Permit . re
41,
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00744
DEVELOPMENT SERVICES DATE ISSUED: 10/4/2005
�. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 DA - 00100
SITE ADDRESS: 12970 SW HALL BLVD ZONING: I -
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Code correction to existing feeder.
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: 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:
MAGNO, LLC THELMA HUMPHRIES 3D ELECTRICAL SERVICES INC
8800 SW COMMERCIAL ST. PO BOX 173
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: Phone: 503 - 657 - 9173
FEES Reg #: ELE 3 - 460C
L1C Description Date Amount SU 1478
SUP 44785 S
[ELPRMT] ELC Permit 10/3/2005 $80.30
[TAX] 8% State Surcharge 10/3/2005 $6.42 REQUIRED ITEMS AND REPORTS
Total $86.72
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 -80 2- 4.
Issued By: A2.�., Permittee Signature: 37 c .2 2.1 (
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:
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.
OCT -01 -2005 SAT 02:58 PM P.002/002
Electrical cal Permit A t OR O I FICIl: usu. ONI.V
City of Tigard P CT 3 2005 bat d d D F3 Permit No. C,JOpj
13125 SW Hall nlvd•, Tigard, OR 9722 Plan Review
Phone: 503.639 4171 Fax: 503.598.1960 ' "•e 'r 1.1 t , Date/13y: Other Permit:
Inspection Line: 503.639,4175 CITY OF TIGARD • _ a p , . /_ -e bete leo.dyIBy: 7 :, lid Bee Page 1 for
Internet: www,ci.tigard.or.us BUILDING DNISiO Notified/Method: Supplemental Information
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❑ New construction i n Addition/alteration/replacement Please check ail that apply:
❑ Demolition El Other: ['Service over 225 amps, comm ['Hazardous Location
r r, :� +T r ;11y t +r ; a .e srt " u',' .,�: ca[ ,: , i t {�r �i r t l l � f { 41 y 1 �1 �, , , ❑Servioe over 320 amps - rating ❑nuildng over 10,000 sq. it„
t s : +•:_tf .:,` i i. 1 ; '•I fn' �G� �l q S rti t R .( ' hi 0. :5�',4S , ;'it r!��i�IZ:ii• "rf { Ii:, 7..t� 1.9if :�.FaKI:14 Of i- and 244Tnily dwellings 4 or more new residential
❑ 1• and 2 - family dwelling li.1 Commeroisl/industrial D Accessory building ❑ System over 600 volts nominal units in one structure
❑ Mul' - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
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�! , .: t� , a:, ; .:• ^.c. ;rr�:n •• •,.�, , ^t • . ' 'F "`I: ^tw ai�:.yv.:4I;� D0ccupantloadover99persons ['Manufactured structures or
„ C� ( ! iYt t t i(0).t { , '4t'2r; it,' ,.(ffit: vl " t'�4' , iNfi�r : \l ,u�l t i) ,,• . orfo4i,- ti I . 11 OB en htui l an RV park
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Job no.: Z2.. I t .' Job site address: 17_ 0 ci d HC-L- ❑Health -care facility ❑Ocher:
Submit 2 sets of plans with any of the above.
City /State/ZIP: • '' 7 7-2-3 The above are not applicable to temporary construction service.
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Suite/bldg. /apt. no.: Project name: pia,, y„o F.�:. '! , .
i I ' / M1• :1. •'II:Y D (N� .
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Deaadpttea Qty. goo. ?oral !
Cross street/direntions to job site: New residential single- or multi - family dwelling unit.
Inch des attached garage,
1,000 sq. ft. or less 145.15 4
Subdivision: Oen= Ba. edd'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residen 75.00 2
7
s;r . �[ , :y:_ 1 :'�� , , ,f ( .:,,r,. . ; , gin Limited energy, non-residential 75.00 2
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r�' i`{' IC l �uf:• Is: J: �! isisa/i;;PL�; %�i,; � � . > . , ��s !1 - ,� '::y ' •�t5, \a� ,•a,;it!r.; , ti � �i�� .' i }}' � )3ach manufacturedormodular
•.rt4 �. ..t. R�:: :. `r .I. twi��L .� ._'riY >,iv._ i: J..i;l ° . .. :ltT t1P7'�,
�, ` dwelling, service and /or fleeder 90.90 2
i► -ex WI f ._ s , A- .e • e r +e 's t' ' M I Services or feeders installation, alteration, and/or r cation
CC) J cperez, ccfrt, 6,o. f d It (,a p (C 200 amps or less / 80.30 c)3±,:. 2
{? ; T; r. : I • , �l . . , :,,yi t =; ;.•.l ,,r 3� .:, q 0 a to 00 a 106,6 2
ff' '
� d . : ,., , ,, : V.' �L, l S� /, L: i ' E i , 1: 7 i') FF . tits i J ` 4'r h , + (f s. .22.1 4 . R,' �)�u , �+ 1 ., 2 l amps 4 amps 5
k',. ,,. ._.,, r_, f� _ _ ::%.... t .. ,.i t :,N �. ,,f, kl ;.a r z a :, .J ,�S s.t t � 1 R F,l .is 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps V 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only • 66.85 2
City /State/ZIP; Temporary services or feeders inatallatlou, alteration, and/or
Phone: ( ) Fax: ( )
relocation
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 1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps - 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
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'.,, •r• 'r d `: ; { ^i: i' r [ ".r i ' ;''1, ;y'r ;e ,i A:• Fee for branch circuits with
t I 'f l if )i ir. y il ll [..,_ I1W: ' i � _.. .�� �m 1 . �',ll �J�11t�7 , i4, .; �U�i <. .I h b :.
',''..;',I=1,':-.t r ' " ` ` service or feeder fee, each 6.65 2
Business name: G C. (C t i 5'.RU/ e . 5 branch circuit
B. Fee for branch circuits
Contact name: h a - ■ without service or feeder fee, 46.85 2
Address: C5 each branch circuit
Ba ch add'l branch circuit 6.65 2
City/State/ZIP: if . G' )t- -) / 170 111.5 Miscellaneous (service or feeder not included)
Phone: ( .3) Pump or irrigation circle 53.40 . 2
'� Sign or outline lighting 53.40 2
E -mail: Signal circuit(a) or CI
limited -
g: ;!I .f: •r. Y ri'•`t' 'G;.'[' 'tf • ` ll; , "p'! ' �•, 9 "'1 >: � '= i, :i5r•� mg r;,
•esS� i; t` !'a*' 1i, ' yij•a} • It' rA 0', :7Y'i Hti• i; :e i „ 1 .., ..t +l:: -I •, energy lteration
�:a. , ',',! til' / ���?. { .t •:,, ,•, •11 r` `' :a .,. ?::�� , ,.;ii, : : ?7i �' ., a .... ,, ht�. I!: .... f..-,...... ^..,i�';� °.t.;yS4 %Hirt,;) gYa Describe: , 2 2
extension. cri e: Page
Business name:
Address: Erich additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: - Investigation per hour (1 lir met) 62.50
Phone: ( ) P ax; ( ) Industrial .rant . er hour 73.75
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i , 7 e uprv, Lio, JI Sub total Q() 3 O
Suprv. Electrician signature, required: ,�il li /11 � Plan review (25% of permit fee) ..---
State surcharge (8% of permit fee) ( o 1
IMEIIIMOLEMERIVILMIIII I Date: ) d 6 A
TOTAL PERMIT FEE E36/7--,
Authorized signature: Thle permit application expires if a permit fa not obtained withIn 180
days after It has been accepted as complete
Print name: Date: a Pee methodology set by Tri- Couaty Building Industry Service Board
" Number of inspections per permit allowed.
i tsutitlna \PanetWILC- PmnItApp.doe 12/08 440.46IiT(1rdmicOW,Y 5
CITY OF TIGARD .. .
BILI'I'C'oJNG DIVISION A.
PERMIT #: ELC2005.00744
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/412005
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' � IL.
INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7:00AM PAGE: 73
SITE ADDRESS: 12970 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAGNO HUMPHRIES
DESCRIPTION: Code correction to existing feeder.
OWNER: THELMA HUMPHRIES, MAGNO, LLC PHONE #:
CONTRACTOR: 3D ELECTRICAL. SERVICES INC PHONE #: 503 - 657 -9173
Inspection Request Scheduled For: Date: 10/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017947-01 503 - 657 -9173 Y
Corrections /Comments /Instructions: 'm I bL
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--------- PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL •' CA L FOR INSPE TIeN ❑ ADDITIONAL FEES ASSESSED
/ / fI�//
Inspector: f/ i Date: 1 6 Phone #: (503) 718- Z I /
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