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Permit
t Fn CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00214 r111 DEVELOPMENT SERVICES DATE ISSUED: 4/28/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102DA - 00401 SITE ADDRESS: 13125 SW HALL BLVD ZONING: CBD SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: Emergency electrical repair of service panel. 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: TIGARD, CITY OF OREGON ELECTRIC CONST /GROUP 13125 SW HALL 1010 SE 11TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: Phone: 503 - 234 - 9900 Reg #: LIC 203 SUP 4460S FEES ELE 26 -95C Description Date Amount Required Inspections [ELPRMT] ELC Permit 4/28/04 $80.30 [TAX] 8% State Surcharge 4/28/04 $6.42 Elect'l Service Elect'l Final 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 f. in OAR • 011 -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. • -sued By: k ; Permit Signature: _i �f 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: 4 7°7 1- /- DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day APR -28 -04 09:49AM FROM - Oregon Electric Estimating 5032313587 T -064 P.001 /002 F -002 ,,,,, r- !Electrical Permit Application OFFICE USE ONLY A City of Tigard Date received: 'es eV Permit no.:&Gat, - 0C.,,W / A 13125 13125 SW Hall Blvd Project/apt. no.: Expire date: �sl " ,,all Phone; (503) 6394171, FAX: (503) 598 -1960 Date issued: By: IReceipt no.: Internet address: www.ci.tigard.or.us Case file no.: Payment type: - 24-Hour Inspection Re • uest 503 - 639 -4175 U 18,2 family dwelling or accessory CortmercialTndustrial U Multi- Tamily ❑ Tenant improvement ❑ New construction 0 addition /alteration /replacement ❑ Other. . ❑ Partial JOB SITE INFORMATION Job Address: 13125 SW Hall Blvd, Tigard Bldg. No_: Tax map /tax lot/account no.: Lot: Stock: Subdivision Pro ect Name: TI • and Libra Desert • tion and location of work on • romis • . Emerergency Panel Change. Estimated Date of cons • letlonrins • ection: Will ou call forIns- ection within 24-hours? , Yes: e . No. ❑ Pro ect Contact John Ramirez r 3) 969 -2204 Phone CONTRACTOR APPLICATION t'EE JI:HEDULE •axno. Job No.: 72004 _ Deacnpuon Qty Fee (Oa - ) Total imp 'New'resrdenhalsmgan or multi - family per dwelling Business name: Oregon Electric Group unit Includes attached garage. Service Included: Address: 1010 SE 11th Ave, 1000 sg. R or less $ 145.15 5 - 4 City: Portland!State; OR Zip: 97214 Ea Addl 500 $F or potion S 33.40 $ . - t Phone: (503) 234 -9900 Fax: (503) 234 -1001 I E -mail: Limned Energy, 1 & 2 Family $ 76,00 $ • 2 CCB no.: 203 Elec, us, tic. no.: 26 -95C Limited Energy, Multi -Famlly - $ 75.00 $ - z City / ■ = f '%, N. . 95 Each manufactured home or ., / modular dwelling. 5crvice swarm • au(r ndnrtg • • .. rrrq.4 d t =: 4/2612004 and/or feeder. _ $ 90.90 $ - 2 Service or Feeders • Su Elect Name -rint ;Mark Ken, = License no: 44603 hutattation, Alteration or Relocation: PROPERTY OWNER 200 am.sorleee 1 $ e0,3o $ 80.30 2 Name (print): 2olampa 400ampa $ 108.85 $ • z Mailing Address: a0lamos- 600emps $ 160.50 $ • z City State: !Zip: aotamps- l000ampe $ 240,00 $ - 2 Phone: f l Fax: 1E-mail overl000A $ 454.65 $ • 2 Owner Installation: The installation is being made on property I own which i$ Reconnect Only $ 66.85 $ - not Intended for sale, lease, rent, or exchange according to ORS 447. Tem po Feeders rary - Serv lnstallatlon g g or 479, 670, 701. Alteration or Rolocatlon: Owner's si- nature: - _ Date: 200 a • Of JEW $ 66.85 $ • 2 ENGINEER 20lampa- 400ampa S 100,30 $ - 2 Name: Over 40lamps• eooamps $ 133.75 $ - z Branch Circuits • New, Address: Alteration or Extension Per Panel; A. Foo for branch City: State: Zip: circuits with purchase of service or feeder fee. each branch Phone: Fax: E -mail: circuit 5 0,65 $ • 2 B. Fee for branch circuits W/Out Purchase of Service Or PLAN REVIEW Feeder. lot BranchCltt $ 46.85 $ • 2 ❑ Service over 225 amps -comm ❑ Health - care facility Each additional branch circuit $ 0,66 $ - ❑ Service over 520 amps - rating of ❑ Hazardous location MiszelteneOua - (service or feeder net ineludedi 1 &2 family dwellings ❑ Building over 10.000 square feet four or Each pump or Irrigation circle 5 53.40 $ • 2 ❑ System over 600 volts nominal more residential units in one structure Each sign or Outline !AMC' $ 53,40 $ - z ❑ Building over three stories 0 Feeders, 400 amps or more signal Circuit(e) or Limited Energy Panel Alteration or Extension 0 Occupant load over 99 persons ❑ Manufactured structures or RV park — S 75.00 $ • 2 0 Egress/lighting plan ❑ Other. -Description: Submit 2 sets of plans with any of the above. The above are not applicable to temporary construction service. Each AddltMnallnspeCtlen Ovof the Allowable in any of the Notice: This permit application Above. Perinspection expires If permit iSnot . . $ 62.50 $ abalnad within 1a0 days after it Investigation fee; hos boon accepted as !Other complete. $80.30 Permit Fee Plan review 25% smote State Surcharge 8% $6.42 Tv Total $86.72 CITY OF TIGARD 24 -Hour BUILDING Inspection•Line (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Reggested —04 AM PM BUP Location /3 / 2 - S /41 r J_ Suite MEC Contact Person " ri ,,c-c) 3 _ ?es 9- 2 2 pr f ) PLM Contractor E. 0" - ) SWR BUILDING Tenant/Owner A- ELC Z (')'V — 00a/4 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: � SIT Post & Beam � q Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing 'n ) Insulation t `� � e-4/ \/ W d Drywall Nailing Firewall Fire Sprinkler C ) '64) Fire Alarm Susp'd Ceiling Roof Other: 1�, Final l, )\) 1 i 1 � _■■ _ 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 T FAIL • Service oug -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART \FAIL SITE ❑ Pleas- call for einspection RE: El Unable to inspect — no access Fire Supply Line ._ , ADA Approach/Sidewalk Date Inspector Jt _ / Ext Other: Final DO NOT REMOVE this Inspection record fro the job Ate. PASS PART FAIL CITY OF TIGARD 24 -Hour , BUILDING Inspection Line (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP • Received CP 'rD Date Requeste. AM PM BUP Location r � \ Suite ' - MEC Contact Person `Ye T Ph ( X)3 Wci —2-4s PLM Contractor Ph ( )) ° SWR BUILDING Tenant/Owner O ; - / ELC Q . ' -0-0 ) q Footing / d L �_ g ✓ ELC Foundation Access: Ftg Drain ELR r� Crawl Drain / Slab Inspection Notes: SIT Post & Beam MRS Shear Sheath/Shear W Ext eah/hear Int Sheath/Shear Framing Insulation n / , ) Q S co -v5-2_ © �/ Drywall Nailing 1( �lJ 1 v Y T1 Firewall f ( Fire Sprinkler V Fire Alarm Susp'd Ceiling Roof I 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 P RT FAIL : L Se , - Rough -In UG /Slab Low Voltage Fire Alarm PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ,1134/4 0 Please call for reinspection RE: Ill Unable to inspect — no access Fire Supply Line ADA / ,/- �-pp 1 35? , to Approach/Sidewalk Date l9 ✓ I n s pector — h �l / 10 / �J'S'� [ Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL