Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT MIT #: 7-0 0578
DATE ISS 8!28/200
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 134AB -03300
SITE ADDRESS: 10330 SW SCHOLLS FERRY RD ZONING: R - 12
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: MUSLIM EDUCATIONAL TRU
Project Description: Electrical service for (3) modular classrooms.
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: 3 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: 1 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: X CLASS AREA/SPEC OCC:
Owner: Contractor:
MUSLIM EDUCATIONAL TRUST FIVE STAR ELECTRIC, INC.
PO BOX 283 PO BOX 555
TIGARD, OR 97223 BANKS, OR 97106
Phone: Contact #: PRI 503 - 324 - 0948
FAX 503 - 324 -0973
FEES
Description Date Amount Reg #: ELE 34 -665C
[ELPRMT] ELC Permit 8/28/2007 $401.50 • LIC 158231
[ELPLCK] ELC Pln Rev 8/28/2007 $100.38 SUP 4622S
[TAX] 8% State Surcharge 8/28/2007 $32.12 REQUIRED ITEMS AND REPORTS
Total $534.00
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 0' : 952 - 001 -0100 You may obtain copies of these rules or direct questio OUNC at 503.246.6699 or 1 800.332.2344.
Issue = 11 /��l / j+� Permittee Signature: ir(
1
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.
-410
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Recessed i, / D '/ Permit No Ea.407.4
13125 SW Hall Blvd . Tigard, OR 97223 . I 'Ian Review
Phone: 503.639.4171 Fax: 503 598 1960
_�; EE '�a;- . i 1II4 "" m ■ ratr: Other Permit
Inspection Line: 503 639 4175 7 t1: '• I' Date Ready:BS pr� ® See Page 2 for
Internet. www.ci tigard or us Rirr � Notified /Meth:T. - eV ! Supplemental Information
TYPE OF WORK ■ i t . P' PLAN REVIEW - _ . -
ED New construction KAddition /alteration /rei& tf 1�
t ®W / Please cheek .•r that apply
�w'� ❑Service over 225 amps. comm'1 DI location
❑ Demolition ❑Other: ��Q�4
❑Sers ice over 320 amps - rating ❑ Buildng over 10.000 sq Il..
CATEGORY OF CONSTRUCTION of I- and 2-famil dwellings 4 or more new residential
❑ I - and 2 family dwelling IkCommercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ] I:ceders. 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
( - 6 I 103 i1,� e ❑health - care facility ❑Other
Job nn. Job site address Submit 2 sets of plans with any of the above
City/State /LIP: - l\( n r - Q_ i 72 \ The above are not applicable to temporary construction service
f \ FEE* SCHEDULE
Suite /bldg. /apt. no.: Project name: m � I
V�(,J� i C ^ " Desrripuun I Oty I Fee. I Tom!
Cross street/directions to job site: New residential single - or multi- fantil■ duelling unit.
Includes attached garage.
1.000 sq. fl or less 145 15 4
Subdivision: Lot no.: Ea add] 500 sq Il 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
C v�/S� dwelling, service and /or feeder 90 90 2
x 1JO IN 1 2 , 6AC.i l Z., Services or feeders installation, alteration, and /or relocation
200 amps or less 3 80 30 Leir) 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106 85 2
401 amps to 600 amps - ^ iz! 160 60 IV), 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 sersices or feeders installation, alteration, and /or
relocation
Phone: ( ) 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
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for blanch circuits ti rrh
service or feeder fee, each
Business name: branch circuit 6 65 2
B Fee foi branch circuits
Contact name: iruhaa service or feeder fee,
each branch circuit 46 85 2
Address. Each add] branch circuit 6 65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax . ( ) Sign or outline lighting 53.40 2
E -mail: Signal cireuitls) or limited -
CONTRACTOR energy panel, alteration, or
extension Describe Page 2 2
Business name: Five Star Electric, Inc.
Address: PO Box 555 Each additional inspection over alloys able in any of the above
Per inspection 62 50
City /Slate /Z1P: Banks, OR 97106 Investigation per hour (i hr mm) 62.50
Phone: (503) 324 - 0948 I Fax: (503) 324 - 0973 Industrial plant per hour 73.75
F:LECTRICAL PERMIT FEES*
CCB Lie.: 158231 Electrical Lie.: 34 -665C Suprv. Lie.: 4622C Subtotal 1,1 OI.C)
Suprv. Electrician signature. required: , , / flan re% Bess (25% of perm fee) 00.30) r �. State surcharge (8% permit fee) 52.I 1 2
Print name: 1 G• stem �s Date: �` l iy" J p J 53L
�`�A G.f�► `" J TOTAL PERMIT FEE -1 ,aO
Authorized signature: This permit application espires if a permit is not obtained ssithin 180
lass after it has been accepted as complete
Print name: Date: • Fee methodology set by Ti i -Coon} Budding Industry Service Board
•• Nu nhe (A Inspections per penult allowed.
1s3B uilding\Permas\Et.C- PermitApp.doe 12103 440 - 36151(10 /0JCOMM:1i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00578
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/28/2007
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 s' ''
INSPECTION WORKSHEET FOR DATE: 8/31/2007 TIME: 7 :00AM PAGE: 29
SITE ADDRESS: 10330 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MUSLIM EDUCATIONAL TRU
DESCRIPTION: Electrical service for (3) modular classrooms.
OWNER: MUSLIM EDUCATIONAL TRUST, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503- 324 -0948
Inspection Request Scheduled For: Date: 8/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054981 -01 971- 246 -6022 N
Corrections /Comments/ Instructions:
FL 148 AQoTe
Na Fibs
*PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V V Q l Date: %( I Phone #: (503) 718- 2114
CITY OF TIGARD
BUILDING DIVISION • - PERMIT #: ELC2007 -00578
8/28/2007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 F AX. ''!- I
8/30/2007 7:00AM 16
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10330 SW SCHOLLS FERRY RD
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: MUSLIM EDUCATIONAL TRU LOT #: TYPE OF USE:
PROJECT NAME: Electrical service for (3) modular classrooms.
DESCRIPTION:
MUSLIM EDUCATIONAL TRUST,
OWNER: FIVE STAR ELECTRIC, INC. PHONE #: 603- 324 -OR40
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 8/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final : , 90 503-718-2426 N
Corrections /Comments /Instructions:
Q S 04A' R i4 c $ � 'ioa ' s , (J fNT
S F-/. '3E" '-' 5Lrfe021! _
``). ).ag.L 5A PANLL6 - (o S14ML sc,liebv A 5
m A l t 4 S - 4 € 13E5 NAB itst _
g
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , N tS Date: 3 o I �) Phone #: (503) 718- 2
I V