Permit C ITY OF TIGARD.+ ELECTRICAL PERMIT
PERMIT #: ELC2005 -00852
DEVELOPMENT SERVICES DATE ISSUED: 11/1/2005
s =ma& 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD -01400
SITE ADDRESS: 15686 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: MARRIOT LOT : JURISDICTION: TIG
Project Description: TI, (5) branch circuits, low voltage for audio /stereo. Job No. 6751
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: 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:
PACIFIC REALTY ASSOCIATES JARMER ELECTRIC INC
500 108TH AVE NE 5105 SW 4511-1 AVE
P 0 BOX 3646 PORTLAND, OR 97221
BELLEVUE, WA 98009
Phone: 503 -624 -6300 Phone: 246 -5381
FEES Reg #: LIC 6924
Description Date Amount SUP 4044S
ELE 26 -14-14
4C
[ELPRMT] ELC Permit 11/1/2005 $148.45
[TAX] 8% State Surcharge 11/1/2005 $11.88 REQUIRED ITEMS AND REPORTS
Total $160.33
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work w' I ha r1.ne in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
susp ed for more -n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rul s are set forth in OA' 9 '11-0010 through OAR 952 - 001 .0100. You may obtain copies of th- - u es • r direct questions • • OUNC at
5 - 246 -6699 or 1 -800 -3i -2 � � � •
Is ed By: . • ' L/ 1Ll _I .i Permittee Si 1 ti/cl/l;i «r
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
•
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: // /PAZ DATE:
LICENSE NO: �f`f.$ •
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.
- Electrical Piit A 1 I li • \' tion 1 0k ()Fl l( F. U SE ONI
a ••
_ Received
�;ity t (.Tigard f + DateB : ip o� .!p i� ' Permit No.: , .. 1:168:5
13125 SW Hall Blvd., Tigard, OR 9722'. r• \ ,, r P . I • Plan Review
Phone: 503.639.4171 Fax: 503.598.19'0 \ --- \- 4 -: ryr.. ;'' � ; \ Date/11 : Other Permit:
Inspection Line: 503.639.4175 'L Date ReadyBy: ® See Page 2 for
Internet: www.ci.tigard.or.us 00-22-21105 Notified/Method: Supplemental information
TYPE OF WORK PLAN ..REVIEW
❑ New construction IrAddit10161 t o / lilikera4r Please check all that apply:
❑Service over 225 amps, comm'I ❑Hazardous location
El Demolition ❑ Oth - n 1 I ' I, I , •
❑Service over 320 amps -rating ❑ Buildng over 10,000 sq. ft., -
" CATEGOR 1 CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling 0 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories :Weeders, 400 amps or more
❑ Multi - family 0 Master builder 0 Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION . ❑Egress/lighting plan RV park
❑Health facility ❑Other:
Job no.: 6 75/ Job site address: / ft sr3461) �SE& t, .02 /LL.4 I : bmit 2 care sets of plans with any of the above.
City/State/ZIP: rz - i t - s e 4 ; ,MI i 1 ?,1 LA / The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: / G, 4 1 , - / Ifif -Ad_$ FEE* SCHEDULE .
Deserlpdon [ Qty. I Pee. I Total ' --
Cross street/directions to job site: /)4 ,11 o v i SE k0.` Ae 4 ( New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/2,ersi 04 E I - � � /, iecr�� dwelling, service and/or feeder _ 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ , PROPERTY OWNER . I ❑ TENANT ■ .. 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: ( ) I 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 dreuits- new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee,
Address: each branch circuit 46.85 ;/� 2
Each add'l branch circuit _ y 6.65 91,e) 2
City/State/ZIP: Miscellaneous (service or feeder not induded)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
-
CONTRACTOR energy panel, alteration, or ✓00
extension. Describe: / Page 2 74,s 2
Business name: Th,2 M E2 Et_Ecrd`ie t Iajc....,
Address: S/ o 6'w di ss � - ; S & .o O Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: ,q, 7 - 4 - •t) 4 B 2 `9 7 22/ Investigation per hour (1 hr min) 62.50
Phone:
3) 2.4Cv — 153 S / Fax:
I (503) 2U y - g-0 3 7 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*. .
CCB Lic.: to 2, y I Electrical Lic.: 2(o- / u/u/C.I- Suprv. Lic.: (/Qt/q5 Subtotal Nez1"
Suprv. Electrician signature, required: /' e. - Plan review (25% of permit fee)
r i-
Print name: ( 55 - i i 4 2 / „.2 ,e ^'1 E ate: /0_2 6 _Us' State surcharge (8% of permit fee) /l Y
TOTAL PERMIT FEE // 0 3 3
Authorized signature: ----- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: �A" 0, � . Date: / 0. 1� - Fee methodology set by Tri- County Building Industry Service Board
J Number of inspections per permit allowed.
is Building\Perrtdu\ELC-PcemitApp.doc 12/03 440- 4615T(10/02/CAM/wEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00852
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2005
Phone: (503) 639 -4171 ' I r'
Inspection Requests (24 Hrs.): (503) 639-4175 ell L II
INSPECTION WORKSHEET FOR DATE: 11/23/2005 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 15686 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: MARRIOT LOT #: TYPE OF USE:
PROJECT NAME: y/— MARRIO_
DESCRIPTION: TG - (5) branch circuits, low voltage for audio/stereo. Job No. 6751
OWNER: PACIFIC REALTY ASSOCIATES, • PHONE #: 503 - 624 -6300
CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246 -5381
Inspection Request Scheduled For: Date: 11/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 022355 -01 503. 246.5381 �Y�
1--6 W V da kt
Corrections /Comments /Instructions.
GRAM -- )0 . t 3 'LA
t-cu.) \16L'ic-) - Q,IC_
�❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
p
Inspector: GIS RI 066 ° c Date: II 23 E14 Phone #: (503) 718 - 44 4
,
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2005-00852
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2005
Phone: (503) 639 -4171 4 �.
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'.. °__..
INSPECTION WORKSHEET FOR DATE: 12/1/2005 TIME: 7:08AM PAGE: 513
SITE ADDRESS: 15686 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: MARRIOT LOT #: TYPE OF USE:
PROJECT NAME: COURTYARD BY IvARRIOT
DESCRIPTION: TI, (5) branch circuits, ow voltage for audio/stereo. Job No. 6751
OWNER: PACIFIC REALTY ASSO+ ATES, PHONE #: 503624 -6300
CONTRACTOR: JARMER ELECTRIC INC PHONE #: 246 -5381
Inspection Request Scheduled For: l ate: 17.1 1/2005 Pour Time:
Code # : = ion Description Co firm # Contact # Message
199 Electrical fin-. 022 . -01 503-246 -5381 Y
1•
Corrections /Comments /Instructions:
ki M k Q.
IS PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e • N' LL Date: I'll ' Q6 ....9 Phone #: (503) 718mi 6