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Permit C ITY OF TIGARD ELECTRICAL PERMIT w PERMIT #: ELC2004 -00576 DEVELOPMENT SERVICES DATE ISSUED: 9/13/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AD-00900 SITE ADDRESS: 14800 SW SEQUOIA PKWY ZONING: I -P SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: (6) additional circuits for At Home Services. 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: 5 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: HOME DEPOT USA INC IDEAL SERVICES INC BY MARSHALL + STEVENS INC 3525 S ALDER ATTN: MELISSA SHAPIRO TACOMA, OR 98409 PHILADELPHIA, PA 19103 Phone: Phone: 253 - 671 - 2160 Reg #: LIC 154353 FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 9/13/2004 $80.10 [TAX] 8% State Surcharge 9/13/2004 $6.41 Rough -in Elect'I Final Total $86.51 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: Permit Signature* / _ OWNER INSTALLATION ONLY er— 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 Electrical PermitOE Y7ED FOR OFFICE USE ONLY City Of Dateiv — /' ` �. Permit No.: e-t, a y -- 0 yi 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.5983 1 3 2004 All'it Date/B : other Permit: Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: IBM Supplemental Information .:%.i_..."1.,4; •: till _ .; r," r 3 ��t�����! : w ., � .. _.,{•�, =1. ^ z t •:° ss yyr 55 .. aa - , +`' , � 1�"''1�' "�``:,i.v : :, ":s : : «y :i . - '' �'.! 9 .r fp y .-- r = "µ . t 5 ;F y v IY h."4:5:.. .f, c S S ,. a' "P A '; RE'. f`;+:'Ci -x �r 2� r.� - � 4'. ' -7 -.F- M _ :�`Y�,W .. �SY fix t;�., •,, ^,.. �,ic -s ��., '.'k�r�:4. , � ❑ New construction t8, Addition/alteration/replacement Please check all that apply: ❑ Demolition ` ❑Service over 225 amps, comm'l ['Hazardous location y] Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., - s ,. <% y '''' F r, ^~ "=1 - °a. -!' o 1 - an d 2 - f dwellings J • w�� , " � � M' " '_CA�'�GOIfiY� �OP!�S�I YLI�"I'EOO lY���� ., ^�'^ !�• � wellin 4 or more new residential ❑ .-- 1 and " 2 - family dwelling fa. Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories ['Feeders, 400 amps or more ❑ Multi - family ❑Master builder El Other: ❑Occupant load over 99 persons ❑Manufactured structures or � ': , : ; i , ,;•" � ._ � :' •� .," ; = .i�� � I �; �iI�fF'� RM$ TIO1�i3 J , _ .. ` '`�= •�'� t ❑ Egress l ighting plan RV park Job no.: I Job site address: f `/go l/5h4? Lie,,,,, ❑Health care facility ['Other: p Submit 2 sets of plans with any of the above. City /State /ZIP` ill ©� , 972,z3 / The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: I Project name: � ;per / 7 " Description I Qty. I Fee. f I Total I " Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: � Limited energy, non - residential 75.00 • 2 iA ; rY �;.c '?.:.. _„ �:': ..._ �K? « 0= •'' = =v;' :. ;�><�r$ *_� ?s � - Each manufactured or modular /_ t _� dwelling, service and /or feeder 90.90 2 J ib /0r e. /2 t /S ©yZ -/Um - Services or feeders installation, alteration, and/or relocatio ,." �S a e , /� � 5 200 amps or less 80.30 2 <_4, - ;," 201 amps to 400 amps 106.85 2 _.. • ❑%;P1tOP�It�'1' r C , ' t 1 ty , . ; t ,_ " , .�N�T: +�-, � �-Y ' " ^ °' 401 amps to 600 amps 160.60 2 Name: r1 40 � .1L ( Q Q v , 1 L . 601 amps to 1,000 amps 240.60 2 Address: ` C3R)ko• 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 '1 relocation Phone: ()7p3) 6 79 - -3y U 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ;.;" a'- ii,, ,o r• N 'uf,; i ^: ': y -ti ', A. Fee for branch circuits with r ` service or feeder fee, each Business name: - f - G j / .S'��, ' 5 =m C branch circuit 6.65 2 Contact name: Y B. Fee for branch circuits /U1 .J 5 0 I without service or feeder fee, each branch circuit 46.85 g5 2 Address: 3 ``o 5 0 ` . e9si- -- _ Each add'I branch circuit , 6.65 J3, 'ZS 2 City/State /Z C - �i , �„.t to (1 4 , e t ro Miscellaneous (service or feeder not included) ) ) Z !� ) Z 1 Pump or irrigation circle 53.40 2 Phone: 3 b7 (4.� j '7 Sign or outline lighting 53.40 2 E - mail: t Signal circuit(s) or limited - ;1' �- z*.'•`... = :':a:V. .. °l'':•'4i; '� : ';';.001�1°.,�Of'�Ii; .'; .7::�r=.i4 %°;•: -s ;`' -,&,; �" "',` ; _> .x� � energy Panel, alteration, or `° " �" extension. Describe: Page 2 2 Business name: ,1 ./ _SSrZ. ' . 5 _ / rt/e___ l Address: 3 z__.J 6 O • � Each additional inspection over allowable in any of the above t /4 Per inspection 62.50 1 q) City /State /ZIP:C- v k i ,q /, 41161- IQ/l,( , Investigation per hour (1 hr min) 62.50 Phone:25,) 6 -- 2.4 7/� (7 I Fa 0 f z Industrial plant per hour 73.75 ''ilt%Iti I2ICi' P7'4ILIVTI�'', ES ." .. r: -: �: _.. CCB Lic.: / >j i.) 53 Electrical Lic.:37 ': gc Suprv. Lic.: /5 ) 5 Subtotal ' W ,./ Suprv. Electrician signature, required: / j ` '� �- Plan review (25% of permit fee) Print name:,,G r Ls9 5 - i - r 5,0 I Date: — / 0 Li State surcharge (8% of permit fee) i f . 4/ TOTAL PERMIT FEE A ,S'/ Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board •• Number of inspections per permit allowed. i:\ BuildingWermits \ELC- PemitApp.doc 12/03 440 461Sr(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information �• LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* 0 Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: M175 1 .70 Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical • ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC•PemtitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION PERMIT #: EL004 -00576 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2004 Phone: (503) 639 -4171 ®p��i lik Inspection Requests (24 Hrs.): (503) 639 -4175 .�.... 1 _ . . . INSPECTION WORKSHEET FOR DATE: 4/7/2005 TIME: 7:14AM PAGE: X22_ SITE ADDRESS: 14800 SW SEQUOIA PKWY CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: HOME DEPOT DESCRIPTION: (6) additional circuits for At Home Services. OWNER: HOME DEPOT USA INC, PHONE #: CONTRACTOR: IDEAL SERVICES INC PHONE #: 253 - 671 -2160 Inspection Request Scheduled For: Date: 4/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 003810.02 253 -671 -2160 Y Corrections /Comments /Instructions: N C • • PAIA4 k` VL(\ k c PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ► . Date: ' 7 ° Phone #: (503) 718-