Permit CITY OF TIGARD , ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00720
° COMMUNITY DEVELOPMENT DATE ISSUED: 10/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112D D - 01400
SITE ADDRESS: 15686 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: MARRIOT LOT : JURISDICTION: TIG
PROJECT: MARRIOTT
Project Description: 1 br. circuit, low voltage for DATA.
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: SIGNAUPANEL: 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:
PACIFIC REALTY ASSOCIATES JARMER ELECTRIC INC
500 108TH AVE NE • 5105 SW 45TH AVE
P 0 BOX 3646 PORTLAND, OR 97221
BELLEVUE, WA 98009
Phone: Contact #: PRI 503 - 246 - 5381
FAX 503- 244 -8037
FEES
Description Date Amount Reg #: ELE 26 -144C
[ELPRMT] ELC Permit 10/19/200' $121.65 LIC 6924
[TAX] 8% State Surcharge 10/19/200' $9,73 SUP 4044S
Total $131.38 REQUIRED ITEMS AND REPORTS
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: - / ! Permittee Signature: Ce7piedi Qri ! Py(.J
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.
.,+: j �trical Perm . it t� �E ��;: IV � FOR OFFICE 1 1SE (N1_1
City of Tigard Received Permit Nf�da_
13125 SW Hall Blvd., Tigard, OR 97223 ((`` 1 1 2007 Da R �� /4/ i
Phone: 503.639.4171 Fax: 503.598.1960 t % +p`•,• 1 , p : w Other Permit:
Inspection Line: 503.639.4175 T ' j yy n� / _4i! {:- _ Date Ready/By: la See Page 2 for
Internet: www.ci.tigard.or.us c1 1 Y Ur I i° Notified/Method: �, Supplemental Information
B -, a ; 1 TIS1O `61
PLAN REVIEW
❑ New construction !4 Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ['Hazardous location
OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling IXCommerciaVindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family 0 Master builder ❑Other.
JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ['Manufactured tured structures or
ark
Job no.:
C c L , . ❑Egress/lighting plan P
g2_13?.... Job site ad / Y4 , $ ( ,J O J Ct f)ICUt C ❑Health care facility :Other
Submit 2 sets of plans with any of the above.
City/ State/ZIP: I , (1.V T " 2- - 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name) C lG2hh„.a FEE* SCHEDULE I I
D no i ptba Fee Total
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'' 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: DESCRIPTION Limited energy, non - residential 75.00 2
ION OF WORK Each manufactured or modular
PCej 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 circuits — 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
B. Fee for branch circuits ,
Contact name: without service or feeder fee, / 46.85 4/D 2
Address: each branch circuit
Each add'' branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Phone ( ) I Fax :: ( ) Pump or irrigation circle 53.40 2
E Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: / Page 2 7.5 2
Business name: Z/4t2 £2 EE v`tL e Ik3G
Address: 5 ( rW Y 4 - 1%--- , Sr e_ .o O Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: / 7 A.) 4 0 , . 9 7 2 2 / Investigation per hour (1 hr nun) 62.50
- Phone: (S53 ) Z y t , — �3 t1 r / I Fax: (&)3) 2 St',) 3 7 Industrial plant per hour 73.75
ELECTRICAL PERMIT. FEES*. . , •
CCB Lic.: 6,92 ti I Electrical Lic.: 26 / 4 Suprv. Lic.: go Subtotal /2 / 4 3
Suprv. Electrician signature, required: /' G...•—______ Plan review (25% of permit fee)
.T— State surcharge (8% of permit fee) q / 3
Print name: j7'2-1 / 4 2 ,,./4-.e. 141 1 ate: Jo _/ 7_ —d 1
_ / TOTAL PERMIT FEE /3/ 31(
Authorized signature: / ":".0 � Tbls permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete
Print name
tyZ �! q ,V Date: / D. / ��b� • F ee met set by Tri -County Building Industry Service Board
J •• Number of inspections per permit allowed.
iMuildngTernits\\EELC.PcmitA . 12/03 440 -461 ST(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION #: EI_C2007 00720
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10119/2007
Phone: (503) 639 -4171 ± III
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2007 TIME: 7:01AM PAGE: 79
SITE ADDRESS: 15686 SW SEQUOIA PKWY, CLASS OF WORK:
SUBDIVISION: MARRIOT LOT #: TYPE OF USE:
PROJECT NAME: MARRIOTT
DESCRIPTION: 1 br. circuit, low voltage for DATA.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JARMER ELECTRIC INC tV.i C F PHONE #: 50324 6-5381
Inspection Request Scheduled For: Date: 11/2/2007 Pour Time:
Code # Inspection Description Rfirrk# Contact # Message
199 Electrical final 058857-01 503246.5381 N Y
Corrections /Comments /Instructions:
Komi
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C7'� O' 6 Date: a'2.' 01 Phone #: (503) 718 - 1- '44