Permit C ITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2004 -00521
w1r1, DEVELOPMENT SERVICES DATE ISSUED: 8/19/2004
I
c ` 13125 SW Hall Blvd., TiStard, OR 97223 (503) 639 -4171
PARCEL: 25111 DD -06400
SITE ADDRESS: 15810 SW STRATFORD LP
SUBDIVISION: STRATFORD ZONING: R-4.5
BLOCK: LOT : 061 JURISDICTION: TIG
Project Description: Panel change
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/ FOR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MORRIS, RANDY WILSONVILLE ELECTRIC INC
15810 SW STRATFORD LP PO BOX 845
TIGARD, OR 97224 WILSONVILLE, OR 97070
Phone: 503 - 671 -1480 Phone: 503 - 638 -5353
Reg #: SUP 3854S
LIC 75752
FEES ELE 3 -307C •
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/19/2004 $80.30
[TAX] 8% State Surcharge 8/19/2004 $6.43 Rough -
Elect'I Final
Total $86.73
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other ape icable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 • . • of issuance, if nork is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopte . by the • -gon -tility Notifi : ion ' enter. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies oft ese • es or di -ct questio to • NC at 03)
246 -6699 or 1 -800- 332 -2344.
Issued By: :Ktp_/ Permit S'•
OWNER INSTALLATI 6 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
Electrical Permit A pplication )n FOR OFFICE USE ONLY
City of Tigard R ECEIVED Date /B : . 7 _.1./ Permit No.�L ( 9 9/ � A
13125 SW Hall Blvd., Tigard, OR 97 2 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 l 1 B Date : Other Permit:
Inspection Line: 503.639.4175 1 9 2004 ^- I I .. Date Ready/By: EMI See Page 2 for
Internet: www.ci.tigard.or.us AUG /1UN Notified/Method: Supplemental Information
l fljJ +r.`; - PLAN REVIEW
❑ New construction • UItOtneeprfigONcement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location
['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
In I and 2 family dwelling ❑ 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 ❑ Other: ['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
! Health - care facility ['Other:
Job no.: Job site address:
�.. 8/ 0 c ' it, 5 4 rrfbil) ID ubmit 2 sets of plans with any of the above.
City/State /ZIP: 77 6 /1 Q r 7 � 4/ The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: FEE* SCHEDULE
Description I Qty. I Fee. 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'! 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
DESCRIPTION OF WORK Each manufactured or modular
�� dwelling, service and /or feeder 90.90 2
1 CJ�.Q V ��pl \r•-.6, Services or feeders installation, alteration, and/or relocation
200 amps or less / 80.30 82, .3v 2
0' PROPERTY OWNER 1:1 TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: pk y (SA. 0 Rtt. s 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: 0-63) 4 7 g - / y Fax: ( ) relocation
200 amps or less 66.85 I
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 ❑ 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,
each branch circuit 46.85 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
l extension. Describe: Page 2 2
/
Business name: U - S CA y Ei Fo ne4
Address: Pm Svc rye Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: 6f) j 8 0.JV1". / ' '' 0 "I e) Investigation per hour (I hr min) 62.50 • Industrial plant per hour 73.75
Phone: CID)) 43r. 6 - s F. • ° 3 ) 3f- P V sT D V ELECTRICAL PERMIT FEES*
CCB Lic.: `767 6 , Electrical 3 ,. , , L Suprv. Lic, : 36,6.1.s Subtotal Av . 3 a
Suprv. Electrician sign. • re, requi • e: t .. , Plan review (25% of permit fee)
Print name: i , .. 4 E 1 Dat„ / q ' State surcharge (8% of permit fee) l ,
TOTAL PERMIT FEE 8L 93
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.\ Building \Permits \ELC- PerrnitApp.doc 12/03 440.4615T(10 /02/COM/WEB
I
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lime: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Red ested .5 2 U AM PM BUP
/ 5 - / ._ ,/ / •
Location • �...� - Suite MEC
Contact Person Ph ( ) 6,38 PLM
Contractor Ph q — 75" (/cf SWR
BUILDING Tenant/Osag. R 0L-vtek ELC e'700 sa (
Footing (t 7 / � � ELC AIM
Foundation Access:
Ftg Drain ELR
Crawl Drain SI P,,
Slab Inspection Notes:
Post & Beam ir
Shear Anchors /
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation FL P-1\1670 - 6� PAY b ,W �� �-1
Drywall Nailing (" T1 (�+
Firewall &AC J gl = C
Fire Sprinkler
J
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 •
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
—rT1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•i• /STO PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line I �'v
ADA
Date 2-20- 0 1 Inspector GA rQ ` " 69L, Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL