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11151 SW 4ALL BLVD 49-56
CITY ®P •1 'GA R® ELECTRICAL PERMIT
PERMIT#: ELC2002-00431
DEVELOPMENT SERVICES DATE ISSUED: 8/30/02
13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 PARCEL: 1S135DA-02402
SIfF ADDRESS: 11155 SW HALL BLVD 49-56
SUBDIVISION: ST. JAMES APARTMENTS ZONING: R-12
BLOCK: LOT : 010 JURISDICTION: TIG
Proiect Description: #51 Install 4 branch circuits.
_ RESIDENTIAL UNIT _ TEM_P_SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNiOUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FOR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
_v _ _ ADD'L Ii.SPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION::
201 - 400 amp: 1st W/O SRVC OR FOR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOL..T .,O AINAL:
Reconnect.only: _ _ SVC/FDR_>= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JOHNSON, LYNNE AND R BLAKE ROSE CITY ELECTRIC CO INC
TRUSTEES 4012 NE CULLY BLVD
2445-A MAKIKI HEIGHTS DR PORTLAND, OR 97213
HONOLULU, HI 96822
Phone: Phone:
Reg #: 29�61ft7S
LIC 3567
ELE 2.6-113C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 8/30/02 $66.80 2720020000( Elect'I Final
5PCT CTR 8/30/02 $5.34 2720020000(
iTotal $72.14
This Parmit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all ether applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is
suspended for more than 180 days. ATTENTIGV Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503)
24E-6699 or 1-800-332-2344
Permit Signature: , . Issued By:
_ OWNER INS?ALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent,
OWNER'S SIGNATURE- �_ _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURF OF SUPR. ELEC'N: __ . r t DATE
LICENSE NO:
gall 639-4175 by 7:00prrn for an inspection the next business day
ElectriicA Permit Application
}� 42,54W-HAUMv
a Datereceiv�,)�i ';y Permitno.
Ci OfTigard and
j'Y
Project/appl.no.: Expire date:
Addres: iget 2Z� Date issued - By �' Recei tno.:
Gty ujTigardP
Phone: (5 -4171 n rIFatx: (503AUG 2 1001 Case file no.: Payment type:
Land use approval: U1 Y UV ii- AKU
t] I &2 t;atnily dwelling or accessory minercial/indt ;trial U Mulu-family U Tenant improvement
U New construction U Addition/alteration/replacement U Other._ U Partial
Job address: S _ S (n-a 4*5 1 IBIdg.no.- Suite nu.: ITax.map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: L,8 N-S _ Description and location of work onpremises: 170
`�,--
Estimated date of comps tion/ins cdon:
Olt Al1I-L1CA'f1.(-)N 1.11'.11" SCHIAW111111"
Job no: � 2'� �' Fee Max
Business n true ( nesniption (hy. (ea.) Total no.Insp
New rmidenlial-single or multi-famihv per
Address: 4012 N$ Q LY BLVD dwellbtgunit.Includes attachedgarsge.
City: PORTLAND State:OR ZQ'7213 Serviccincludp&
P043 287 616 4 Wl 3 282 1 Bail; 1000 sq.ft or less _ 4
CCB no.: Elecbus lic.no: 96 113C Each additional 500 sq.ft.or portion thereof
Limited energy,residential 2
City/metro 11C.n0.: Limited energy,non-residential _ _ 2
i Each manufactured home or modular dwelling
signature of supervising electrician(required) Date Service and/or feeder 2
Sup.elect.name(print): F 1, Go t ham I License no S Service orfeeders-installation,
alteration or relocation:
OWNER 200 amps or less 2_
Name(print): 201 amps to 400 amps 2
--- 401 amps to 600 amps 2
Mailing address: ��5��= 601 amps to 1000 amps --- 2
City: State: ZJP: Over 1000 amps or volts 2
Phone: Fax: rE-mail: Reconnectonl I
Owner installation:The installation is being made on property I own Terrtpoaryservicesorfeeders-
which is not intended for sale,lease,rent,or exchange according to Instailaticn,alteration,orrelocation:
201 amps or less 2
ORS 447,455,479,670,701.
201 amps to 4011 snips 2
Owner's sl nature: Date: 401 to 600 ams 2
Bunch circuit--new,alteration,
or extension per pawl:
Name: - A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: StatC: ZiP: B. Fee for branch circuits without porchase �S 2
of:.ervice or feeder fee,first branch circuit:
Phone: Fax: E-mail: Each additional branch circuit:
Misc.(Service or feeder not Included):
*Service over 225 ampa-commetri&1 13 Health-are facility Each pump or irrigation circ:e - 2
U Jrrvica over 320 amps-rating of I&2 0 Hazardous location Each sign or outline lighting 2
family dwellings U Building over 10,000 square feet Pout or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal more residential units in one,,tructure alteration,or extension* 2
Building ower thtee stories ❑Feeders.400 amps or mcre !
Occupant load over 09 persons U Manufactured structures or RV park Desaition:FAch addlllonal Inspecllon over the allowable in any of the above:
❑Fgress/lightingplan U Other: J_ ---- Perinspection
Submit---sets of plum with any of lbe above. investigation fee
The above are not applicabie to tempotraty c omr(ruction service. Other
_-- __—,_ar-- Permit fee__........"""...$
Not all}wbftd m steeps�:cads,pleas cal!►rw;;ic Oo fr.me iarmn sum. Notice:This permit application
O Visa ❑MasterCard expires it's permit is not obtained VII.-in review(at _%) $
cradle card aumber �. -- __�_L___ within 180 days after it has been State surcharge(8%)....$
E p1Y1 accepted as complete. TOTAL. .......................$
Nana d urAnrldcr u atwvn on cm4hi card
—
r
S
Cadhdder sigcnrarc --- - — Amount 410dg1!WOKOO
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee...................................................... ~$75.00
Number of Inspections per pennit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-)er unit
1000 sq.ft.or less $145 15 4 ❑ Audio and Stereo Systenis
Each adoitionai 500 sq.ft.or
portion thereof _ $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manurd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $9090 2
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relaxation
200 amps or less $80,30 2 f-� Vacuum Systems.
701 amps to 400 amps $106.85_^ 2 L
401 amps to 600 amps $16060 2
---- Other _
6C I amps to 1000 amps $240.60 _ -- - - - --- --- --- ^-
Over 1000 amps or volts $45465.__ 2
Reconnect only $66 85_ 2 I
-temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Fee for each system.......................................................... $75.00
Installation,alteration,or relocation
200 amps or less $66.8r 2 (SEE OAR 918-260-260)
2C1 amps to 400 amps $100.3( 2
401 amps to 600 amps $133.7 j 2 Check Type of Work Involved.
Over 600 amps to 1000 volts,
see"b"above. Audio and Stereo Systems
Branch CI-cults ❑ Boiler Controls
New,alteration or ezteiision per panel
a)The fee for branch circuits ❑
with purchase of service or Clock Systems
leader fee.
Each branch circuit $6.65 2 Data 1 elecommunicetion Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit I $46.85 � � HVAC'
Each additional branch circuit — $6.65
Miscellaneous —C� �� Iris trurnen tation
(Service or feeder not included)
Each pump or irrigation circle $5340 _ Intercom and Paging Systems
Each sign or outline lighting _ $53.40
Signal circuit(s)or a limited energy
panel,alteration or extension _ $75.00 Landscape Irrigation Control'
Minor Labels(10) $125.00
� Medical
Each additional Inspection over
the allowable in any of the above Nurse Calls
Per Inspection $62.50
Per hour _ $62.50
In Plant a7:75 Outdoor landscape Lighting*
Fees: Protective Signaling
Enter total of above fees $ _ ❑ Other
8%State Surcharge $ _ �---_—Number of Systems
25%Plan Review Fee No lice-ises are required. Licenses are required for all other Installations
,%"'Plan Review"section on X
front of application
Fees:
Total Balance Due $
-- Enter total of above fees S`.__._
❑ Trust Account p _-. 8%State Surenarge $__
I_--- Total Balance Due $.
i kdsts\formslelc-fees Aoc 10/09!00
CITY OF TIGA.RD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP — --
Received _._ -Date Requested AM PM BLIP
Location __- ��r �� �_- -_._.Suite ��~� MEC
Contact Person ��� �l-L-t Ph( } 1 PLM
Contractor-_ _- -__. __ Ph( ) SWR f�
BUILDING _ Tenant/Owner V ELC �2
Footing _
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - -
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final ----
_PASS PART FAIL - �----�----�-- �- -����----_---
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains - - - - --
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:_ - -- - --- -
Final
PASS PART FAIL
_MECHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART_ FAIL -
ELECTRICAL A
Service
Low Voltage
Fire Alarm
[Final Reinspectinn fee of$�� _� required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA _ PART FAIL
SI [� Please call for r inspect' n RE:__ [] Unable to inspect--no access
Fire Supply Line
ADA �t �1
Approach/Sidewalk Date Q ` Inspect � ~` Ext_�_�..
Other.
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OP a/kRD 4-Hour
BUILDING ispection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
"Up
Received _Date Requested l �AM_._ PM__ BUP
Location --Suite MEC
Contact Person _ PPLM
Contractor_ Gh t�" _) vim[_ SWR /
BUILDING_ Tenant/Owner ___ ELC ''
—4X 7
Footing
Foundation ""r-- ELC
Access:
Fig Drain �Z'5L ELR
l".iawl Drain
Slab Inspection Notes: SIT
Post&Beam V
Shear Anchors _ --
Ext Sheath/Shear _
Int Sheath/Shear —
Framing —
Insulation j r
Di ywail Nailing -- —--
Firewall lam'
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
FAlarm I�1
gapPART FAIL u Reinspection fee of$ __. __required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE — [� Please call for reinspection RE: Unable to Inspect-no access
Fire Supply Line
ADA Cf,
' n 1,..�
Approach/Sidewalk Do" y- Inspctoet .-�=semJ Ext _
Other:
Final _ DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL