Permit CITY OF TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
; DEVELOPMENT SERVICES PERMIT #: ELR2004 -00092
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/6/04
SITE ADDRESS: 11365 SW TIGARD ST PARCEL: 1S134DC -00700
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: WIRING FOR VALVES TO IRRIGATION CONTROLLER
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: X
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BAPS TEMPLE NEW GROWTH LANDSCAPE LLC
PO BOX 41160 PO BOX 1571
SAN JOSE, CA 95160 BEAVERTON, OR 97075
Phone: 408 - 453 -6464 Phone: 408 - 453 -6464
Reg #: E41.01 -453 1,CB
503- 439 -3341
FEES Required Inspections
Description Date Amount Elect'I Final
[ELPRMT] ELR Permit 4/6/04 $75.00
[TAX] 8% State Surchart 4/6/04 $6.00
Total $81.00
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 throuc
Issued by Permittee SignatureL.400/1 • A /
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Apr -0. -04 10:01 Mike Kolod 5034398877 P_02
'Electrical Permit Ap 11 �// ED I.tiu sill l(1 1 tin tl\l.1
City of Tigard n A T � A 20D T ��(� -/ )-�
Perm' N.
13125 SW Hall Blvd, Tigard, OR 97223 APR ®6 2004 flat /
Pisa [te+xn
Phone. 503 639.4171 Fax: 503 598.1960 ' nr, 4 1 1 Date I5 . mien Perm 6sooSD
CITY OF TIG �_
Inspection Line 503.639 4173 Date Rest By hire El Internet, www.ci.tigard.or.w Notified/Method. /Method. SSupp ental Informaboe
at ULDJN(� f)lVISIOm
TYPE OF WORK PLAN REVIEW
V a,Ncw construction ❑ Addition/alteration/replacement Please check all that apply
❑ Demolition El O t h er: 0Serviceover225amps,comtn'I ❑Haulyduua owtiun
CATECORY OF CONSTRUCTION ❑ Service over 320 amps - rating ❑Builders over 10,000 an, ti
of I • and 2•femily dwellings 4 or more new residential
❑ 1- and 2 - family dwelling N. Commer'ciaVindustrial Q Accessory building ['System over 600 volts nominal units In one nruarurc
['Building over three atones ❑Feeders 400 amps or nor•
❑ Multi ❑ Master builder El Other:
❑Occupant load ova 97 persons 0 Manufactured structures o
JOS SITE INFORMATION AND LOCATION [] EgressiliStdinS p er, RV park
Job no.. Job site address. 11316 s 1 I rn) St ❑Ileahh- sets facility ❑other: — _
_ D ^ p� U Submit 2 as of plans with any of the above.
City/State/ZIP; : I 1 0(j, 1 /22_3 The above are not applicable to tentporury ounsvuvtiun service.
Suitr/blcig /apt. no Project name $��k.P.�'. "gym HOP S D�
Cross struk.t/directions to job site: P I� VJ Inc_ New residential single. or multi.fandly dwelling %lt. ad -
- ladudea attached garage.
1,000 sq R or less 145,15
Subdivision: 1.ot no.: Ea. add'I 500 sq. R. or portion 33.40
1 .imRed energy, residential 75.00
Tax map/parcel no.: . Limited energy, non+osidential — 75.00
DESCRIPTION OP WORK • Bach manufactured or modular
- } � dwelling, service and/or feeder 90.90 ,
IN 1 I n
low 401te r VA I V(2j ` 1 � f t 5At I `J/" � C flti' a l let service Services or feeders installation, alteration. and/or relocation
200 amps or less 80.30 .
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85
Name. 401 amps to 600 amps 160.60 ,
.__ 601 amps to 1,000 amps 240.60
Address: Over 1,000 amps or volts 454.65 ,
Reconnect only - 66.85
L Ity /Staten /.IP: V - Temporary services or feeders installation, alteration, and/or
Phone: ( ) l Fax: ( ) relocation _
200 amps or less 66 85 I
Owner installation: This installation 1s being made on property that 1 own %%itch is not _ 201 amps to 400 amps 100.30
Intended for sale, lease, rent, or exchange. according to OR +47.449, 670. and 701 . -..,_
401 amps to 600 amps 133.75 `
Owner signature: Date: Brunch dreidta - rum, alteration, or extension, per panel
0 APPLICANT 1 ' CONTACT PERSON a. Fee for branch circuits u sib
. ► /� service or feeder fee, each 6.65 '4' Business name: /�/e�{,J / Y �� � iI W scop 4 branch circuit . -
Contact name: t D I B. Foe for branch circuits
_ I ✓ a I �i !°i Z r ' . without service or feeder fee,
Address 0 • (a I517
5" 1 l � I I each branch circuit 4G.g5
Each add') branch circuit 6.65 2
City /SttttcfLJP 'J / t 0/2.. 9 '1 0'7 5 Miscellaneous (service or ceder not Included)
Phone ( s9 7J9 33T / !'ax:: (503) L� 88 Si gn ar outt
71 erii ion
ig i g e i 53.40 2
i S linne e lighting 53.40 2
t :- InaiI' 41 I�f.;� I. � cp y - S >f r net- Signal circuit(s) or limited.
• CONTRACTOR energy panel, alteration, or
' 1 extension Describe. 1 Page 2 •---• 2
Business name: New r3& l.0
l in mdSCGG L
P LC• 11
Address P U l�� I S7 1 Rath additional Inspection over allowable in allot the above
Per inspection 62 50
City /State/ZIP: al°o%de f j - per , 0( cm87r Investigation per hour (I hr mm) - 62 50
Phone: (55 ) 931_ 3341 - I Fax: ( 545 ) 4361 _ g 0 Industrial plant per hour 73.75 ` -
tC B Lic. 1 ELECTRICAL Pamir FEES*
1 Z S 1 El ectrical Lic.: Supry Lic.:
Subtotal '13 , 0 0
Suprv. Electrician signature, required: J r ,' Plan re n
view (23 %ofput fee) ��
Print name: • , '�` r 1 /I State surcharge (8% of permit fee) Ip.an --
I Date: T K o)
TOTAL PERMIT FEE •R• D
Authorized signature. paean appttc lion e.pleea Ifs permit U not obtained within 1 60
Print uti�nt:,�1 /� r 1 � � u � , • / I/ J � l ate ben accepted u complete
• t ` ._ ��� rUI+� manna-gnu days our It has • bee .et by To-County Hushing industry service Boeard
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line_ (903) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 7 � Date Requested ��� AM PM BUP
Location 7Tikt Suite MEC
_
Contact Person lit. ' Ph ( ) 57a? ac ,2k PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain 6
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear SWF
Int Sheath/Shear
Framing
Insulation ! p„ . � cr - `� P n ,,., frn
Drywall Nailing wfcl / [1 �� 1lQJ
Fi rewal I
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
EkEttRICAL
S ice
Rough -In
UG /Slab
of
ir- larm
Fi • Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
( PART FAIL
TE 111 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 �I Inspector Kim / fffL&tjExt
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL