Permit • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00407
Alzptiy :tI A DEVELOPMENT SERVICES DATE ISSUED: 6/13/2005
"'I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 CC -01000
SITE ADDRESS: 13660 SW PACIFIC HWY 62 ZONING: C - G
SUBDIVISION: FIR GROVE VILLAGE LOT : JURISDICTION: TIG
Project Description: Panel change.
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: 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:
KUBIN CARON ABC ELECTRIC
520 SW 6TH AVE #400 135 NE 9TH
PORTLAND, OR 97204 PORTLAND, OR 97232
Phone: Phone: 503 - 233 - 7551
FEES Reg #: LIC 26 -1226C
Description Date Amount SUP 5096S
ELE 161501
[ELPRMT] ELC Permit 6/13/2005 $80.30
[TAX] 8% State Surcharge 6/13/2005 $6.42 REQUIRED ITEMS AND REPORTS
Total $86,72
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: 1 a Permittee Signature: 9" 0 Ni) V
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.
JUN -13 -2005 09:43 AM P. 01
, _ weetrical Permit A li
1`01( 1 1('I•: IRA. ()NIA
City of Tigard ; ! • 1 Received
13125 SW Hall Blvd., Tigard, OR 97223
ratan I 6 , / 3 05 - - emit No / ../e6--79e/ e
Phone: 503.639.4171 Fax: 503.598.1960 r „>., )ir, i Review
Inspection Line: 503.639.4175 J U t 1 1 3 _ , I , ly ,'- , J J Date -tom n3 Other Permit:
vArw ct tigard or us i 1 - --
„ rl { + I, I !) , )i oti ethod_ See pip fo'
q s {r i.' n t + ' Supplet lafotw
...,.. ... ,. � 1V .fly
Internet ,m
New construe -_ - , � � � ,,
❑ bon t , , . I I ,r � 1 1 , l i f .111 , { x iN , n �)' +^" I�i1;,
A� er, , , d'
► +-�' p �7 �T Please ' I li I o- `1 , .Lr k 9 t,v x .., St m +., G :� -, ,. lf,
❑ Demolition Q Other check an that apply:
l l it 'I } i ,11 ,r,;, ` . i {' �1 V service over 1 225 1 amps, comet ❑Hazardous location
,1 ; I .0 l - ., „,, t .: ,7 I ` J , : , - _• ❑Service ove 320 amps - ratin
I g ❑Hondas over resid 0,000 a ll., • �: 1 - end 2 - family dwelling ' ”
of 1- and 2- family dwellings 4 or more new residential
8 ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder 0 Oth 0Building over three atones ['Feeders, 400 arms or more
i, 4 I ':•'.,',,i::.•,, ! ❑Occupant load over 99 persona ❑Men ctured structures or
u
❑8 ighnn plan ltV park
•..... Sin B P
Sob no.: to • Job site address • ' ['Health facility ❑Other;
Submit 2 seta of plans with any of the above-
City/State/ZIP: • ■ O
1 . The above
Suite/bld / are not applicable to temporary construction setvlce
g. apt• no.: , •-
ProJectname: I C 'i ' - { If{I ;, � I j+ l4ta, f+l' ,,a+' 1141,)
�. Deeariptial � ;�; h 1C ..,,� ** +
Cross street/directions to Job site: Qtr Pee. rent
�•
�� • 1st 41 New residential single- or multi- family dwelling unit.
linIIIIIIIIIIIIIIII Includes attached garage,
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: 138. add'I 500 e sq. ft, or —�
q portion 33.40 I
Tax trap /parcel no
r t Ll Limited energy residenti 75 y
`,elt.,r! ?{ +I, { , 1 1 ' f ; :. r$Y non - re sidential 75.00
2
Limited ens
-
Each manufactured or modular
`� ( , 1 `_ ` dwelling, service and/or feeder _ 90.90 2
$ervIces or feeders Installation, alteration, and/or relocation
:.I' I `t'Flt 1 , ., ,. , 200 amps or leas 80.30
ikl1+ 1 {i,d,'„t,� ,1 {,,, 1 , 401 a 201 amps to 400 amps 106.85
Name: 2
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
City /State/ZIP: Reconnect only 66.85 2
Temporary services or feeders Installation, alteration, and /or
Phone: ( ) Pax. ( ) relocation
Owner installation: This installation is bein g made on property that I own which is not 201 20 amp amps o 400 s t to 400 amps 100 .30 00. I
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 • 2
Owner Signature 401 amps to 600 amps 133.75 2
_i r Date Branch circuits - new, alteration, or extension, per panel
: 'i
A Fee for branch circuits with
�,: r service or feeder fare, each
= I branch ci 6.65 2
Contact name: ' B. Fee f or branch circuits •
without service or feeder fee,
Address: each branch circuit 46,85 2
l �" Each add'l branch circuit
City/State/ZIP: 6.65 2
y / . "� Miscellaneous (service or feeder not included)
Phone: ( ) Pump or irrigation circle J 53.40 L J 2
�y.�l'SI�IUi �.I. ��.,,. + � ' lll'l' ). t,,' 1 I , I _ , _ Signal circuits 11 or limited- 53.40 2
,! ;. . energy pane alration, or
a
/ extension• Des Page 2 2
Address: t� , . , ' Each additional Inspection over allowable in any of the above
•
Per inspection 62.50
1 .i t Investigation per hour (1 hr min) 62.50
crimrimwmam ( ) Lndush Ial plan t per hour
( Suprv. ���� J Idi..; •, , ll,l �a .
,r.h tubs ,,..7,3.7,5_, l ..' {II r ll ? h'' , r
Electrical Lic rv. Lic. ) l ' 11 liik, tik
ECEIMPLI Subtotal RO
Suprv. Electrician signature, required; �� ..e6 Plan review (25% of permit fee)
l _iv / , _ ; � Date: 4 / J � State surcharge (8% of permit fee) d
TOTAL PERMIT PEE -� t2 �
Authorized signature:
■
,
Tbte permit application expires If a permit le not obtained within 190
days after It has been accepted u co
/ ' Date: • Fee methodology set by Tri- County Handing Industry Service Board
I •• Number of inspections per permit allowed.
1: 1.13uilding1PormitAELC-Ppr,, itApp. 12/03 440-461 Jr(lolp2COM/WHa
- CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13 /2005
Phone: (503) 639 -4171 : +,e
Inspection Requests (24 Hrs.): (503) 639 -4175 —Ilk fi__..
INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 68
SITE ADDRESS: 13660 SW PACIFIC HWY 62 CLASS OF WORK:
SUBDIVISION: FIR GROVE VILLAGE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: FIR GROVE APTS
DESCRIPTION: Panel change.
OWNER: KUBIN CARON, PHONE #:
CONTRACTOR: ABC ELECTRIC PHONE #: 503 - 233-7551
Inspection Request Scheduled For: Date: 7/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 010623 -01 503.2337551 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FO' IN PECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -- / ' Date: 1 1 I Or Phone #: (503) 718-