Permit A_ . CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00215
I DEVELOPMENT SERVICES DATE ISSUED: 3/31/2005
` ca l I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102BA -01200
SITE ADDRESS: 12585 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. LOT : 053 JURISDICTION: TIG
Project Description: New panel cover.
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: 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:
MORLAN PROPERTIES DEKORTE ELECTRIC
5529 SE FOSTER RD PO BOX 12379
PORTLAND, OR 97206 PORTLAND, OR 97212 -0379
Phone: 503 - 624 -7381 Phone: 503 - 288 -2211
FEES Reg #: ELE 34 -541C
LIP 1075
Description Date Amount
SUP 40755 5
[ELPRMT] ELC Permit 3/31/2005 $46.85
[TAX] 8% State Surcharge 3/31/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
•
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 a re 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 - 332 - 344.
Issued By: Permittee Signature: '41 Q�
OWNER INSTALLATION ONLY (T /`
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 - 6394175 by 7:00 a.m. for an inspection that business day.
This permit cab 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.
DEKORTE ELECTRIC LLC 5032882231 P. 0
S 1
03/31/02:29pm 001
•
IVE® • •
E� FOR OFFICE 1'SE ON �. . — � .
Eleetrica Permit a L\
City of Tigard 2005 /A Permit Na: _ ,•D a , 5
13125 SW Hall Blvd., Tigard, OR 97223 - ` P lan Review
�' y OF TIGARD �^'.. OtherP+mmit
Phone: 503.639.4171 Fax 503.598. ��f � I � • Date/By:
Inspection Line: 503.639.4175 •
_ Dare Read m rir ® See Page 2 for
Internet: www.el.tigard.or.us Ac q G t. Ok_ Paitir Notified/Metho 7 Supplemental Information •
. . -.. -
'': TYPE ;Oii WORK : ; PLAN : REVIEW. , .. : _
❑ New construction J g Addition/alteration/replacement Please check all that apply:
❑ Demolition [] Other: OService over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft,
• . • CATEGOR'V OF CONSTRUCTION` . 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
❑Building over three stories ❑Fecdcra, 400 amps or more
1:1 Multi- family 0 Master builder ❑ Other:
❑Occupant load over 99 persons OManufactured structures or
JOB . SITE INFORMATION; A1I D. LOCATION .. ' ❑Egress /hghtimg plan RV park
Job no.: 05 Job site addrrss: f. �' ( • `` `` 1 ❑Health -care facility ❑�
V'] I I Z5 J (1.iC.ITI Y'i (� Submit i sets of plans with any of the above.
Ci • /State/ZIP :1' q J The above are not applicable to temporary construction service.
Suite/bld /a t. no.: Project mane: In .
FRE . $CC)<## - E : . . :. :" - ::
& P J (�� > r V 1 Gl C C� .1/\ Description I Qty. I Fes I Total •
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. it or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. it or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2 • • DESCRIPTION` OF WOR'k • Each manufactured or modular
p dwelling, service and/or feeder 90.90 2
I� Cu. '" e_ n1 e�3 ('ff T �. t� r e l CIS-.I p(.Z.. v'1 (_,I Services or feeders installation, alteration, and/or relocation
C.5V 200 amps or less . 80.30 2
❑ PROPERTY OWNER: . El Aj� 201 amps to 400 amps 106.85 2
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 serviees or feeders installation, alteration, and /or
Phone: (5 224 3) ( � - 1 5z , I Fax: ( ) relocation
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 10030 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
• Cl A.PPLICAN' • . . • • • . ❑ CONTACT PERSON A. Fee for branch circuits with
I. service or feeder fee, each
Business name: . branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 r 2
Address: Each add'I branch circuit 6.65 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
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: DeKorte Electric . —1 e— •
Address: PO Box 12379 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 972112 Investigation per hour 0 t. min) 62.50
Phone: (503) 2.8$- 3'a\ \ I Fax: (503) 288 -2231 Industrial plant per hour 73.75
ELECTRI PERMIT; .0188, .
CCB Lic.: 159954 Electrical Lic • 3 54 S pry Lic.: •.i 75S Subtotal 'T 62 _ g s
Suprv. Electrician signaUue, required: � �� 0 , �� Plan review (25% of permit fee)
u ^ ( _ State surcharge (8 %of permit fee) 3 . �S
Print name: K em I`..V r A . Date. J I (' s f^
TOTAL PER FEE 5 0 _ to 0
Authorized signature: This permit application expires If a permit is not obtained within ISO
days after it bas bee. accepted as complete
Print name: I Date: • Fee methodology set by Tri.County Building Industry Service Board
F+4ED o a 3 fr I If2.S.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELG2005.00215
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/31/2005
Phone: (503) 639 -4171 : h
Isp Requests (24 Hrs.): (503) 639 -4175 _ -_' ` .L.
INSPECTION WORKSHEET FOR DATE: 4/11/2005 TIME: 7 :10AM PAGE: 31
SITE ADDRESS: 12585 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. LOT #: 053 TYPE OF USE:
PROJECT NAME: GEORGE MORLAN
DESCRIPTION: New panel cover.
OWNER: MORLAN PROPERTIES, PHONE #: 503-624 -7381
CONTRACTOR: DEKORTE ELECTRIC PHONE #: 503-288-2211
Inspection Request Scheduled For: Date: 4/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 004212 -01 503-740 -9769 Y
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Corrections /Comments /Instructions:
J� 0 1\` \ 1 , an SS AN L/ \.- R L& C. A Piville DOD k o n,
gt3N 16 Q,_\INN/ 0 1-D o\IN'e I a._ui 'c, c_; A,
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(41
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: gu J 7 Date: // G "Phone #: (503) 718 -