Permit 51 q ' "t % CITY OF TIGARD ELECTRICAL PERMIT
° ' COMMUNITY DEVELOPMENT
PERMIT #: E /19/20 -00854
DATE ISSUED: 12/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102CC -00700
SITE ADDRESS: 13599 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: ENZO FAMILY MASSAGE
Project Description: Electrical TI - (5) 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: SIGNAUPANEL:
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: 4 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:
DENNIS HORTON NELSON ELECTRIC LLC
19220 VIEW DR 1745 4TH AVE
WEST LINN, OR 97068 WEST LINN, OR 97068
Phone: Contact #: PRI 503 - 267 -8529
FAX 503 - 237 -6472
FEES
• Description Date Amount Reg #: ELE C123
[ELPRMT] ELC Permit 12/19/200' $73.45 LIC 168080
[TAX] 8% State Surcharge 12/19/200' $5.90 SUP 3506S
Total $79.35 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 18 day ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 1 -0010 thro O 2- 1 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
[� Issue By: ( ` Permittee Signature: K /1da0N--
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: _ ;ALL da1v'" 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 �
E'f ctri'cal Permit Application 1.014 (111 1( 1' I s1: O\I.\
Received M I
City of Tigard Date/6 iq a Permit No.: C Q7 � 8 5
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/B .
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: 63 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: n Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction VrAdditi0n/alteration /replacement Please check all that apply (submit a sets of plans w /items 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 as 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling til Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
motor load of
JOB SITE INFORMATION AND LOCATION ❑ Addition of new system. larger separately derived system.
['Addition `'A ", "E', "1 -2" "1 -3 ",
Job no.: Job site address: I00HP or more. occupancy.
I /3.5."99 stv 4 ❑ Six or more residential units. 0 Recreational vehicle parks.
Ci ` /State /ZIP: /� � r 1 ❑ Health -care facilities. ❑ Supply voltage for more than
h / /�� �Ci�17� ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: ( Project name: CA)xO 614 I l y 417 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I 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. ft.) 75.00 2
Ad44 tU • hh Ce fe CeAC/� Limited energy, multi-family 75.00 2
v cs (with above ft.)
Services or inst s or feeders install llati r)n, alteration, and/or relocation
200 amps or less 80.30 2
( OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ` ( c , (.40 (Z'rQ N 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: ( ) I 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 599 amps 133.75 2
Owner signature: Date: Branch circuits – new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits p�
Contact name: without service or feeder fee, 46.85 ' o
first branch circuit
Address: Each add'l branch circuit 1 6.65 14 40 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling. service and/or feeder 90.90 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 • 2
Business name: 72e 11'2' f/ ,/ / Signal panel, e r t limited- o or
y /L .t/� � C C� (� energy panel, alteration, or
Address: ./7Y5.– ,9 extension. Describe: Page 2 2
City/State/ZIP: t, 4//9 /I 4 0, g7G6'ef Each additional inspection over allowable in an of the above
Phone: jk7' pJ� Gr Fax: ,237- 6e/72 � Per inspection 62.50
� ( Investigation per hour (1 hr min) 62.50
CCB Lic.: fi; roses I Electrical Lic.: (42 3 I Suprv. Lic.: 3506 S Industrial plant per hour 73.75 '
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 73.'y 5
Print name: Rt ChUU/ 4 /{i,rei Date: /2 – / C 7 Plan review (25% of permit fee):
State surcharge (8% of permit fee): ' 90
Authorized signature:////' //}lCft ^� TOTAL PERMIT FEE: 71: 35--- y r/ This permit application expires if a permit is not obtain within ISO
Print name: Date: days after it has been accepted as complete. •
• Number of inspections allowed per permit.
1 IBuilding1Pamni 'ELC- PermitApp.doc 05/23/06 44046157( 1 I /05 /COMAVF -B
•
•
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2007.0tI854
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/2007
Phone: (503) 639- 4171I�II
Inspection Requests (24 Hrs.): (503) 639 -4175 _ -W
INSPECTION WORKSHEET FOR DATE: 4/3/2008 TIME: 7:02AM PAGE: 52
SITE ADDRESS: 13599 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ENZO FAMILY MASSAGE
DESCRIPTION: Electrical it - (5) branch circuits.
OWNER: HORTON, DENNIS PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC PHONE #: 503 - 267 - 8529
Inspection Request Scheduled For: Date: 4/3/2008 Pour Time:
Code # Inspection Description C nfirm Contact # Message
199 Electrical final /067805 -01 503-701-9783 N
Corrections /Comments /Instructions: 'N
PASS ❑ PARTIAL APPROVAL
ill CANCEL ❑ NO ACCESS
AIL
11] CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 1 v d e7 ` Date: 4'1 Crk Phone #: (503) 718 -1A
4
CITY OF T'IGAF3 ® . f a 200l.- at LOS (.®
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ;. ONpvlll
Inspection Requests (24 Hrs.): (503) 639 -4175 _ .! ,.__..
INSPECTION WORKSHEET FOR DATE: 4/' 70 • TIME: PAGE:
SITE ADDRESS: 1$ eA6 ti IA 4C - t , \_ v CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: - DESCRIPTION: 0
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # . Inspection Description Confirm # Contact # Message
iA5 /U6 . 5 eLorwe,,
Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V 6 ( Date: / K Phone #: (503) 718- 2 4- Z
•
CITY OF TIGARD.
BUILDING DIVISION A. . PERMIT #: ELC2007-00854
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1g/2007
Phone: (503) 639- 4171 ICI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/18/2008 • TIME: 7 :02AM PAGE: 10
SITE ADDRESS: 13599 SW PACIFIC HW( CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ENZO FAMILY MASSAGE
DESCRIPTION: Electrical TI - (5) branch circuits.
OWNER: HORTON, DENNIS PHONE #: 901 3
CONTRACTOR: NELSON ELECTRIC LLC PHONE #: 503 -267 -8529
Inspection Request Scheduled For: Date: 1/18/2008 Pour Time:
Code # Inspection Description onfirm # Contact # Message
- 499' Electrical final 063537 -01 503-980-8585 N
tab NA C.o�R. oa1,y
.
Corrections /Comments /Insittuctions: V
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL [] CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Y " Q'ES Date: I — I is v " Phone #: (503) 718- 1 -44'
CITY OF TIGARD,.
BUILDING DIVISION PERMIT #: ELC2007- 00854
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/2007
Phone: (503) 639-4171 ' 2 t4 j •I A`
In Requests (24 Hrs.): (503) 639 -4175 ' ..
INSPECTION WORKSHEET FOR DATE: 1/10/2008 TIME: 7:00AM PAGE: 50
SITE ADDRESS: 13599 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ENZO FAMILY MASSAGE
DESCRIPTION: Electrical TI • (5) branch circuits.
OWNER: HORTON, DENNIS PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC PHONE #: 503.267 -8529
Inspection Request Scheduled For: Date: 1/10/2008 Pour Time:
Code # Inspection Description - Confirms# Contact # Message
130 Ceiling cover ((62943.0i 555-55 b.a N
Corrections /Comments /Instructions: __ _ .
9 AM
❑ PASS ❑ PARTIAL APPROVAL K4 CANCEL ❑ NO ACCESS •
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES•ASSESSED
Inspector: ■ 1 " •V Date: I '10 ' (A Phone #: (503) 718-1.!___
CITY OF TIGARD, _
BUILDING DIVISION S PERMIT #: ELC2007.0t18E4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/2007
Phone: (503) 639 -4171 /4ru�„ u
Inspection Requests (24 Hrs.): (503) 639 -4175 : _..
INSPECTION WORKSHEET FOR DATE: 1/9/2008 TIME: 7 :01AM PAGE: 31
SITE ADDRESS: 13599 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: EWZO FAMILY MASSAGE
DESCRIPTION: Electrical TI - (5) branch circuits.
OWNER: HORTON, DENNIS PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC (� 5 - t\ #: 503:167 -8529
Inspection Request Scheduled For: Date: 1/9/2008 Pour Time:
Code # Inspection Description C. . ' m # Contact # Message
130 -. Coiling cover 062836-01 503-980-8585 Y
- 3.O
Corrections /Comments /Instructions: 9 R o ff_
cv Ain ltbIc1
❑ PASS ❑ PARTIAL APPROVAL [CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 06 1-0 Date: I ' V Phone #: (503) 718- leflrt___
CITY OF TIGARD,,_
BUILDING DIVISION A 4 PERMIT #: ELC2007.008E4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12(19/2007
Phone: (503) 639 -4171 Il
Inspection Requests (24 Hrs.): (503) 639 -4175 - __..
INSPECTION WORKSHEET FOR DATE: 1/7/2008 TIME: 7:00AM PAGE: 59
SITE ADDRESS: 13;99 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ENZO FAMILY MASSAGE
DESCRIPTION: Electrical TI - (5) branch circuits.
OWNER: FIORTON, DENNIS PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC PHONE #: 503 -267 -8529
Inspection Request Scheduled For: Date: 1/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
185 Mimic. inspection 062622 -01 503 - 267 -8529 Y
Corrections/Comments/Instructions: •
1
Co s ? CX<1 N U.- On c c,A 8 P , M17. 330.30
M s i ? bct? gL-L. -E A PW- AZ'. 33 o
& 6 \-?frisco4 ALA v gO ■ S AR • 3 1423 (nj CO
S N /y0 N M cli2 • ?)3 .3 0
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
N ►j FAIL A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 0 be L Date: I' 0 Phone #: (503) 718 - r l ! "
•
CITY OF TIGARD,
BUILDING DIVISION > PERMIT #: ELC2007.00854
13125 SW Hall Blvd., Tigard, OR 97223 -, DATE ISSUED: 12/19/2007
Phone: (503) 639- 41711i�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.:�� __
INSPECTION WORKSHEET FOR DATE: 17J21/2007 TIME: 7:03AM PAGE: 79
A
SITE ADDRESS: 13599 SW PACIFIC I�11NY C T � CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
•
PROJECT NAME: ENZO FAMILY MASSAGE
DESCRIPTION: Electrical it - (5) branch circuits.
OWNER: HORTON, DENNIS PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC PHONE #: 503 - 267 - 8529
Inspection Request Scheduled For: Date: 12/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Elegoii oI rough. 061972 -01 503267-8529 N
MC uJ 4 LL, CO V'S it. —
Corrections/Comments/Instructions:
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &Aa woe Date: 12' 21' 01 Phone #: (503) 718 - ow&