Permit • 1
C ITY OF TIGARD ) ELECTRICAL PERMIT
/ O PERMIT #: ELC2006 -10058
DEVELOPMENT SERVICES / DATE ISSUED: 3/21/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S115BD -00100
SITE ADDRESS: 11782 SW ROYAL VILLA DR ZONING: R -12
SUBDIVISION: LOT : JURISDICTION: URB
Project Description: MF service. Job # 16981.
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: 1 601 +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: 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:
CAL AM PROPERTIES PARKIN ELECTRIC INC
12450 SW FISCHER RD #300 14001 FIR STREET
TIGARD, OR 97224 OREGON CITY, OR 97045
Phone: 503 - 968 -1280 Contact #: PRI 503 - 657 -4958
FAX 503 - 557 -1059
FEES
Description Date Amount Reg #: ELE 34 -4C
[ELPRMT] ELC Permit 4/5/2006 $90.90 LIC 35151
[TAX] 8% State Surcharge 4/5/2006 $7.27 SUP 4241S
Total $98.17 REQUIRED ITEMS AND REPORTS
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 -2344.
Issued By: S — Permittee Signature:
\ 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.
- 03/20/2006 MON 14:22 FAX 503 557 1059 Parkin E1Ictric ®001/004
Electrical Permit Appli . Oj n FOR OFFICE USE ONLY
• City of Tigard ,l DatdB y �.'3 ,21 - D p 'Per( PemritNo. 6C- 000 �O0S
13125 SW Hall Blvd., Tigard, u R 7223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1Q60 c3 (, 2Q - -- r.,, -; 1 '� Date/By: Other Permit:
Inspection Line: 503.639.4175 tA�+ a ll. , : Date Ready/8y: • la Sea Page 2 for
Internet: www.citigard.or.us RD Notified/Method: ' .. upplemental information
:a— y� -, . 1'7 t , .. .r G"_ - _ - . .L !c - _ . n-.;c v � 7 r�.r+,i - `Q v
[a -,,,P`.7,21.--:, - Y y ., :-" . '` � .._ ;Y., ?- W-- -," Cti ) ..,. '�. :.�tY i,_.... • f G _ x „ r r — ted - .-, �_ ... -, : ', *".: ` ; 't -. , - :Z ,'` �'a `. �.- `1 `���"� 1 '•� s?�n • •
❑ New construction . in; !' ltion/alteration/replacement • Please check all that apply:
❑ Demolition • Other: ❑Service over 225 amps, comm'l ❑Hazardous location
�- -p ., w t E El Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
L'*� fn '
z -' �r lli J d a K r "' ∎ WdF r q) )e (-, --,'' ek t , t � ir+ �,' 7?t'
_ Yz i w t + t _ �� ;�,,. - �, �_ of 1 -and 2- family dwellings 4 or more new residential
and 2 -famil d e n ;- . L .. .
y g ❑ CommerciaUindustrial i ❑ Accessory building ❑System over 600 volts nominal units in one structure
Multi family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑Manufactured structures or
't _ ? ,. •{ _t_ N 1 W4 ii y�� 4 - M, 1Jtri !> [1 t.. t��9KN f,u'r nZ __ �
� .. s __ _ ,.�...c ... .z ,T _...��_ :�..�'.�a.....�. _ ,� ❑ H e$J/ll plan RV. park
•
• Job no.: / 442( Job site address: -/ ` �L . .. v ` i ) r ❑Health - care facility ❑Other
Submit 2 sets of plans with any of the above.
City/State/Z1P: (l 1 .02-, The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: 9.09 Al V I �l �' ,, , _ , 2 ` � � ..L . z . 'i .. C1 Description Qty. Fee. Total ..
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'I 500 sq. ft. or.portion 33.40 1 _
Limited energy, residential 75.00 2
Tax trap /parcel no limited energy, non - residential 75.00 - 2
e a .,m-1. _ t.� _„?;.,_..._. , L_ ., 13" , ..),=., , :7;:::.:,' , 2i-, ` ; ,:. _? i_ �. `` ;r!1" ::�' ', ... f - > �, .. , ��a - , Each manufactured or modular
M , ^ S� �� dwelling, service and/or feeder 90.90 qU. °f 2
V 1 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
'•= i �Jr S" d 7 C 'r'. . 4 t- f 9 -45 ai i ! r ._ .-: Y Si e 201 amps to 400 amps 106.85 2
'" 5' �-`' ��- L-= �. c » s�- L'- .u._�-= _.y:��_...�, __..,_ � a 401 amps to 600 amps 160.60 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 services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
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. +. - /. u e ��_ r ..= .,. . _ .
. . ! . a . � r . ._ r . y` i' i Fee for branch circuits with
1 � ' Y i _ . a . A service or feeder fee, each
Business name: branch circuit 6.65 2
•
Contact name: B. Fee for branch circuits
without service or feeder fee,
46.85 2
Address: each branch circui •
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
E -mail: Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
rarlcm i iecinc - ,Inc. 14UU I Fir Street . . -' ;, c ex panel, cribe :ion, or
extension. Describe: Page 2 2
Oregon City, OR 97045 503- 657 -4958 fax: 557 -1059
I Contractors License #: 34-4C exp. 07 -01 -06 Each additional inspection over allowable in any of the above
Supervisor: 4241 - exp. 07 -01 -06 Per inspection 62.50
Contractors Board Reg #: 35151 exp. 10 -12 -08 Investigation per hour (1 hr min)' 62.50
Metro # 2416 exp 11 - - Industrial plant per hour 73.75
Owner: •,,:, ;_ -,a :- — r- 7 �,� .,; : --- _
.-Q'w `1"r;> C '.;i; r '� <�`:..,.t pyV �7vdN,ycli,'J,".7 �i ....... --" �: t
._. _ .. nfnc�le. �. - h. -A = r` : : -.....
Subtotal R(�, I
Suprv. Electrician ature, sign required: ' Plan review (25% of permit fee) et t7
Print name: �� Date: State surcharge (8% of permit fee)
Lcf/r� TOTAL PERMIT FEE cb , I -7
Authorized signature:
This permit application expires if a tdt is not obtained within 180
Print name: days after it has been accepted per as complete
�!/ /D ,B •�i9d',tr✓a / Date: • Fee methodology set by Tti -County Building industry Service Board
•• Number of inspections per permit allow
islBuildingl crmitslELC- PerrmtApp.doe t2/03 440-4615r(10 /02/COM/WEB
.
• CITY OF TIGARD j CAL
BUILDING DIVISION PERMIT #: 20:0c0 - l DOS
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ^'I :—
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
8'2_ v �e �
SITE ADDRESS: �:E'.cC/
l � 7 0 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -.a --ego Pour Time:
Code # Inspection • - - _ i.tion r i Confirm # Contact # Message
11 q �' - 7 4 19S -
pv
.v► F-`,-
Corrections /Co 1a nstructions:
CC
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G--i q) w Date: 5 1 7 -1 6 6 Phone #: (503) 718 - 1 .