Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00531
DEVELOPMENT SERVICES DATE ISSUED: 7/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600
SITE ADDRESS: 09575 SW LOCUST ST ZONING: C -
SUBDIVISION: LEHMANN ACRE TRACT LOT : 005 JURISDICTION: TIG
Project Description: Fire repair, (80) branch circuits. Job No. 895403 - 1771
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: 79 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:
PHOENIX INNS LLC CHERRY CITY ELECTRIC
BY VIPS MOTOR INNS INC 8100 NE ST JOHNS ROAD D -104
29757 SW BOON ES FERRY RD VANCOUVER, WA 98665
WILSONVILLE, OR 97070
Phone: 503 - 638 -9284 Phone: 360- 571 -4411
FEES Reg #: ELE 37-620C
LIC 91668
Description Date Amount SUP 3486S
CITY OF TIGARD MENU 7/27/2005 $572.20
[TAX] 8% State Surcharge 7/27/2005 $45.78 REQUIRED ITEMS AND REPORTS
Total $617.98
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 :- ort 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 -801 3
Issued : : xP J Permittee Signature:
OWNER INSTALLATION ONLY •
The installation is being made on property I own which is not intended for sale, Ieas:Ir rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATI s ONLY
SIGNATURE OF SUPR. ELEC'N: 4A / 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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Electrical Permit Applicat - : IR OFFICE USE,ONLY
2 i `.1 g of Tigard Received ® ��
Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 P a 7 !7 „Ago ... 6:653 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Ht �iry1PY 111 DateB : Other Permit:
Inspection Line: 503.639.4175 �.al�: c� Date Ready/By: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: , Supplemental Information
., -* k tai* -'; es , r. ;�e..� - .? {fi_. : r._- ^" _ _
" ="�S` ;:��;�..{)�� C C+�, <;,... .._-.€ f .;- _x� :: ,.,,.. = . ,., _
.F'�.._ .,:�d`_..#�.;:h'� ;s:N -a`�� � sI_,I�VID�
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❑ New construction . Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l ❑Hazardous location
El Demolition 111 Other:
- •,4 4 ;., - '.- n a _� - - - . .�: ; ,e z - n , ❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
t : . ''- 'r UC 1 a RMTR IM.i ce' $ , =,Y _ t.y oft - and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi family Master builder ❑Other:
^ . , DOccupant load over 99 persons ❑Manufactured structures or
`,I. ava•: � SYT �O., m IOl`F FI? L GAFIO � ,W «,..A i. ❑Egress /lighting plan RV park
Job no.: Job site address: [
r ❑Health care fa cili ty
II-44 �"✓ � v L _ s ..1---
Submit 2 sets of plans with any of the above.
City /State /ZIP: ` t 1 The above are not applicable to temporary construction service.
`�(,� , y ;�:,:..,:�� : mss;. .:: •.c
Suite/bldg. /apt. no.: Project name: Y P 1 �{ 4�1 �/ �/ . Y ;:,:::z E * ='S( HED F)TE. - ' ... : .
7. Y ' Description n Qty, Fee. Tote
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: 1 5 / Q ix__ —ems Tod Limited energy, residential 75.00 2
='' l : -t "`err {e':: «4r. k ..- .:.,.z. H ' : .� . ,,s. n ,a: Limited energy, non - residential 75.00 2
', ; m• � '" :l F'irgiw,x' ^ ,„ �- ,„ �l ; E W(7R_,�,�, -,& " � •x ' s s•. s 1 .. Each manufactured
,�.,�.a�,�„ui°� or modular
A � dwelling, service and /or feeder 90.90 2
r V2.Q !/�-A Services or feeders installation, alteration, and /or relocation
99 200 amps or less _ 80.30 ' 2
:`sIA, - x:r k =�,, «.;..:.:. :..a� rxY,�=v~�' . -fir, " X;:' -t4 :z r„�pZ1tW- g'r 7 , r , E.:..a. - -', �:: ,., ,-, ;, s4., o',c rG 201 amps to 400 am
a ' , ''P1,-1,4ER1 Y O N It . .� -aV ❑ V` 1i 1TAN ek �.t, p amps 106.85 2
7 401 amps to 600 amps 160.60 2
Name: �' K 1, vO 601 amps to 1,000 amps 240.60 2
AddresS'?t/ V t PS i l ` � b((_., 7 �WG I !V� Over 1,000 amps or volts 454.65 2
I � I t7 a- &f t Le---E Reconnect only 66.85 2
City /State /ZIP: cgs 757 rdG2, L , 42Q y ) t -)' L t . - , . Temporary services or feeders installation, alteration, and/or
/ Q relocation
Phone: 6 6 3 ) ( 2 ' ' 'a-g" 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
` I « " `� " - i , t ° C" - -- r A. Fee for branch circuits with
� � �� : ��� I� � T',� � ' �: �, fix""��� u*td� ri��: "^J"""'' "s�.ag yr i h
� ;,:��_ ,r,,, P � k T U Irk, P��tS01 , f
". ° "� � `° service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, /
Address: each branch circuit ( 46.85 / 0 2
Each add'! branch circuit 7�l 6.65 250-2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax: ( )
Sign or outline lighting 53.40 2
E -mail: .
Signal circuit(s) or limited-
•�s; ��i° '. �'',,:'t;at?`:� , d 3�'i <., . ,� =-sue -+. ,.�,= =n� ` En. .x ..�.�,,.;�.•�.' :,�s,xsy a , a'vi ° energy panel, alteration, or
�`sfi;lr.�;.
fatr + - anit} 4 GQ TRAC= ;®R, ` + ai' . x'°r� ' MV . e: r.; , gy
'�- '�"«�',sz....r.� z:� %:,+W�sua.��,%�'L';r -v.. ,a�,.�;,a- .'� r �m,:.:..r,... .. P
k ,,, sw _. �s:.. �i:. v:.+ 5. �•;,' ,r,:An�?�sr�h"-- .x %w €'�?x:cxx`� � -
!'� extension. Describe: Page 2 2
Business name: (�
Address: ci ) ( y� S , �, ^ 0. J ( I O Each additional inspection over allowable in any of the above
I t v J V V I Per inspection 62.50
City /State /ZIP: ap1( ,4 C Y�,t( 5 Investigation per hour (1 hr min) 62.50
Phone: Ik0 -40 Industrial plant per hour 73.75 •
CCB Lie.: `( /(e6 g Ele . al Lic.:37 �} Suprv. Lic. /4L Subtotal
Suprv. Electrician signature, required: / / Plan review (25% of permit fee)
(((.__ /// [/C, 715
State surcharge (8% of permit fee) „,„„_,
Print name: J
v v 1 s 7 7 J , l 21 �p 5
C/ N Date: I// / ,/ TOTAL PERMIT FEE hi 7 qf
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
iABu tiding \ Permits \ELC- PermitApp. dec 12/03 440- 4615T( l0 /02/COM /WEB
Electrical Permit Application ity of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
a -ace- ..�; "w_s:. �r.r s ti t 1 xra ? ..
V. ® tat W e C r3 „.
. ,fcy�r3.� �e.""� i�L�.s�i.'x'S� cr;
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
Burglar Alarm
Garage Door Opener*
n Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
n Other:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems •
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
_ Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \ Building \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD - -
BUILDING DIVISION PERMIT #: ELC2006 -00531
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2005
Phone: (503) 639 -4171
Aelkb,,f U,� ,�r. �
Inspection Requests (24 Hrs.): (503) 639 -4175 AA
INSPECTION WORKSHEET FOR DATE: 9/2/2005 TIME: 7 :03AM PAGE: 69
SITE ADDRESS: 09576 SW LOCUST ST CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: i105 TYPE OF USE: .
PROJECT NAME: PHOENIX INN
DESCRIPTION: Fire repair, (80) branch circuits. Job No, 896403 -1771
OWNER: PHOENIX INNS LLC, PHONE #: 603- 6313 -9284
CONTRACTOR: CHERRY CITY ELECTRIC PHONE #: 360 -671 -4411
Inspection Request Scheduled For: Date: 8/2/2005 /2005 Pour Time:
Code # Inspection Description Con • Contact # Message
199 Electrical final 1 13567 -01 360. 607 -6653 Y
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Corrections /Comments /Instructions: 7\
10\ P■ '
PASS ❑ PARTIAL APPROVAL ❑ CANCEL I j NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/
Inspector: Date: U dip Phone #: (503) 718 - `I)i
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