Permit • Y CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00001
COMMUNITY DEVELOPMENT DATE ISSUED: 1/2/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-03703
SrrE ADDRESS: 11624 SW LOMITA AVE D -10 ZONING: R -12
SUBDIVISION: PLAZA GARDEN WEST APARTMENTS LOT : JURISDICTION: TIG
PROJECT: LOMITA WEST APARTMENTS
Project Description: Panel change. Job No. 56943S
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:
1616 SHORELINE LLC STONER ELECTRIC
182 HOWARD ST #6 1904 SE OCHOCO STREET
SAN FRANCISCO, CA 94105 MILWAUKIE, OR 97222
Phone: Contact #: FAX 503 - 659 -2824
PRI 503 - 462 -6500
FEES
Description Date Amount Reg #: ELL 26 -122C
[ELPRM'uELC Permit 1/2/2008 $80.30 LIC 44823
[TAX1 OState Surcharge 1/2/2008 $9.64 SUP 3496S
Total $89.94 REQUIRED ITEMS AND REPORTS
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 - o - .an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rul -s are set forth "n 'AR e - 001 -0010 through OAR 952 -0 01 -0100. You may obtain copies o these rules or direct questions to OUNC at
503.246.6699 or 1 .800.33' .234':
Issued :y: 4 r Permittee Signa ure: •7!'I/ � '
._� irurlL
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:
• TRACTOR INSTALLATION ONLY 441 SIGNATURE OF SUPR. ELEC : _ _ 41!�� D /ek - DATE: /Are
LICENSE NO: 9
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.
01/02/2008 09:48 FAX 0 001
a
Electrical Permit A 1 1li _ E 't. V l Oft ()1.1.1(.1 i ,si: r i.l'
•
City of Tigard 7 Q
13125 SW Hall Blvd., Tiga S a. O D:. Q Od t� Penult No.: f� , ; —axe,/
, .. � 9 60 �O U Plan Review
Phone: 503.639.4171 Fax_ 56-.`98,19 t Other Permit;
Inspection 503.639.4175 Line: a N` Date Re B
Internet: Line: tigard.or.us P `` O i `I":P� adY o r ' S for
tV? Notificd/Method:
(6 SupplementelI�ormation
❑ New construction Le eration/replacement Please check all that apply:
❑Service over 225 amps, comm'I ❑Hazardous location
❑ Demolition er
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft,
of ] 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
Multi- family , ❑ Master builder El Other. ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
❑Egress/lighting plan RV park
Job no.: 5( 3 Job site address: / /k ,i ,/ ❑Healtlt - care facility ❑Other
Submit 2 sets of plans with any of the above.
City /S1ate/ZIP: 'Ti .4.-4ZD, o, 972..2. The above are not applicable to temporary construction service.
Suite /bldg. /apt. no. :. j d I Project name:
Description Qty. Fee Total "'
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 1 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
Each manufactured or modular
_J/ RE— � ///%G11�L dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less — ( 80.30 99.30 2
20] amps to 400 amps 106.85 _ 2
Name: r h _ -� J / 401 amps to 600 amps 160.60 2
' ! ] t 41 .-x , 601 amps to 1,000 amps 240.60 2
Address: / g ' a / - , - ,� n / Over 1,000 amps or volts 454.65 2
City/State/ZIP: F� fX / C r P Reconnect only 66.85 2
d� -A-,0.41 A e4- ' . i /e5 Temporary services or feeders installation, alteration, and /or
Phone: ( ) I Fax: ( ) relocation
Owner installation: This installation is being made on property that I own which is not 200 amps to 400 00. 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
4 01 amps to 400 amps 100.30 2
_ 401 amps to 600 amps 133.75 2
Owner signature: Date: - Branch circuits — new, alteration, or extension, per panel
A Fee for branch circuits with
Business name: service or feeder fee, each 6.65 2
branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee,
Address: first branch circuit 46.85 2
Each add'1 branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
E - mail: Sign or outline lighting _ 53.40 2
Signal circuit(s) or limited -
energy panel, alteration, or
Business name: STONER ELECTRIC extension. Describe: Page 2 2
Address: 1904 SE OCHOCO Each additional inspection over allowable in any of the above
City /State/ZIP: MILWAUKIE, OR Per inspection 62.50
Investigation per hour (1 hr min) 62.50
Phone: (503) 462 -500 I Fax: (503) 659 -4968 Industrial plant per hour 73.75
CCB Lie.: 44823 I Electrical Lie.: 26 -122C I Suprv. Lie.: 3496
Subtotal 8p, 30
Suprv. Electrician signature, required: mac/L.4 R Plan review (25% of permit il fe fee) ) $
Print name: MICHAEL FALCONER 1 `
Date: / / 2108
State surcharge (12% of permit fee) 949 V
Authorized signature: TOTAL PERMIT FEE 89.94
This permit application expires if a permit Is not obtained within 180
Print name: days after it has been accepted as complete
Date: * Fee methodology set by Tri -County Budding Industry Service Board
** Number of inspections per permit allowed.
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CITY OF TIGARD
. •
A
BUILDING DIVISION PERMIT #: ELC2008-00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/272008
Phone: (503) 639-4171 1 \
Inspection Requests (24 Hrs.): (503) 639-4175 ..414, - AIL
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 11674 SW LOMITA AVE D-10 CLASS OF WORK:
SUBDIVISION: PLAZA GARDEN WEST APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: LOMITA WEST APARTMENTS
DESCRIPTION: Panel change. Job No. 56943S
OWNER: 1616 SHORELINE LLC, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 503-462-G5m
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description Confirm...# Contact # Message
199 Electrical final 06344001 503-347-5238 \ Y
Corrections/Comments/Instructions:
Pm
N
\ '
\\I
4 PASS El PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
• ' _ CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: —.--, NtY6t ... Date: 1 41 ' ti Phone #: (503) 718- _____