Permit ...„ CITY OF TIGARD ELECTRICAL PERMIT
I III ° PERMIT #: ELC2006 -00645
_ COMMUNITY DEVELOPMENT
D ATE ISSUED: 11/9/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 207 ZONING: C -G
SUBDIVISION: TIGARD PLAZA LOT : 002 JURISDICTION: TIG
Project Description: KATHYS. (8) branch circuits.
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: 7 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:
TIGARD PROPERTIES INC ELECTRICAL CONTRACTORS & DESIG
2106 SE OCHOCO ST 150 NE VICTORY SUITE A
MILWAUKIE, OR 97222 GRESHAM, OR 97070
Phone: Contact #: PRI 503 - 666 - 9358
FAX 503 - 667 -7965
FEES
Description Date Amount Reg #: ELE 26 - 466C
[ELPRMT] ELC Permit 11/9/2006 $93.40 LIC 47712
[TAX] 8% State Surcharge 11/9/2006 $7.47 SUP 18825
Total $100.87 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
1 `
Issued By: jillit,i __.„ `a Permittee Signature: _ .�� Q P
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for.an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
r
El Permit Applica / FOIL OFF CF. USE ONLY
Rec /�� �(
� Date/By: �g 6�./ errmt al �C �C�� t�D1 9s
Ci f oTi and G� Planning Approval Sign
ty g Date/By: Permit No.:
13125 SW Hall Blvd. NOV. S 211 Plan Review Other
Tigard, Oregon 97223 D Date/By: Permit :No.:
Phone: 503 -639 -4171 Fax 503 -598 ° V „ A
'' Post- Review Lend Use
l %NO `�:�; f s : ; j Date/By: Case No.:
Internet: www.ci.tigard.or.us B .•� 1 Contact Jtar El seepage 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental information.
.w i ,a S Mi P ; .} .- : -W wl�. l,c .. - .:e , j . : t.; ... i ;I; ,f .•
'.' ; : ��� ..$��4� * ;?a�:zE11��,• �+'+`Q' �'WUItK _: `: *•,,:�s.ttk'�'''. ":':�'� • :',: ; � • �r•i�. `:• P VI : �P1�9'te'tb:�e, r lilAl�ltl isti � p � . �,�:, fl , .� =
Service over 225 amps- (] Health -care facility
N New construction Addition/alteration/ lacement Other: Demolition commercial ee v ❑ Bu ilding s over 10,000 ❑ Service over 320 amps - rating of � ❑Building over 10,400 square feet,
f•- i •'y' =r+ P , g00.1.4• .V1 NCONS ,ICT)[,OW°,'s r: * I & 2 farruly dwellings four or more residential units in
1 & 2-Family dwelling Gi Commercial/Industrial ❑ System over 600 volts nominal one structure
Accessory Building • .Multi -Famil y
El Building over three stories ❑ Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
Master Builder • Other: ❑ Egress/lighting plan ❑ Other:
' I ' IN v..r e N - a1,0.' ,N . ;. fr -V-4: :: -' W' Submit sets of plans with any of the above.
The above are not a livable to tern . ra construction service.
Job site address: 111y c,, y h11 : ; #■i: :,�•.�f 13t a ' i ? 1. ` ,�` •
Suite #: t o I I Bldg. /Apt. #: Number of Inspections per permit allowed
Project Name: Xu d ku.s Description Qty Eee (ea.) Total 1
Cross street/Directions to job site: New reddentlai eingle or multi-family per
, dwelling salt. Includes attached garage.
11 Service
f••�� ) 10 0 sq. �esss • 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax ma • • arcel #: Each manufactured home or modular dwelling
0 g l2.+7W OW LIMT.t tlT, It;1 a ` 7 AI 1 ': :t ".- ' service and/or feeder 90.90 2
1 Services or feeders - installation,
i •' i R, 1tyure ska 'Iteration orretocatlorl:
v 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
r� : 7 T y: q 601 amps to 1000 amps 240.60 — 2
iiia7 'i.0 ; :i : ' ' iiTSEW,Ii i; h5 �i`` �'' Erk,13:. �'3 EM Over 1000 amps or volts 454.65 2
Name: Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State/Zip: 200 amps or less 66 I
201 amps to 400 amps 100.30 2
401 600
Phone: Fax: to amps 2
_ _ � e 133.75
' I , Z,� f2.`?* . 5 ' 16 +55 91 0' 7Ts °; ' ' Branch circuits- new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State/Zip: • B. Fee for branch circuits without purchase of
service or feeder fee, that branch circuit l 46.85 W 6 , t' 2
Phone: I Fax: Each additional branch circuit 6.65 yG • ,0` 2
E -mail Miac.(Servlee or feeder not included):
n rl :' ,m Each ptmrp or criR,ation circle 53.40 2
`+ ?I1' t, hwiu��: ��f1�����F��+Fthlltillir+WlJrl�i i•k :. 2
Each sign or outline lighting 53.40
Job No: • Signal circuit(s) or a limited energy panel,
Business Name• alteration, arextension Paget 2
•Electrical Contractors & De Descri
Address:1 50 NE Victory Suite A -
Clt /State/Zl Each additional Inspection over the allowable in an • of the above:
Y P:Gre s ha m Oregon 9 7 0 3 0 Per inspection per hour (min. 1 hour) 62.50
Phone:(503 ) 6 6 6 - 9 3 5 8 Fax: (50 3) 667-7965 Investigation fee:
CCH Lic. #: 47712 Lic. #:26-466C otha` -,� a. u2 ;� . F �,: ;
Supervising electri
ci - �°�. +�-- �:�_F ;�.. ;.,. ; �. �r� � _ ..
'n st -- ma Subtotal $ • 0
signature required: Plan Review (25% of Permit Fee) $ .
State Surch < :. e 8% of Permit Fee $ • '4 7
Print Name: �°era..? s Lic. #: 1 9 8 2 S TOTAL PERMIT FEE $ 0 • . 7
Authorized U Notice: This permit application expires If a permit is not obtained within
Signature: Date: 18D days after It.haa been accepted as complete.
*Fee methodology set. by Tri- County Building Industry Service Board.
(Please print name)
i :\Data \Permit Forms \ElePermitApp.doe 01/03 •
2 - d S 96 L - L99 -EOS B suo'oeuluo3 ieoI.a4oa13 WdSE :S 9002 BO ^oW
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELG2005 -0015
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639- 4171 °`__�
Inspection Requests (24 Hrs.): (503) 639 -4175 � &- -
INSPECTION WORKSHEET FOR DATE: 11/14/2006 TIME: 7 :02AM PAGE: 3.;
SITE ADDRESS: 11945 SW PACIFIC HWY 207 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: KATHYS
DESCRIPTION: KATHYS. (8) branch circuits.
9
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: ELECTRICAL CONTRACTORS & DESIG PHONE #: 503 - 666 -9358
Inspection Request Scheduled For: Date: 11/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 039726-0/ 503-666-9358 Y
Corrections /Comments /Instructions: 5
Lo Lk-) \. - 4\%
CD
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
DV t'e,
Inspector: Date: ' I I I q I (j Phone #: (503) 718- AL__