Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00384 ;: DEVELOPMENT SERVICES DATE ISSUED: 6/28/2004 ''� ��' I- ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126BC-01506 SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 350 ZONING: C -G SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: 7 branch circuits. 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: 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: 6 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: WYSE INVESTMENT SERVICES CO. R C COSTELLO ELECTRICAL 111 SW 5TH AVE. STE 1100 ROGER COSTELLO PORTLAND, OR 97204 1439 SE 17TH LOOP CANBY, OR 97013 Phone: 503 - 294 -0400 Phone: 263 -2385 FAX Reg #: 260-8483 3834S LIC 87402 FEES ELE 3 -344C Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/28/2004 $86.75 [TAX] 8% State Surcharge 6/28/2004 $6.94 Rough - Elect'l Final Total $93.69 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 -2 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: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day • I Electrical Permit A 1*c , . * ri FOR OFFICE USE ONLY Received// , -/ Electrical G F C.. Date/B :CO / I Permit No : _ . ✓/ �' by City of Ti and Planning Approv. Sign g Date/By: Permit No.: 13125 SW Hall Blvd. luN 2, 6 2004 Plan Review Other Tigard, Oregon 97223 DateBy Permit No.: Phone: 503 -639 -4171 Fax: 5 0� ��B �. Post - Review Land Use �/�, Date/By: Case No . Internet: www.ci.tigard.or.us U ING DIVI --.4,. a �) Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 5 c - -4175 Name/Method: Supplemental information. TYPE OF WORK PLAN REVIEW (Please check all that apply) ❑ New construction Q. Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location ❑ Addition/alteration/replacement E Other: TZ ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, CATEGORY OF CO TRUCTION 1 & 2 family dwellings four or more residential units in ❑ 1 & 2- Family dwelling [ICommercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more ❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above. n The above are not a to temporary construction service. Job site address: Ctap� SW WaShill5.l S it:dt FEE* SCHEDULE Suite #: 39c, x 36'0 Bldg. /Apt. #: Number of inspections per permit allowed Project Name: S. F A Description Qty Fee (ea.) Total 1 New residential - single or multi - family per Cross street/Directions to job site: dwelling unit. Includes attached garage. Service included: 1000 sq ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33 40 1 Limited energy, residential 75.00 2 Subdivision: Lot #: Limited energy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 Services or feeders - installation, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160 60 2 El OWNER I ❑ TENANT 601 amps to 1000 amps 240.60 2 _ Over 1000 amps or volts 454.65 2 Name: O� E /yt f ( ,5 4 0 Reconnect only 66.85 2 Address: hi i w i �L. jci --- - c JA, I 1 Q 0 Temporary services or feeders - installation, alteration, or relocation: City /State /Zip: of A- k h U I n ` q1 Zo (.1 200 amps or less 66.85 1 Phog ?-2C i- 0400 Fax: 201 amps to 400 amps 100.30 2 ❑ APPLICANT ❑ CONTACT PERSON Branch n h circuits amps 133.75 2 Branch circuits -new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 6.65 2 City /State /Zip: B. Fee for branch circuits without purchase of 9 // p service or feeder fee, first branch circuit / 46.85 �b .b5 2 Phone: Fax: Each additional branch circuit aQ 6.65 3CI Ad 2 E -mail: Misc.(Service or feeder not included): CONTRACTOR Each pump or irrigation circle 53 40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, Business Name C �,os -l.P (p —� alteration or extension Page 2 2 (. ti �� Descn lion: Address: _ City /State /Zip: (p�� Ulm v C _ Each additional inspection over the allowable in any of the above: Per inspection per hour (min I hour) 62.50 Phone: 5 ? 3 zieZ -140 Fax: Sol . 9, ;Z,-7(4V) investigation fee CCB Lic. #: k7L 4oZ Lic. #: 3 - 36/1/e , (, Other: Electrical Permit Fees* Supervising electrician 11 -1 -0Y 101 Subtotal $ $G, "3 S signature required: c" — Plan Review (25% of Permit Fee) $ Print_Name: y- e.... Co s4 it. Lic. #: 36/3 41--C State Surcharge (8% of Permit Fee) $ 6 . gi4 C) 7 TOTAL PERMIT FEE $ 93 . Authorized / 0. l • • N otice: This permit application expires if a permit is not obtained w hin Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) i:\Dsts\Petmit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard • .-Page 2'= Supplemental Information LIMITED ENERGY PERMIT FEES: • RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: n Audio and Stereo Systems n Burglar Alarm ❑ Garage Door Opener n Heating, Ventilation and Air Conditioning System n Vacuum Systems ❑ Other COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 91 8- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation n Intercom and Paging Systems O Landscape Irrigation Control ❑ Medical n Nurse Calls O Outdoor Landscape Lighting n Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all other installations i \Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line : (503) 639 -4171 MST • -7 BUP Received Date Requested 8 _ °� AM PM BUP Location �� o`ZO U) ?4 � � Suite 3Cd MEC Contact Person Ph ( ) PLM Contractor Ph ( ) 9 g 6?-- 7 ADO SWR c1 BUILDING Tenant/Owner S F ELC ■ 040 7 - 0 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam NUM Shear Anchors Ext Sheath/Shear gifir Int Sheath/Shear Framing Insulation Drywall Nailing � { 1 Firewall 1 1 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 Fire Alarm 420 PART FAIL 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. - Please call for reinspection RE: Unable to inspect — no access Fire Supply Line / ADA D e--Z 7 - © d l Ins actor I - '' ' pUc ? . Approach /Sidewalk p Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL