Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -01001
DEVELOPMENT SERVICES DATE ISSUED: 1/31/2005
--� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 AB -01501
SITE ADDRESS: 07555 SW HERMOSO WAY
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT : 021 JURISDICTION: TIG
Project Description: I
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: 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:
DAVIDSON, ROBERT GREENWAY ELECTRIC COMPANY
7545 SW HERMOSO WAY 9460 SWTIGARD STE. 104
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 503 620 - 6020
Reg #: LIC 153421
ELE 34 -617C
FEES SUP 5025S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/31/2005 $46.85
[TAX] 8% State Surcharge 1/31/2005 $3.75 Rough -in
Elect'l Final
Total $50.60
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 a re et forth in V • R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -06 9 or 1 -800 -332
Issued ��� �� ��' 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
,
03 '27,12005 14:12 ®�
GREENWAY ELECTRIC CO PAGE 01
`l • t ectricaJ. Permit Application
City 'Tigard 1JAN 2 7 2005 Receive a / r 415"...- Permit No.: a ii - 7,..... /00/
13125 SW Hall Blvd., Tigard, OR 97223 Plan Ro
Phone: 501639.4171 Fax: 503,598. �•-mi ;\
Inspection Tine: 503.639,4175 ITY OF TIG t f { i Da Ready/By: Other Permit; s r+�7 ,,. Date Ready / h,rk H gee page 2 for
Internet: www.ei.ti gard.er.us fied Method
�,r Noti
I DING DI / , Supplemental information
�
> ty - F!. F ��p, � s'T✓ � ^ r n 4l i � ' . R y �
!L .'1!•�3y�: . r. _, r aT � 3 , i u ll n •' . b ii 13 : 3 Iy,'.,1r'+#i,. .k " �*y :�';1
v �,, } r 4!!�1. i , m o . .1 . 'ii"
!.14' 4 1s :1 ,„ \ ) 1 �. ' ,, we er • sr t d, C 8 r. a, ; 7 pp a e • ' „ ",, , ,.,. 4 , H wi rt c r r „ : a
� ;.:.. sro „> „n�). :h .t.•ev” ;.+r � I.u... r : +I: �irttT RR �t� .l�ttlt<tcY3 1�,�1�9l t °,'' 1{ �.�� r }O SIlI�. 'H�. yY ��1 4 f � s a
.hf4 it ,'19th �, ,� 1 A r �� tP. � a . ., t£: r,�.l _i'�r�it�l .. .li '.. ; n..., . :i<!� ;� sd+ t ::
❑ New construction 131 Addition/alteration/replacement Please chcck all that apply:
['Service over 225 amps, comm'l ❑Harsrdoua location
El Demolition ❑Other:
? ? "' : �""v : 2 ;tsr + �r �xs ,arr:m.. r t ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
t
l , +l;:r: s!'t n . 4• i:. v ' d ' '.1 N� i e1,i,, w ^;
. : :, .cv;;,,r °.,• ;e:er:.; : ::;4; :N rv:. ar b �e. r t y D , a'l :, of I -and 2-family w
� : ��'rs. tnda�`` ts6ti�:” ,a��`,�, €a�i E ' TM' �' t ,� . , (�6 ���; ' „t.,e ±
�� ly d el lings 4 or more new residential
❑ ' I- and 2- family dwelling T ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
CD Building over three stories ❑Feeders, 400 amps or more
Multi =famil y ❑ Mastcr builder ❑ Oth
❑ Other:
v;' "p,aNg�.;; ^.ey `r , >•• ; s a v a�I V �,i;a ";5 t ❑Occu ant load vCl'
d l 't n „ 7 171 2i ? : , %' 1: �1t� r I q K ` r r ,4 r, r l ;! W N k, 4./ •• 4 ” s iPi i �rd) • r.. p 99 persons OManuf cwred structures or
aE K ( .it'.p -,rl Trk.rh:„r,74.1,4., rca . . ,a aA. -4 1Y u11LA 11 w .4 ❑Egress /lighting plan RV park
?
Job no.: 1031 -14.3 Job site address: 7555 9/V Ficmoso Way DITeaith -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State./ZIP: Tigard, OR 97140 The above arc not applicable to temporary construction service,
Suite/bldg. /apt. no.: • I Project name: . ,r'el:`;(3�'" l It " ;� ��`�1' q I ": ",,i „!i�;F; < I'.'?.7y
J e: Minuteman pump connect , . ;ii. n :A f r Q a %r„br;i7,;. :a,u ii:::�F!5;:;^.��'k,.�.; , :
Do ertptton Qtv. E. Tat.l ”
Cross street/directions to job site: 72nd New residential single or multi - family dwelling unit. -
Includes attached garage.
1,000 sq, ft. or less ... 4
Subdivision: Lot no.: Fa. add'l 500 sq, ft. or portion 33.40 1
Tax map parcel no.: Limited energy, residential 75.00 2
P : �` r ,; i: n E . - .,- z t Rt;.lxti aM �, , r , , Limited energy, non - residential 75.00 2
.. ; t,! 5 r wr 3�''...1•,r:a >;�.r Ala r .7.: r r z r rI I ,, Fo'-� ry 3 ; 3 I er
"a!"'r�Jlr�S�G61 t. d i� y ;9' `11 Each manufactured or modular
install power for lift station dwc11in8, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
; ; t` T; 200 amps or less 80.30 2
4.0ii pis ;:11. Itgw r 01,ta u� }{i�'.*.o rtirt I�TF'i lr�:� ktti5` 1 'sc , 4p StV aPNttT u, vi" 401 amps t0 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454,65 2
City /State/ZIP: Reconnect only 66.85 2
Temporary services or feeders installAtion, alteration, and /or
Phone; ( ) Fax; ( ) relocation
or
Owner installation: This installation is being made on property that 1 own which is not 201 1 20 amps to less 66.85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. a s to 400 amps 100.30 2
401 amps to 600 amps 133.75 2
Owner signature: Date: —
Branch circuits - new alteration, or extension
, � K1t,iTt�i!Sn 1j °t� �,, a A" _ f , per panel
f ' c r Sl4i.. • 044, nl4Yi�4 t1i lit g 1 ; , .z . ,, . •:, „ I t t l ` � �:` u , A. Fee for branch circuits with
Business name: Greenway Electric service or feeder fee, each 6,65 2
bench circuit
Contact name: Byron iliayzlett B. Fee for branch circuits
without service or feeder tee,
Address: 9460 Tigard St Suite 104 each branch circuit 46.85 �6 2
Each add'l branch circuit 6.65 2
City /State/ZIP: Tigard Or Miscellaneous (service or feeder not included)
Phone: (503) 6206020 Fax:: (503) 620 -6124 Pump or irrigation circle
- 53.40 2
E-mail: Sign o r outline lighting 53.40 - 2
,,;� , ,r ,.... --� E1 ,,pp P „,,. , Signal circuit(s) or limited- '
' '7'•:?`lJl >,n.3h33;�•y t. . ;yyJ!i, .::�` I'Ttw; r r 'tw P` . ra v t o - energy ;. i• "v,.. s.: 9;is4 4 ?a;:.t:?,l #t *"e�Y 6a? �Si`,ar t. , .. �t;zl {,i1.1ttr ?i "a?k. energy panel, alteration, or
Business name: Greenway Electric extension. Describe; Page 2 2
Address: 9460 Tigard St Suite 104 Each additional inspection over Allowable In any of the above
-
City/State /ZIP: Tigard Or Per inspection 62.50
_investigation per hour (1 hr min) 62.50 -
Phone; (503-620-6020) t� Fax: (503- 620 -6124) Industrial plant per hour 73.75
CCB Li 0 t , ' Y� . . Iti nr,t' r' ... ii 1 Ir•...r:, I r r •: �' «; ` j,.
Lie.: 153421 `�`�\, I Electrical Suprv Lie.: 5025S
a: a`"i . s'�s1 "' ! J` '"k' :ii'Yl ^``
Lie,: 34 -r,17c
Subtotal � t .5 �
\
Suprv. Electrician signature, required: I J Plan review (25% (If permit fee
Print name: / r� Date: /27/2005 State surcharge (8% of permit fee) 3. ZS
q. pl \ i C J'� ®car �7
Authorized signature: TOTAI PERMIT FEE 'O - 68
Tilts permit application expires if o permit Is net obtained *thin 180
Print name: days after It has been accepted as complete
Date: • Fcc methodology set by Tri- County Building industry Service Board
"• Number of inspections per permit allowed.
is \Bullding\Permiema -C -p mitApp,doc 12/03
440 4 615T( I 0/o ;/COM /wP. R
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Reque ted — AM PM BUP
Location L.2.A/4/ 4 4 Suite MEC
Contact Person Ph ( ) S PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner G .- ELC ( 7(205– 01 00 I
Footing
Foundation ELC
Access:
Ftg Drain • ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Drywall on
Drywall Nailing
, e
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
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
A
FAIL
C
S
C Ro n
UG /Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line _
Ins
ADA Date — = - G,% Inspect. - ;� Ext
Approach/Sidewalk p
Other:
Final DO NOT REMOVE this inspection reco from t Job site.
PASS PART FAIL