Permit C ITY OF TIGARD / ELECTRICAL PERMIT
1.1 D D PERMIT #: ELC2006 -00578
C OMMUNITY DEVELOPMENT
DATE ISSUED: 10/12/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 BB - 00900
SITE ADDRESS: 11880 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: TIGARD ROAD GARDENS LOT : 006 JURISDICTION: TIG
Project Description: RUSS CHEVROLET. (1) branch circuit for radiant heater. Job # 06 - 902.
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: 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:
KNAUSS, WAYNE /JENNIFER BOB'S ACTION ELECTRIC INC
KNAUSS, HARVEY 2700 NE BURTON ROAD
Go HUMBERSTON, RUSSELL D STE A
TIGARD, OR 97223 VANCOUVER, WA 98662
Phone: Contact #: PRI 360 - 254 - 7200
FAX 360 - 254 -8219
FEES
Description Date Amount Reg #: ELE 37-431C
[ELPRMT] ELC Permit 10/12/2001 $46.85 LIC 53136
[TAX] 8% State Surcharge 10/12/2001 $3.75 SUP 4322S
Total $50.60 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: _ � /�11P Permittee Signature: _ix ‘'N
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.
Electrical Permit Application FOR OFFICE USE ONLY •
City of Tigard
OCT C T 1 '' 2 2006 Received i
/i" ` , it No , n , [ �7
y g Date/B � - Q S' ]i'l -�� Perm �(.17�G6C7 oO�/
13125 SW Hall Blvd., Tigard, OR 97223 CITY OF TICaA - '� Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 r DIVI e /n - "'�P. '° \ _•
BUILDING Other Permit:
! 'O .L Date/B .
Inspection Line: 503.639.4175 �-w. L Date Ready/By: Runs' El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: .. Supplemental Infornrafimt
r s, • , t• t :•IYl,! ' ' .h': l'rL Y ,:r:,� , ,�.....,, .., V
�,�� c � ' 7 rt - '�+',, }u „^! r r,N.�,: '5�? 9�yT <'' a1.'., .`�.. ^ t .t:( ��i'' ;w;::. ,.: .,
' IEW
` .
❑ New construction ❑ Addition/alteration /replacement Please check all that apply:
['Service over 225 amps, comm'l ['Hazardous location •
❑ Demolition ❑ Other:
• �rr'r ' . L• S: + t t �,, t �:< w aFNnc = =r r ^,:c q4�+ „t :"�`;P'' 1 , ; (r.:�, t/'t ❑Service over 320a amps - rating ❑Bulldog over 10,000 sq. ft.,
'� c, I� C 'i � O + of t- and 2-family dwellings 4 or more new residential
T] 1- and 2- family dwelling 2 CommerciaUindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories [Weeders, 400 amps or more
❑ M 0 builder ❑Other:
a•, a Multi-family t R g am, •� M, s.. o n• , r t u Other:
t �a y ��.��- ❑ Occupant load over 99 persons ❑Manufactured structures or
s>;":`�`- tan - ' ti' o I I •,( k� ' da ': [ T Mi;IG "a�VM ❑ Egress /lightingplay RV park
t{ '+ +.stac4i l h1c!! .: a iF�.
Job site address: ❑Health -care facility ❑Other:
06 - 902 11880 SW Pacific Hwy.
Submit 2 sets of plans with any of the above.
Job no.:
City /State/ZIP: The above are not applicable to temporary construction service.
Tigard, OR 97223
Suite/bldg. /apt. no.: I Project name: t 4 i_ uiz l;' _:�l t:.: EE* SGHEi5..01 : :: ..
Description I Qty. I Fee. I 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 map /parcel no.: •
Limited energy, non - residential 75.00 2
±` c' . p .. r• , � . , .. l W :Y y ' rim
i•r' 40 a} ., ':'" 4 i �
. E u �•� . r; o . b.j ', IN A �y,j1-. c t4 Each manufactured or modular
• dwelling, service and /or feeder 90.90 2
Radiant Heater connection Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
� ,� �,,,�� �' _{�,
a?v� t:S .:;;ry .tqt � tM s�� afl� '�' � i :'I'`at .Lfiif�"tr .f 9�� ItEI ¢Nr,T;<iJr' RSf"�1 g 401 amps to 600 amps 160.60 2
Name: Russ Chevrolet 601 amps to 1,000 amps 240.60 2
Address: 11880 SW Pacific Hwy. . over 1,000 amps or volts 454.65 2
.. Reconnect only 66.85 2
City /State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
Fax: ( ) relocation
Phone:
( 503) 530 - 1281 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
� _ ' "'" f ''r" • 1N
M 1�.4 a �.'r�/ y 0 ?1 ,` .' L I :i. •: .1. t ~ 4 t •r •' 17, i ' A. Fee for branch circuits with
` ; ' . ti:• '� a ``'`Y�^ ''� ` service or feeder fee, each 6.65 2
Business name: . branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 46.85 2
each branch circuit
Address:
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
a� r nr•Pw. °� tw a s c. s ast ;l::teu•• exaru u,+ ej` t'ps ., t t
'd.Si 3+ 's� 'r � ilR'�d'-`i l�Tag,1 ygM [ 7:'�:lif`�,e 1'�^a7�F t { plc: energy panel, a Describe: r-n, or
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: 2700 "A" Each additional inspection over allowable in any of the above
2700 NE Burton Rd. A Per inspection 62.50
City / State/ZIP: investigation per hour (I hr nun) 62.50
Vancouver. WA 98662
Industrial plant per hour 73.75
Phone: ( 360) 254 -7200 Fax: (360) 254 -8219 .3L � , aaar;�f1 }E-, R: - ._�...-...._ ---; ^::;::• .:::...,,. .
a::�(i'�r. �r�t�;�b1: ,,, LE, �� ' .. .
CCB Lic.: 53136 Electrical Lic : 7_ 1c Suprv. Lic.: 4 22S Subtotal 46.85
Suprv. Electrician signature, required: ,/ / /3„_______ Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) 3.75
Kevin Bro selle 10/9/06
TOTAL PERMIT FEE 50.60
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri County Building Industry Service Board
•• Number of inspections per permit allowed.
l: \B wilding \Permits\ELC- PermitApp.doe 12/03 440•4615r(10/02/COM/WEB