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Permit • R CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00418 ecatiA r � DEVELOPMENT SERVICES DATE ISSUED: 7/12/2004 r �' JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 110 D C -02200 SITE ADDRESS: 15570 SW PACIFIC HWY SUBDIVISION: WILLOW BROOK FARM ZONING: C -G BLOCK: LOT : 011 JURISDICTION: TIG Project Description: Emergency shutdown. 1 branch circuit. 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: TIGARD, CENTER LP STONER ELECTRIC 9777 WILSHIRE BLVD #609 1904 SE OCHOCO STREET BEVERLY HILL, CA 90212 MILWAUKIE, OR 97222 Phone: Phone: 503 - 462 -6500 Reg #: LIC 44823 SUP 3496S FEES ELE 26 -122C Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/12/2004 $46.85 [TAX] 8% State Surcharge 7/12/2004 $3.74 Rough - Elect'I Final Total $50.59 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 -800-33 344. Issued By: Permit Signature: �jQd • 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 639 -4175 by 7:00pm for an inspection the next business day 07/09/2004 FRI 09:46 FAX 5036592824 STONER SERVICE a002 "-" F pR OFFIC E t_ SE U\I_ Electrical Permit Appi V E D , City of Tigard n e , / I l Permit rr °.: li..C Oo�• ODIiii 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review p P Phone: 503.639.4171 Fare 503.598.1960 JUL 9 2004 » � I'(' Datr 1utiX la See Page 2for D Ready/By: Inspection line: 503.639.4175 - f 1 supplemental Information Internet: www.citiganior.us CITY OF TIGARD 19/411.61KiiiiiiiISION PLAN REVEW : ❑ New construction 1 Addition/alteuulion/leplacement Please check all that apply. ❑Service ova 225 amps, comm 'I (3 Hazardous location ❑ Demolition Other ❑ Service over 320 amps – rating (] Buildng over 10,000 sq. ft., : CATEGORY OF CONSTRUCTION . of 1- and 2- family dwellings 4 or more new residential ['System over 600 volts nominal units in one structure ❑ 1 - and 2- family dwelling N. Commercial/industrial ❑ Accessory building ❑ Building over three stories I ] Feeders, 400 amps or more ❑ Multi- family 0 Master builder ❑ Other: ❑Occopent load over 99 persons I3Manufactured structures or t ill *irt INI+ORMATION*".#,I7.4TION ❑Ege011ighting Plan RV park /� F4/.0y ❑ Htalttttare facility I ]Othtr Job no.: � 74 ` Job site address: I �j S O I V er F(� Submit 2 sets of pleas with any of tl a above. J City/State/ZIP: 0 q `1,9 3 The above we not applicable to temp nary construction service. ( b1��1 -� 1 t- 7 sib . F Suite/bldg./apt. no.: Project name: - ` b. ran I Tatar I •• Cross street/directions to job site: • New residential single- or multi -fat oily dwelling mat. Inelada! attached garage. 1,000 sq. IL or less 145.15 4 / Subdivision: I Lot no.: Fa add'] 500 sq. tt. or portion _ 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non- residetial 75.00 2 DESCRIYTTON: WOt3>� Each ma ufactued or modular PeP` / I,s 2 dwelling, service and/or feeder 90.90 2 �9G ©/T �, J v1' ` � rd � 5 Service; or feeders installation, all eraton, and/or relocation 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 ? O ❑ 'TENANT .. 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Over 1,000 amps or volts 454.65 2 Address I I i . -i — i • _ I � l . it Reconnect mty 66.85 2 City/State/ZIP: I \ Temporary services or feeders hat tallatian, 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 1 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 1 133.75 1 2 Owner signature: Date: _ Brae&& cheerio –sew, alteration, or extortion, per panel :r: t * IPFSl9oN % ` ;': k : A Fee for branch circuits with ° �:. .D.ORiACT'• ` service or feeder fee, e ach .'::''c`- :. . 6.65 2 Business name: branch circus B. Fee for branch circuits ,/� Contact name: without service or feeder fee, ( 46.85 14 (7 2 each branch circuit _ Address: Each add'I breach circuit 6.65 2 City/State/ZIP: lt4iaedlaneons (service or feeders not Included) Pump or inigation circle 53.40 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2 E - mail: - Signal crcnit(s) or limited - CONTRACTOR _ energy panel, alteration, or extension. Describe: 75.00 2 Business name: S;E NER t LEC -T' 1 C Each additional inspection over i dlowabk in any of the above Address: 190 4- SE O e- h o c . oo per isepeetion - 62.50 City/State/DP: M r L tA/A -V tf< 1 E , O R / q 72. a a Investigation per hour (1 hr min) 62.50 Phone: (SQ3) 46 2 - (a s00 I Fax: (5 ) (, : 3— 49(0 s Industrial plant per hour 73.75 ELECTRICAL P ERMT[ FEES* CCB Lic.: 44e,e3 I Electrical Lic. :26, 22 L I Suprv. Lic.: 34 - 9( o s Subtotal c Suprv. Electrician signature, required: Mk,,,Q Plan review (25% of permit fee) { Stare surcharge (8% of permit fee) 7 Print name: M 1 K>= r4 L co /�(E R Date: //� /� O. (! ( TOTAL P;iRM1T FEE Authorized signature: This permit application expires If • permit Is not obtained within 180 days after it has been :accepted as complete Print name: I Date: .� Fee nuthodology by Tri- Cotmty Building Industry Service Board • CITY OF TIGARD 24 -Hour BUILDING Inspection, Lif.QL(503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST 710(26/Y1 7 / .76 BUP Received / Date Requ sted AM PM BUP Location ` 55 ,de'_ • Suite MEC I Contact Person Ph ( ) 6 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner X C�6e Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Not �. SIT e Post & Beam ` l�J��J! �) rY1< Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall - p jj Ft v / Fire Sprinkler ! � '! Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PA ART FAIL E EC Se ' Rough -In UG/Slab Low Voltage Fire Alarm A PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. El Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date 7- 7-(0- 0 Inspector/ / LiiirWagr_ Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL