Permit C ITY OF TIGARD ELECTRICAL PERMIT
r PERMIT #: ELC2005 -00443
�ql n DEVELOPMENT SERVICES DATE ISSUED: 6/23/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134BC -00200
SITE ADDRESS: 12196 SW SCHOLLS FERRY RD ZONING: C -
SUBDIVISION: GREENWAY TOWN CENTER LOT : JURISDICTION: TIG
Project Description: Security Camera's & quad for controller at electric room.
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: 1
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:
SAUNDERS, WILLIAM W TRUSTEE OES LLC
2155 KALAKAUA AVE STE 500 12785 SW TV HWY SUITE F
HONOLULU, HI 96815 ALOHA, OR 97006
Phone: Phone: 503 - 649 - 4404
FEES Reg #: LIC 159395
ELE 34 -572C
Description Date Amount SUP 4587S
[ELPRMT] ELC Permit 6/23/2005 $121.85
[TAX] 8% State Surcharge 6/23/2005 $9.75 REQUIRED ITEMS AND REPORTS
Total $131.60
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 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: -� p Permittee Signature: To g.. p1,c
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 23 05 10:58a Jim Noreen (503) 649 -4652 p.1
. 'A1ec> rical Permit Application ^ _ .. C F o R O F 1 f ( . I : S I: O \ 1.1
City o Tigard rJBy. 6 6.!' PermitNo 0 adW
13125 SW Hall Blvd„ Tigard, NEC) i i Pim Review J
Phone: 503.639.4171 Fax till ".,, ' ` , By. Other Permit
Inspection Line: 503.639.4175 �J.1. , 'I J.. Due Ready/By: iu El See Page2 for
Internet: www.ci.tigard.or.us ') . 211U.1 (n�(n�[[ Notified/Method 1-i Supplemental Information
,. T1'PE O O PLAN REVIEW
d ❑ New construction ;Addian /h laeement Please check all that apply:
❑ Demolition ��AaG D ❑Service over 225 amsps,00nmt'I ❑Hazardous
El Service over 320 amps— rating ❑Boidng over 10,000 sq. tt.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling 12 ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑ Multi family ❑Master builder 0 Other_ OBuildiug over three stories ❑ Faders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lightingplan RV park
❑He
Job no.: Job site address: /2/ %. .i"4hGi Submit sets o off plans ❑
Submit 2 2 sans with any of the above.
City /State/ZIP: `"
i i ✓i G11� The above are not applicable to temporary construction service.
'
FEE• SC:REDPLE
' Suite/bldg. /apt. no.: I Project name: • yaalpdm I Q r• I Pea I Total
Cross street/directions to job site: G,to 2+....04 f . 4. CQ.s."k ✓ New residential single or math family dwelling unit.
/ Includes attached garage.
.> C i,,. ✓ / C, n� eV Ci� /�! �� ,/,./. J rrir'�/' //e �fr d o ( 1,000 sq. ft or less 145.15 4
Subdivision: Lot no.: Fa add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non-resideo>ial - l 75.00 yo 2
DESCRIPTION OF WORE Each manufactured or modular
dwelling, service and/or feeder 90.90 2
X / /gi "✓ /' ��oa!! ' a ,/ _2GU✓'3 C4 , yn G✓ci•s,, Services or feeders Installation, alteration, and/or relocation
G ....,.'l 4 A E 61 �-C+ e ,--..f �,/' c-vh 7/6 PQ'..' 4 s / ✓h 200 amps or less 80.30 2
1:1 PROPERTY OWNER r ❑ TENANT /2oow1, 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 services or feeders installation, alteration, and/or
Phone: ( ) l 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 100.30 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 circuit, — new, alteration, or extension, per panel
A
❑ APPLICANT ❑CONTACT PERSON Fee for branch circuits with service or feeder fire, 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 4•75 2
Address: Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting • 53.40 2
E-mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
Business name: a�S e L G
extension. Desariba Paget 2
Each additional Inspection over allowable in any of the above
Address: ��� s�,� 11/ � y J ` / 72 Per inspection 62.50
City /State/ZIP: / 4/• 41 a� .57,3,36- ^, Investigation per hour (1 hr mum) 62.50
Phone: S�t:6) ‘75' " , I Fax: ($) 3) g . W...c.� Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES`
CCB Lic.: /Sy J9S [Electrical Lic.: J S Li, . 5'z ?..' subtotal /,Z, /. Fs
Suprv. Electrician signature, required: ; 4 Plan review (25% of permit fee) ,,.67-
State surcharge (8% of permit fee) 7. %y
Print name: G Acs ,,; 6', Date: g , /05 TOTAL PERMIT FEE
/.3/. ,4e)
Authorized signature: This permit application expires if a permit Is not obtained width 150
days after it has ben accepted as complete
Print name: I Date: • Fee methodology sal by Tri -County Building Industry Service Board
•• Number ofimeectioos or permit allowed.
�6• -�
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2005- 00443
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005
Phone: (503) 639 -4171 .° "" Ili I
Inspection Requests (24 Hrs.): (503) 639 -4175 :�
INSPECTION WORKSHEET FOR DATE: 7/6/2005 TIME: 7:12AM PAGE: 1
SITE ADDRESS: /2196 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: GREENWAY TOWN CENTER
DESCRIPTION: Security Camera's & quad for controller at electric room.
OWNER: SAUNDERS, WILLIAM W TRUSTEE, PHONE #:
CONTRACTOR: OES LLC PHONE #: 503649.4404
Inspection Request Scheduled For: Date: 7/6/2005 Pour Time:
- Code # Inspection Description Confirm # Contact # Message
Electrical final 010839-01 503-710-7986 N
Corrections/Comments/Instructions:
( r
1
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 12 (/ S _ Date: 7
- 6 [S Phone #: (503) 718 -