Permit r
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00144
l DEVELOPMENT SERVICES DATE ISSUED: 3/23/04
,{ j, °6 1I, 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S134DC-00600
SITE ADDRESS: 11355 SW TIGARD ST
ZONING: R - 4.5
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Cell site
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: 2 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
RED HILLS ELECTRIC & TOWER SERVICES
PO BOX 490
DUNDEE, OR 97115
Phone: Phone: 503 - 554 -8244
Reg #: LIC 134593
SUP 4390S
FEES ELE 36 -84C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/23/04 $160.60
[TAX] 8% State Surcharge 3/23/04 $12.85 Elect'I Service
Elect'I Final
Total $173.45
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 perms 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.
z" Issued By: ( • � � Permit Signature: /
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:
CONTRACT INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: A /4.G,� -- DATE: ,03/D7
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
• ' Electrical . .. . .. ,!T.:vqi,....
Electrical Permit Ap co EGF IV ED
, ..
. .
FOR OFFICE USE ONLY . • • . :'' .;./.•.,..-,
City of Tigard Received
Permit No
ge-e—gall -DO
13125 SW Hall Blvd , Tigard, OR 97223 mAg 3 2004 Plan Review "".. -
Phone: 503.639.4171 Fax. 503.598 1960 " A NAPlall# Date/B / Other Permit &tit /0 - 00 - -
Inspection Line: 503 639.4175 Date Ready/By lulls 0 See Page 2 for
Internet: www ci tigard or us Notified/Method Supplemental Information
CITY101GF,TDIGivP:1;,redli_-_-_.‘ No
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,-.. :01A,- - -:.,:l..:.02. , ,,/,..--. '"4:7• t -, `----- . .,'" ,:------------ ,-'- --- - - -
'i New construction 0 Addition/alteration/replacement Please check all that apply
['Service over 225 amps, comrn'l 0Hazardous location
D Demolition 0 Other:
pService over 320 amps - rating 0Buildng over 10,000 sq ft,
:-.. ekiid`iii , iiii - eiiisisiiiii6Tigriv - Im 1, :Fi ,,7-, '
- g, -- :',''lgi'',"P'' of 1- and 2-family dwellings 4 or more new residential
0 1- and 2 dwelling ,E. Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
['Building over three stones OFeeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
['Occupant load over 99 persons LIManufactured structures or
' f.'n;i:;',:, 1 4 7: Slifttli:OPki r eiii(*** 1 . 6 NITMTCOON IS;IC;:'-'*07.. ElEgress/lighting Plan RV park
0Health-care facility ['Other
Job no.: Job site address: //s _s 7- ( .) 5 , 7 -
Submit 2 sets of plans with any of the above
City/State/ZIP: 7 /714rte) 4 „,. t 51 2 3 The above are not applicable to temporary construction service.
E:E'
Suite/bldg./apt. no.: Project name: ? e /4 4... / f / e3 ... gi :2.0.. ....,
Description Qty ' Fee. I Total "*
Cross street/directions to job site: //i/ ? - 4 - .-- New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145 15 4
Subdivision: Lot no.: Ea. addl 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
'gl .V Each manufactured or modular
dwelling, service and/or feeder 90.90 2
,12-1:-.) 1 -C
.. Fe C ..../0 fi- deriC g; Services or feeders installation, alteration, and/or relocation
Co
200 amps or less '2., 80.30 i‘c .--- 2
,....t1 4-.--i,... -..,-,.....,..,,,...-...,,,-,..--• ... -i. - .,P.de,, , ..,.7.1,-;...;,....i-JA....„.. , ...:.,..1,-_-, , ,,,, -.:t,-
- — 401 amps to 600 amps 160 60 2
Name t /442.(/ ti - 0 ■AiDc( 4.,,Derit-l'ef/L1 601 amps to 1,000 amps 240 60 2
Over 1,000 amps or volts 454 65 2
Address: // 3 6 - 3 -- _ 7- To 4 4.0 57 ---
Reconnect only 66 85 2
City/State/ZIP: - 1 — C g /4-,.2 0 og. 9'72 2 3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 Fee for branch circuits with
----., ::.-"4-,i' , 0.`,... ,,,,-., _, - .f,,..<, :, ,
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 2
each branch circuit
Address:
Each addl 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 Signal circuit(s) or limited-
V.14%. lq:ItAti' energy panel, alteration, or
extension Descnbe: Page 2 2
Business name: Q - 1 4._ ‘ U
Each additional inspection over allowable in any of the above
Address: ?e 2 i To
Per inspection 62 50
City/State/ZIP: .. '" - b cix... 6,..e.,...i.,-- oa_ 97 // _S--- investigation per hour (1 hr mm) 62 50
Industnal plant per hour 73 75
Phone: (52)3 ) g,.. q Fax. (.2 )3 - / 7 35
CCB Lie.: /34(5-9g Electrical Lic..3 g ... g q d Suprv. Lie :1(3? e s 2r Subtotal / 6 C). 60
Suprv. Electrician signature, required: g iD1 Plan review (25% of permit fee)
Print name:
State surcharge (8% of permit fee) ) . gs
7) j ')i H T
Date: &/ 9„3 / ew
TOTAL PERMIT FEE / 73 I O ....
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 \BuildingTemuts \ELC-PenrutApp doc 12/03 440-4615T( I 0/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
F x� ,: -�-� �,�.- �Y ; . r em =��
,RESIDEl�FT ?�'U�RK.at- {g ;u - r.. =- r4 .; y i
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
WCQ WOR- ONWL ,. F .iiig,. _:,47MIA
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
\Buildmg\Pernuts\ELC- PerttutApp doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received i /sO P Date Requeste 5 /Z a / 9 AM PM BUP
Location / / D 53 — l OJT Suite MEC
Contact Person 76_," Ph ( ) �7" � VS/ pun
Contractor . Ph ( ) SWR r�
BUILDING Tenant/Owner ELC 6 J cz
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
F'
e Alarm
40/11 E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
-
SIT ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line (�
ADA S I Z /l V 1 y� - `� €e � i
Approach/Sidewalk
Other: Date -[ r Inspector /� Ext 1 �f
Final • DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL