66.85 2
City /State/ZIP: - or • • • ; Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( 503) 244 -7047 2 00 amps or less ' 66.85 1 •
Owner installation: This, ilista11'ation 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 ORB 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
. Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
. ' [j' APPLICANT • • • ❑ CONTACT PERSON . A,. Pee for branch' circuits with
•
service or feeder fee, each • 6.65 2
• Business name; branch circuit .
B. ec for branch circuits •
• Contact name: ' • . witho servi or feede fee, 1 4 6.85 46.85 2
each branch circuit .
• Address:. Each add'1 branch circuit 6.65 46. 2
. City /State /ZIP; , • Miscellaneous (service or feeder not included)
• • Pump or irrigation circle 53.40 2
Phone: ( ) , . . Fax: : ( ) Signor outline lighting 53.40 2
E-mail: Signal circuit(s) or limited- •
CO■TRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Tice . Electric Ca
P D B ox 15009. Each additional inspection over allowable in any of the above
Address: p er inspection 62.50
... City /State/ZtP: Portland OR .97293 -5009 Investigation per hour (1 brmin) 62.50
'Phone: ( 503) 233 -8801' • Fax: (503) 872 -8290 indtutrial pleat per hour 73.75 -
ELECTRICAL PERMIT FEES*
•
. : CC'B Lic.: 166 • ElectricalLie.f 26 -126C Suprv. Lic.: 2586S Subtotal 93.40
. Suprv. Electrician signature, required: / .I / Plan review (25 % a of permit.fee) •
� : State surcharge (8% of pennit fee) . 7.47
• ' Print name: • John - 3. •Maloney . • Date: 4/0 05
TOT a, PERMIT FEE 100.87
Authorized signature: . • This permit application. expires if a permit is not obtained within 180
• days after it has been accepted os complete
Print name: • Date: Fee methodology set by Itt County Bui]ding Industry Service Board
•' Number of inspections per permit allowed.
i :\$nitaiug\'crwit:Q-C- PnmliL .pp.doe 12/03 440- 4015Tl1 t /02/COM/WSn
N
CITY OF TIGARD ,
BOILDING DIVISION PERMIT #: ELC2005-00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/22/2005
Phone: (503) 639 -4171 „Alt _
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/26/2006 TIME: 7:10AM PAGE: 109
SITE ADDRESS: 11775 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 008 TYPE OF USE: •
PROJECT NAME: HILLE, LLC
DESCRIPTION: (8) branch circuits.
OWNER: PENNY, JUDY COCHRAN, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503- 233 -8801
Inspection Request Scheduled For: Date: 4/26/20055 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 005309 -01 603-233-8801 N
Corrections /Comments / Instructions:
n PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A.IL S.r INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: I f ' J Phone #: (503) 718 -
CITY OF TIGARD , . ,..,
BUILDING DIVISION .,A PERMIT #: ELC200S-00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/22/2005
Phone: (503) 639-4171 iiitolltfl
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/28/2005 TIME: 7:42AM PAGE: 78
SITE ADDRESS: 11775 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: HILLE, LLC
DESCRIPTION: (8) branch circuits.
OWNER: PENNY, JUDY COCHRAN, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503-233-8801
Inspection Request Scheduled For: Date: 4/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough-in 005651-01 603-233-8801 N
Corrections/Comments/Instructions:
e_ (ILI
IN s■)) 1.; ,
,
REt1.01(k. El NNL- 1 NI Sri 1 oN .
The electrical installation defects noted
on this report shall be corrected and
an InspeOtion request made within 20
calendar days per OAR 918
PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 7) /,17'-i-1/7c. , ------ Date: V 0 0 Phone #: (503) 718-
.. ~. .
CITY OF ��xm n n��m nn�m��wm��
BUILDING DIVISION ' �
=°~°"~~~°""~~= ~�"~.~~"~~". PERMIT #: ELO2005-00272
13125SVVHaUBkd, Tigard, OR072O3 D�TE|SSUED�� e1/22/2005
Phone: (503) 639-4171 A i
|nopeohonRequests (24Hm.):(SU3)G3Q'4176 -�u�-��
INSPECTION WORKSHEET FOR DATE: 9/7/2006 TIME: 7:02Ah4 PAGE: 61
SITE ADDRESS: 11776 EWSREENBURG RD CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 000 TYPE OF USE:
PROJECT NAME: HILLE, LLC
DESCRIPTION: (8) branch circuits.
OWNER: PBNNY.JUDY COCHRAN PHONE#:
CONTRACTOR: TICE ELECTRIC PHONE #: 6O3-233-8001
Inspection Request Scheduled For: Date: 9V7y2006 Pour Time:
Code Description Confirm # Contact # Message
199 Electrical final 036104'01 503-341'7302 N
Corrections/Comments/Instructions:
• A)
f■ PASS I I PARTIAL APPROVAL El CANCEL I | NO ACCESS
--
FAIL \ I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
� ,�.k
i .
Inspector: K~��' . K-�� Date: C I 1 k��N) Phone#: (503) 718-^�0°