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Permit CITY OF TIGARD ELECTRICAL PERMIT , PERMIT #: ELC2007 -00187 COMMUNITY DEVELOPMENT DATE ISSUED: 3/28/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 102A6 -02200 SITE ADDRESS: 12525 SW MAIN ST ZONING: CBD SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT : 015 JURISDICTION: TIG PROJECT: STONE GALLERY Project Description: TI 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: 16 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: JIM TOMA NORMANDIN ELECTRIC INC 26431 S BARLOW RD 51086 NW CLAPSHAW HILL RD CANBY, OR 97013 FOREST GROVE, OR 97116 Phone: Contact #: PRI 357 -5380 FEES Description Date Amount Reg #: ELE 34 -256C [ELPRMT] ELC Permit 3/28/2007 $186.70 LIC 69008 [TAX] 8% State Surcharge 3/28/2007 $14.94 SUP 35585 Total $201.64 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 .• - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rule- -re set fo in 0 - s 5 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies hese rules or direct questions to OUNC at 503.246.:699 or 1.800.3 Issued 1:y: ( ��� i Permittee 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. ELECN: DATE: LICENSE NO: 5 S 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. Electrical Permit Application. FOR OFFICE USE ONLY Ili • .;� " u C of Tigard Date/By: AS 07 PermitNo.: ftg, pa mev07 a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T I G n RID Inspection•Line: 503.639.4175 Date Ja ' �� ® See Page 2 for Internet: www.tigard or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ' 5 Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /stems checked below): ❑ Service or feeder 400 amps or more ❑ Building over.three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling. N'Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 1 100HP or more. occupancy. '� �✓ "� .� r ❑ Six or more residential units. ❑ Recreational vehicle parks. ❑ Health-care facilities. ❑ Supply voltage for more than City/State/ZIP: ' i 5,4'- ) ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions -to job site: Description 1 • Qty. I Fee. I Total 1 • New residential single. or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or.less 145.15 4 Ea. add'I 500 sq. ft: or portion 33.40 • 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. R.) • - 75.00 2 Limited energy, multi - family • / `G �,! • ✓c� "? O 1 . r^ 8 .c1 i Gr• residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation • 200 amps or less / 80.30 • gQ• ) 2 ❑ P ROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 . 2 Name:. 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts • 454.65 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 lease, rent, or.exchange, according to•ORS 447, 449, 670, and 701. . 401 amps to 599 amps - 133.75 2 Owner signature: Date: , Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with • /��� ❑ APPLICANT 1 ❑ CONTACT PERSON above service or feederfee, / lv(( 6.65' . 96 2 Business name: each branch circuit B. Fee for branch circuits • Contact name: without service or feeder fee, • 46.85 2 • first branch circuit Address: Each add'I branch circuit 6.65 • 2 . Miscellaneous (service or feeder not included) City/State /ZIP: • Each manufactured or modular dwelling, service and/or feeder 90:90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 • 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting • 53.40 2 Signal circuit(s) or limited- Business name: ;i / �" 0 Ai A d LI i n/ . /-::: le! c-'iY- c- energy panel, alteration; or • Address: .5 --- - /of, 6 lot, , c /� 5 h 4 kJ 4 '�/ `0 extension. Describe: Page 2 • 2 City/State /ZIP: " - fir � c.,,,Z.. Oft_ C-1 Z / d Each additional inspection over allowable in an of the above Per inspection 62.50 Phone: (S' 1 -, - .5" Fax: (3-4).j) V yS 7 - t/ ] Investigation per hour, (I hr min) 62.50' CCB Lic.:6 1 U O p Electrical Lic 3 ... , Su Lic y s—� S Industrial plant per hour 73.75 • ea ELECTRICAL PERMIT FEES Suprv. Electrician.signature, required: / .,....1. - ,Subtotal: ,/g • 70 Print name: / % Date: Plan review (25% of permit fee): / on N -r.r+ " A./ t a - "�� State surcharge (8 %'of permit fee): /9, ?9 Authorized signature: TOTAL PERMIT FEE: AO( • ' This permit application expires if a permit.ia not'obtained ' thin lit0 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. . I :\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(I1 /05 /COM/WEB • Electrical Permit Application - City of Tigard Page -- Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm • ❑ Garage Door Opener* • ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* • ❑ Other. COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE,OAR 918- 260 -260) Check Type of Work Involved: • • • ❑- Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems • ❑' Data Telecommunication Installation \Fire Alarm Installation ❑ HVAC, ❑ Instrumentation • ❑ Intercom and Paging•Systems 0 Landscape Irrigation Control* • ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective • ❑ Other • Total number of commercial systems: *No licenses are required. Licenses are required for'all other installations I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00187 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 312012007 Phone: (503) 639 -4171 It ',it Inspection Requests (24 Hrs.): (503) 639 -4175 F: _.. INSPECTION WORKSHEET FOR DATE: 8/1/2007 TIME: 7:03AM PAGE: 47 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: • 357 -5380 Inspection Request Scheduled For: Date: 8/1/2007 Pour Time: Code # Inspection Description Con • 11 # Contact # Message 199 Electrical final 053169 -01 503- 313 -2599 N Corrections /Comments/ Instructions: • X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r N V Date: 1(1 01 Phone #: (503) 718- NIA, CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007- 00187 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2007 Phone: (503) 639 -4171 �i,�t:' +I Inspection Requests (24 Hrs.): (503) 639 -4175 - LL INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 77 SITE ADDRESS: 12525 SW MAIN ST • CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: Tl OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 7/31/2007 Pour Time: Code # Inspection Description Confirm Contact # Message 199 Electrical final 053025-02 \ 503 -313 -2599 N 453169 • o I Corrections /Comments /Instructions: e-4 p 6 d E' lopes 1&s CM LSE (IL. t4 ION 1nb v 1M 53011+ r i o f-i Xl J g O bC- Q �b N6 Ol' . i 5 6 r E3 1 ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C'". N6 6 LE Date: It ti 01 Phone #: (503) 718- tiIL16 CITY OF TIGARD - BUILDING DIVISION PERMIT #: ELC2007- 001137 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2007 Phone: (503) 639 -4171 �nou Inspection Requests (24 Hrs.): (503) 639 -4175 pL INSPECTION WORKSHEET FOR DATE: 7/26/2007 TIME: 7:03AM PAGE: 25 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 7/26/2007 Pour Time: Code # Inspection Description Cnafirm # Contact # Message 199 Electrical final 052813-01 503- 313-2599 N Corrections /Comments /Instructions: PQ 04 0 Z c■ot•IML, PLATES Eait.— LL n —. a'i i LE-Ps 111X `!k : A I I ON = t pixx..334 ISEfta_. • 04. My g \?ct.a4ts .. o Ol Lti fox VS_ WirlD goff;S oa Fite 6F sl 0( . ? c<0410 L L., NIL Ptlx v'ATE sit) . CD o€ cbob RQN few. Q Q 1 L®��rg �� 5ict1* . 16 iker • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N d8 L Date: If 161 el Phone #: (503) 718- Tipp, CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELC2007 -00187 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/20/2007 Phone: (503) 639 -4171 mud 1 Inspection Requests (24 Hrs.): (503) 639 -4175 "'! �.. INSPECTION WORKSHEET FOR DATE: 4/24/2007 TIME: 7:01AM PAGE: 13 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 4/24/2007 Pour Time: Code # - '. - ! - scription Confirm — #\ Contact # Message 135 Low voltage 047049-01 503313 -2599 N Corrections /Comments /Instructions: `' --- - - P L s N±2I P w∎ cr' � mac& L u Vb I-7 1 P o .©� A �'L r��- ��� vi�.a t_ . ‘,.SQ_e MS c "I' Ai 5 re c .mCI% C"C \� 1 j \r-,(Z, i iN (ecLb \_ OP 'NW Fc i 6 v..) C.ov a s A () \) b ()P \ ‘ik I 6 r WM! t . ` 2, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS a•- ' ❑ ADDITIONAL FEES ASSESSED Inspector: Cr: tV Date: 1 4 1 4 (Y) Phone #: (503) 718- 2"1 "W CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00107 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/20/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ° 1.. INSPECTION WORKSHEET FOR DATE: 4/23/2007 TIME: 7:00AM PAGE: 21 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -53B0 Inspection Request Scheduled For: Date: 4/23/2007 Pour Time: Code # Inspection Description �o - firm # Contact # Message 135 Low voltage 046971 -01 503-3112599 N Corrections /Comments /Instructions: S ,p ^� 1(� L A (t1 N 6-r i. 3i3 P - Q0 F•z. 5upeepM IN VK11G -- faA CAR LL , Z Nc LL I )( ) p cE t ( ct 0\1 t\) 5 . N pa l be :E5 N< Q t) 4, (4, L- g vL2 L ‘- ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS A FAIL \CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1•) 6 g Date: L1 2 Phone #: (503) 718- 1-114A1 CITY OF TIGARD BUILDING DIVISION S" - PERMIT #: ELC2007 -00187 13125 SW Hall Blvd., Tigard, OR 97223 w DATE ISSUED: 3/28/2007 Phone: (503) 639 -4171 Avole Inspection Requests (24 Hrs.): (503) 639 -4175 �'I�.. • INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7 :00AM PAGE: 17 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 4/18/2007 Pour Time: Code # Inspection Description Confirm -# Contact # Message 120 Electrical rough -in 046710 -02 503- 313 -2599 N Corrections /Comments /Instructions: Q ti S trtz Vigo R. bi) o lit\ ►5 NI p. Co83 Nti 266 • 5 tea' 04.0 n4D i S pt-fa tobE , Ai4 1S . ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS F AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: a"' Iv 68 L Date: 101 Phone #: (503) 718 - Z j CITY OF TIGARD BUILDING DIVISION L PERMIT #: ELC2007-00187 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/26/2007 Phone: (503) 639 -4171 �dy� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 24 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 4/17/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 12.0 Electrical rough -in 046625 -02 503 - 313 -2599 N Corrections /Comments /Instructions: N - • \tS F Al4q Z1 Eta.:1 - 04 cz\1— wl`p 1g �31 \l 61/ ec P m4/ myti F -AwL v\ fT If) 4 "r . 1K)0 3- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � N Date: ` I Oki Phone #: (503) 718- 141-14 CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELC2007 -00187 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2t)/2007 Phone: (503) 639 -4171 l Inspection Requests (24 Hrs.): (503) 639 -4175 ^: _., INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 25 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 4/17/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 046625 -01 503. 313-2599 N Corrections /Comments /Instructions: c13 Ac i tvN GlzovA0 QAArt.. v 5 .D � i 0 v 1 cDuki .a , 6E r=t S 1 cJ _ Ni c., NZ. 1 I0, 3 Q3) ❑ PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (!f NCB 115 Date: 4 n ty) Phone #: (503) 718- DM) CITY OF TIGARD , BUILDING DIVISION t - PERMIT #: ELC2007 -00187 13125 SW Hall Blvd., Tigard, OR 97223 � DATE ISSUED: 3/20/2007 Phone: (503) 639 -4171 I Inspection Requests (24 Hrs.): (503) 639 - 4175 . 44011 ! __.. INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 23 SITE ADDRESS: 12525 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT #: 015 TYPE OF USE: PROJECT NAME: STONE GALLERY DESCRIPTION: TI OWNER: TOMA, JIM PHONE #: CONTRACTOR: NORMANDIN ELECTRIC INC PHONE #: 357 -5380 Inspection Request Scheduled For: Date: 4/17/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 046625 -03 503 - 313-2599 N Corrections /Comments/ Instructions: R0 10sPL'U'G 1101.1 MA oc - PQ`s f t1/4I•c kbb Lzyv VE-1( f � p P 1r 7-067.001 ❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: & IN168 Date: 1 4 11 V Phone #: (503) 718- POO •