Permit •
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00630
COMMUNITY DEVELOPMENT DATE ISSUED: 11/6/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-03703
SITE ADDRESS: 11624 SW LOMITA AVE A - ZONING: R -12
SUBDIVISION: PLAZA GARDEN WEST APARTMENTS LOT : JURISDICTION: TIG
Project Description: 100 amp panel change. Job # 71968.
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:
PARKER, JEROME W TRUSTEE L H MORRIS ELECTRIC INC
BY SUMMIT REAL ESTATE MANAGEME 7051 SW SANDBURG ST, #100
5320 SW MACADAM AVE TIGARD, OR 97223
PORTLAND, OR 97201
Phone: Contact #: PRI 503 - 639 - 2334
FAX 503- 620 -7405
FEES
Description Date Amount Reg #: ELE 20 -39C
[ELPRMT] ELC Permit 11/6/2006 $80.30 LIC 1838
[TAX] 8% State Surcharge 11/6/2006 $6.42 SUP 3006S
Total $86,72 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 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 1.800.332.2344.
Issued By: --1-2? . �� Permittee Signature: . a 2 c>
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.
lc V
Electrical - Permit Appli ac tI,OIl , r G i ° q . \,, F.OR OFFICE 'USE ONLY
s ! (S ; 3 s
City of Tigard 1 t ' "" 4 i / Received _ - /. Permit No.:
DateBy: C., _ /4.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 NOV 0 r 6t1 "''r ''''` Date/By: Other Permit:
Inspection Line: 503.639.4175 ` - Date Ready /By: Juris 0 See Page 2 for
Internet: www cl tigard or.us : , Notified/Method: ) Supplemental Information
_ i 1 � F ( i j �" - " a ° -' r' °'`'P REE
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r :';- „. ._ ._.,.tom „..,- ',� .y,.: s,_m _ „% a�-i.?i 140 a a.. `�K "4 ° 'Sr r T'x".ilf.:.' i20,A ,_.. 6 ' pa;: .. ;„4 . _, ,. ,...„cep.. „,,•,,,t.,, . ..,..r,
❑ New construction 14Ad'dition /alteration /replacement Please check all that apply:
❑ Demolition • ❑ Other: over m' ['Hazardous ['Service o r 225 amps, corn l Hazar location
S
v , ,._ _ , µ, ❑
❑ervice over 320 amps - rating Buildng over 10,000 sq. ft.,
I s �P ,y . G ,
TG,ORY ,OF CONSTRUCTION ms -, : n of 1- 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
EBuilding over three stories ❑Feeders, 400 amps or more
El Multi - family 111 Master builder ❑ Other:
• s , builder f ['Occupant load over 99 persons ❑Manufactured structures or
.•; ; rat:- . ” @ ,,, -' RV
Wit,,; -: fiL's : J,OB; SIT N'F = E ress /li�htin plan P
,, "t;� "i�,•.-"s�`'`t�,s.. .> ,. -. .�.� z,..�, , ..- . . s'�:r, 5;�l' �;;.... ❑ g o g park
P
Job no.: 1 19 (Q Job site address: 1 1 - 2,4 6W (. t l> I 1 -1- facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: `1 311 Oe - The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: p _u, Project name: (io �i—� w A— i' 4 ° M h'f' „ - FE E t;SGHEDULE y =4
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 4
Subdivision: Lot no.: Ea. add'i 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: . non-residential 75.00 2
W x z Limited energy, non idential
r - =DE �'R`IPT[ � F °�� RK -:=�
a` >i`�� SC ON:O VO , manufactured or 3
ems' =. -, „,, � _ ._. �tY�',�� -�.� _���xar- e�.�,...__ _ .. , <..,. �> _,
Each manufach red o nod ular
amp ^_ n An dwelling, service feeder 90.90 2
O0 a
1 ` 1 C� t ���VVV "'f IIII� Services or feeders rs installation, alteration, and/or relocation
200 amps or less ` 80.30 2
, 1 : i; i -ii:, . »' „r; ; „° s, ,, „ ,4 ::.° 201 amps to400 amps 106.85 2
`1` ,, ,:.. ' RQRE- R T:Y; - OW N , E R:>�i: , : `a ,<, : ❑r;TE- NAN"I' � : ! = e, „ ,.. e ,, ,'
., = ..._,_ 44-'4.;• ' ........ ^., % ter•. , tt. „,. ,.:,.
401 amps to 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
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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
', , :€$ A. Fee for branch circuits with
❑;:APELTCANT.-'� „£� �.y C ONT A C T ; ° „PERSON °� ,z
L, - `.':., : ...- , `a : ' " .a.., . ". ,, ,, service or feeder fee, each
Business name: L.H. MORRIS ELECTRIC INC branch circuit 6.65 2
B. Fee for branch circuits
Contact name:
Scott Carton without service or feeder fee, 46.85 2
J ` ( each branch circuit
Address:
\f \I Sara a buy9 Each add'1 branch circuit 6.65 2
City /State /ZIP: — 1( ( Qrd 0 \J Miscellaneous (service or feeder not included)
Phone: (503) 639 -233 Fax: : (503) 620 -7405 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
:7;t f, : >`'' energy panel, alteration, or
�,.�;`"v 1VT,Rt1C`I' �R =` ,£y,> �:,";,. �> gYP
extension. Describe: Page 2 2
Business name: L.H. MORRIS ELECTRIC INC
Address: 7051 SW SANDBURG ST #100 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: TIGARD OR 97223 Investigation per hour (1 hr nun) 62.50
Phone: (503) 639 - 2334 Fax: (503) 620 - 7405 Industrial plant per hour 73.75 •
. u - F,::V`:ELEGTRI€AL PERl)11T:; FEES *= ; / 1 .41 '
CCB Lie.: 1838 Electrical 'c.: 0 -39C uprv. Lie.: 3006S Subtotal 80 3 0
Suprv. Electrician signature, required: P tl , Plan review (25% of permit fee)
F State surcharge (8% of permit fee) Co Print name 0 C L. 2_
, I. tai %I s \; Nate: h 2 04
TOTAL PERMIT FEE e (Q ;, '2 -
Authorized signature: aw , l - ' This permit application expires if a permit is not obtained within 180
� 1(1 days after it has been accepted as complete
i 1 1
Print name: Q A \L Sl hy�� Date: (`I 2,f0� * Fee methodology set by Tri- County Building Industry Service Board
`� ** Number of inspections per permit allowed.
i:\ Building \Permits \ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #1.c 001:3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 41t
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: , • Q TIME: PAGE:
SITE ADDRESS: It �2 \_O AV • \ r CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Ti,,a at Arta
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
C•og wtLK. boat DNSre=T• •
o wo(LX �; ® ® 11.44 / A wl.
n PASS n PARTIAL APPROVAL ❑ CANCEL $ ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: NI 0 8 Date: 1" I Phone #: (503) 718- 11146