Permit ,: , ....
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00350
w�l� DEVELOPMENT SERVICES DATE ISSUED: 5/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S102AA - 04100
SITE ADDRESS: 12230 SW MAIN ST ZONING: CBD
SUBDIVISION: MORINS ADDITION LOT : JURISDICTION: TIG
Project Description: (1) 200 amp service & (30) branch circuits for Phase II.
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: 30 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:
INTEGRITY INVESTMENTS INC ATLAS ELECTRICAL CONTRACTORS
2229 NE BURNSIDE SUITE 86 4403 SE ROETHE RD
GRESHAM, OR 97030 MILWAUKIE, OR 97267
Phone: Phone: 659 -2212
FEES Reg #: SUP 2581S
Description Date Amount LIE 1532
ELE 3 -2C
[ELPRMT] ELC Permit 5/25/2005 $279.80
[TAX] 8% State Surcharge 5/25/2005 $22.38 REQUIRED ITEMS AND REPORTS
Total $302.18
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 � Permittee Signature: . p-
OWNER INSTALLATION ONLY r
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.
glectrical Permit App alif' ; IVED FOR OFFICE USE ONLY
Received , pe rmit No
City of Tigard Date/}3y; �Z ,V OJ J ', G� 35 0
13125 SW Hall Blvd., Tigard, OR 97223 MAY 2 4 2005 Aliko,., a 'I Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ^ } � ! I Date /By: Other Permit:
ction Line: 503.639.4175 ? J I „ Date Ready/By: saris: ® See Page 2 for
Y Y�
et: www.ci.tigard.or.us CITY OF TIGAR D Notified/Method: Supplemental Information
TWIM PLAN REVIEW
l 'Jew construction ❑ Addition /alteration /replacement Please check all that apply:
❑Service over 225 amps, comm'l ['Hazardous location
❑ Demolition 0 Other:
OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling 41 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi family 0 Master builder 0 Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
❑Health -care facility no.: 12400.07 Job site address: 12230 SW Main Street Submit 2 sets of f plans ❑Oto
lans with any of the aboveve
.
City /State /ZIP: Tigard, Oregon 97223 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite /bldg. /apt. no.: Project name: Crown Carpet Phase II
Y Description I Qty. I Fee. I Total I **
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 I
Limited energy, residential 75.00 2
Tax map /parcel no.: -
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder , 90.90 . 2
Electrical for Crown Carpet Tenant Improvement Services or feeders installation, alteration, and /or relocation
200 amps or less 1 80.30 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Narne: 601 amps to 1,000 amps 240.60 2
ess: 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
ion
2000 0 amps ( ) Fax: ( )
relocation
or less 4. 66.85
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
ECAPPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each
Business name: Atlas Electrical 'Contractors, Inc. branch circuit 30 6 199 -90 2
B. Fee for branch circuits
Contact name: Ronald J Gauger without service or feeder fee, 46.85 2
each branch circuit
Address: 4403 SE Roethe Road Each add'l branch circuit 6.65 2
llan
Mi
Oregon 97267 Miscellaneous (service or feeder not included)
City /State /ZIP: Milwaukie, (
Pump or irrigation circle 53.40 2
Phone: ( 503 )659 -2212 Fax: : ( 503 Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Atlas Electrical Contractors, Inc.
Address: 4403 SE Roethe Road Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Milwaukie, Oregon 97267 Investigation per hour (1 hr min) 62.50
Phone: ( 503) F ax: ( ) Industrial plant per hour 73.75
503 659 -2212 503 659 -4944 ELECTRICAL PERMIT FEES*
CCB Lic.: 1532 Electrical Lic.: _2C Suprv. Lic.: 9 Subtotal
279.80 .
'. Electrician signature, required: � Plan review (25% of permit fee)
— /' State surcharge (8% of permit fee) 22.38
Print name: Ronald J uger G Date: 5/23/05
- TOTAL PERMIT FEE 302.18
Authorized signature: ,A : - This permit application expires if a permit is not obtained within 180
r ' days after it has been accepted as complete
Print name: Ronald J Gaug Date: 5/23/05 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Permits \ELC- PeimitApp.doc 12103 440- 4615T(I0 /02/COM/WEB
CITY OF TIGARD
BU1LDING DIVISION PERMIT #: ELC2005 -00350
131 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2005
Phone: (503) 639 -4171 ,"j `� 1 f `
Inspection Requests (24 Hrs.): (503) 639 - 4175 !+ `:_—
INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 77
SITE ADDRESS: 12230 SW MAIN ST CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: CROWN CARPET
DESCRIPTION: (1) 200 amp service & (30) branch circuits for Phase II.
OWNER: INTEGRITY INVESTMENTS INC, PHONE #:-
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659.2212
Inspection Request Scheduled For: Date: 6/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 009956-01 971- 404 -4501 N
Corrections /Comments/ Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
�❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / (� -4� — 0- 7 Date: — Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00350
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2512005
Phone: (503) 639 -4171 .� , /d20 , gp, a 1h l k\
Inspection Requests (24 Hrs.): (503) 639 -4175 ����+ °`__..
INSPECTION WORKSHEET FOR DATE: 6/14/2005 TIME: 7:10AM PAGE: 16
SITE ADDRESS: 12230 SW MAIN ST CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: CROWN CARPET
DESCRIPTION: (1) 200 amp service & (30) branch circuits for Phase II.
OWNER: INTEGRITY INVESTMENTS INC, PHONE #:
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 6532212
Inspection Request Scheduled For: Date: 6/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service/reconnect 009222-01 503 -901 -3336 N
Corrections /Comments /Instructions:
/
►`.�`� PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
7' CALL FOR INSPECTION
❑ ❑ADDITIONAL FEES ASSESSED
Inspector: Date: / `� v ' Phone #: (503) 718-