Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00525
j
1� r DEVELOPMENT B I T S ERVI 9 ES DATE ISSUED: 9/19/2006
13125 SW g OR 503 - 639 - 4171 PARCEL: 2S102BD -01900
SITE ADDRESS: 12920 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: HUDSON PLAZA LOT : OOD JURISDICTION: TIG
Project Description: Install (1) service, (1) feeder and (10) branch circuits. Job No. 412
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: 2 W /SERVICE OR FEEDER: 10 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:
HENDERSON, MARILYN DOROTHEA WILLAMETTE ELECTRIC INC
JENSEN HUDSON TRUSTEE PO BOX 230547
11795 SW KATHERINE ST TIGARD, OR 97281
TIGARD, OR 97224
Phone: Contact #: PRI 503 - 624 - 3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 - 283C
[ELPRMT] ELC Permit 9/19/2006 $227.10 LIC 75059
[TAX] 8% State Surcharge 9/19/2006 $18.17 SUP 1965S
Total $245.27 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 arr forth in OAR • - S:1 - 0rr1 0 through OAR 952 - 001 -0100. You may obtain copies of se_ rules or direct questions ta•OUNC at
503 -2 4 ..... 6699 9r 1 -800- • / - •
Issu By: , l 0 (sL 4 , Permittee SigMature_ _ - _,, f i .
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:
_ C ■. NTRACTOR IN TALLATION ONLY
SIGNATURE OF SUPR. ELEC'N%_ - ' - ' i� i�l ' DATE:
LICENSE NO: ---- 1
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.
SEP 19 2006 10:50RM WILLRMETTE ELECTRIC 5036242938 p.2
Electrical Permit Application FOR OFFIf_ 1 I SIB ONLY
Received / 9 `'.,1 y Permit No.: G Ave, - U � j j ; S
1Q� 0� Tigard ' ` t. Datd
1 3125 SW Hall Blvd., Tigard, OR 97223 Plan R Other Permit:
/" • s DateJB
Phone: 503.639.4171 Fax: 503.598.1960 '" l 1 It
S�' 4�
Sy 1 9 �� ¶..� 0, it Ready/By: 1u,i . ® See Page 2 for
Interco w sae: 503.639.4175 - ---
Internet: www.ci.tigard.or.us Notifred.Method: / a Supplemental information
x ''s . f !. „ s . :S Y�,r i , -..:: µ _z' .. � ri:- '-iot: V gri tl?Fiti ,i#..- __'!ii, ' -x' W' :.. iialli c-. t... .. _. .�- -
..rte;. �il,.; - <.... .... ... 1/ -'Yi`
s Please check all that apply:
gl ' New construction ❑ A' - 01: t ' o tetafiott /replace merit ['Service over 225 amps, comm'l ['Hazardous location • ❑ Demolition ❑n r ❑Service over 320 amps - rating ❑Bulking over 10,000 sq. ft.,
.,. t' 4 > r , r 4 a€ .4 u r - - of 1- and 2- family dwellings 4 or more new residential
i . - 1 i- =,v.�. -. ,....,.- ,ekiii. g..:,.c t4e, , :0:.. -_ .u.;r tic.. `
,.; -.. a ,.. _.., _....._., units in one structure
❑System over 600 volts nominal
❑ 1 and 2- family dwelling ®Commercial/indushial ❑Accessory building []Building over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other ❑Occupant load over 99 persons ❑Manufactured structures or
t = i S. =:'a 'u's u ` r�" =!."':-: t V M ri ni +liti . - 1-4172 E5 _ q .essi{i .{ tm Ian RV park
• - f► � w t p ❑Health -care facility ['Other:
Job no.: 4 i Z I
Job site address: S 4,,tt c Hui ,..i
Submit sets of plans with any of the above.
City /State/ZIP: 7 1�rt 1 at � The above are not applicable to temporary construction service
Suite/bldg./apt. no I Project name: ' 2(. P vt z H- - De,eripdon I Qt 1 Fee. Total ) '.
Cross street/directions to job site: _ Piew residential single- or multi - family dwelling unit.
includes attached garage.
1,000 sq. ft. or less 145.15 4
Lot no Ea. add'l 500 sq. ft. or portion 33.40 1
Subdivision: Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2 _
s ' r , '` .'- !#' 6 ? 8 `� ......... S 1, '' i r . 'i Each manufactured or modular
� _ dwelling, service and/or feeder 90.90 2
l Y .W / �u i �e A 1 Services or feeders installation, alteration, and /or relocation
200 amps or less _ 80.30 lie 2
j t _ i. µ r ii f 201 amps to 400 amps 106.85 2
s F x tf n r. a } - a M , ' . ? . 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.35 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
ids �- - - e, A. Fee for branch circuits with
_.y `lw,p l , i Q1- i , y = a ».S w : � __,,, _ •' 1 -_ p . . i,; ' .. `. ° .'-", i +,
s ._,, _� _ 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 2
first branch circuit
Address: Each add'! branch circuit 6.65 2
City /State /Z1P: Nllscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E > r -ar Signal circuit(s) or limited -
K n i 4 "='' ai is '1 =_ ii f ?1„- ! j. f ,. energy panel, alteration, or
r , '"' , 1 ss,. .li _,,,„ .s,- , x,,.,. ., -m- x a:�. -. k,, ,,- ..... .. ,h' ---,1
extension. Describe: Page 2 2
Business name: L 11 aril ell-' 6 1 e te.:. r-.
Each additional inspection over allowable in any of the above
Address: P 0 6,0A Z? 0 sti) Per inspection 62.50
City /State /Z[P: T i. 9 a r cr 47 r 9 72 1' J Investigation per hour (1 to min) 62.50
Q Z y 2 : 9 3 industrial plant per hour 73.75
Phone: ( ) 2 `!' G 3 ! 1 Fax: (5 ) - r :; a 1 : ' 4i: a a Zfi. .
CCB Lic.: 75os
Electrical Lic.: i i i -ar.,5 G 1 Suprv. Lic.: V 2 Z if - .s' Subtotal z 7 3
_ , . ..._...___........ Plan review (25% of permit fee)
Suprv. Electrician signature, requir ._ - l - �_ I ?'
State surcharge (8% of permit fee) I V
Print name: Oa v ; of re I Date: q- /1 Q�/
TOTAL PERMIT FEF. Jr Z ((i
Authorized signature: This permit application expire. if a permit is not obtained wirhln 180
days after it has been accepted as complete
i Date: • Fee methodology set by Tri- Coaoty Building Industry Service Board
Print name: •• Nnmberofi nspectionsperpermitalbwed.
i:NHni1dm eermitelHLC• Per,nLLnPp.
doc 12,03 44C.461ST(10101 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00525
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2006
Phone: (503) 639 -4171 A ,' q
Inspection Requests (24 Hrs.): (503) 639 -4175 s';+i 61 f_I I
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7: 00AM PAGE: 33
SITE ADDRESS: 12920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 000 TYPE OF USE:
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: Install (1) service, (1) feeder and (10) branch circuits. Job No. 412
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503- 62.4 -3631
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description onfirm #Contact # Message
189 Electrical final \ 046688 -01 503- 624 -3631 N•
Corrections /Comments /Instructions: \ �_
i
KPASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
. Inspector: 4 0 (SES Date: 14 1 Phone #: (503) 718 - 7i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006M(W2E,
13125 SW Hall Blvd., Tigard, OR 97223 q DATE ISSUED: 9/19/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/30/2007 TIME: 7:O0AM PAGE: 27
SITE ADDRESS: 12920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 00!) TYPE OF USE:
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: Install (1) service, (1) feeder and (10) branch circuits. Job No. 412
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: VVILLAMEI 1 E ELECTRIC INC PHONE #: 503 -624 -3631
Inspection Request Scheduled For: Date: 3/30/2007 Pour Time:
Code # Inspection Description ��# Contact # Message
199 Electrical final 045758 -01 � 503-624 -3631 N
Corrections /Comments/ Instructions:
O P+ Z o A .. V 7 ( & — f ••_ V.' ti
i
F t - .
e 6 opli nitN) rrng1 c, 14)c+ ( c c u J 6
F r ')1 r 6 o z_ p21(. esz ". 35 , 30
(ti V-P460-- siiNctA6 bT6 051\wg 1\0'. n (i0
coKiritA L j PAL -
R . t a v V ) ` . s w dr4 F e i n . ki q lr' IN 41.yi (1.6a
--odP ` 6U. 6cfecL. Azq 2l n iT)8 CGS
PASS 1 1 PARTIAL APPROVAL ❑ CANCEL 1 NO ACCESS
7 1/4 FAIL ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1\A) Date: 3 '30.0 Phone #: (503) 718- I7 YV
CIT ■ OF ■ IGI _■ lD
BUILDING DIVISION PERMIT #:ELG20014°00525
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 III
Inspection Requests (24 Hrs.): (503) 639 -4175 __:
INSPECTION WORKSHEET FOR DATE: t - I-1- t'"1 TIME: PAGE:
SITE ADDRESS: 12,9 20 5%4 PP t ` C ‘Aw y CLASS OF WORK:
SUBDIVISION: U LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: toFFvg SAO? (- esiz a04
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: `- t- -0 Pour Time:
Code # Inspection Description Confirm # Contact # Message
113' s .ER.Qi c io <■osk ( s4 0
Corrections /Comments/ Instructions:
S E 4Z V "I e--(C4 ` fi b �' 0 s 1 6 i rJ 67 P GO •
NO `S' bL$ f' S �23 1 .
� 2tJN i D� c L k cAL. e aL
Usscg. Bu -
I PASS PARTIAL APPROVAL n CANCEL 1 I NO ACCESS
I I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ip.- 1Vi�� Date: -1 09 Phone #: (503) 718 - 2'44,
4 ‘ 1111 1916 .
CITY OF TIGARD
BUILDING DIVISION i ,, ' , PERMIT #: ELC200600,25
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2006
Phone: (503) 639 -4171 p �I�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/28/2006 TIME: 7:04AM PAGE: 39
SITE ADDRESS: 12920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 000 TYPE OF USE:
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: Install (1) service, (1) feeder and (10) branch circuits. Job No. 412
OWNER: HENDERSON, MARILYN DORO HEA, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-624-3631
Inspection Request Scheduled For: Date: /1/2912006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
116 Electrical service 040378 -01 503-624- 3631 N
Corrections /Comments /Instructions:
? R3 200 - OVA 1$
ZQK S PAci---ir. 4.k,wy.
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL fI NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 \I 6 6 Date: 11-27 'V 6 Phone #: (503) 718- /gig
CITY ���������������
��nn m OF mnn�|��n���
BUILDING DUNG DUVUSUON PERMIT #: ELC2006-00625
13125 SW Hall Blvd., Tigard, OR 97223 �— ' DATE ISSUED: 911E/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639~4175
; INSPECTION WORKSHEET FOR DATE: 11/29/2006 TIME: 7:04AkA PAGE: 38
SITE ADDRESS: 12920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: OOQ TYPE OF USE:
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: Install Ml service, (1) feeder and OO\ branch circuits. Job No. 412
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-0243831
Inspection Request Scheduled For: Date: 11/2E/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
126 VVo| � 040378-02 503-824-3631 N
150 RoWo`&~
�
Corrections/Comments/Instructions:
~ "
~�S PARTIAL �� CANCEL
-- NO ACCESS
• _ __
n FAIL ri CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
mJ ����
Inspector V ���� Date: Phone #: (503) 718' 1
. , '
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: Et 005'25
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91191
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 --
INSPECTION WORKSHEET FOR DATE: 9125}2005 TIME: 7 :01AM PAGE:.:. 31
SITE ADDRESS: 17920 SW PACIFIC HWY Wol,,N LTY CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA - LOT #: aco TYPE OF USE:
PROJECT NAME: HUDSON PLAZA '
DESCRIPTION: Install (1) service, (1) feeder and (10) branch circuits- Job No. 412 =
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #: .
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-6)A-3631
Inspection Request Scheduled For: Date: 9/2517006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Undergro indI ab cover 037095 - 01 503 - 624 - 3631 N
Corrections /Comments/ Instructions:
kil\flvg ALL g wed I' PvC AfsZ RVIA 44 (
wi H AppiLioNY ry1Af' a-414--. Ne . 3 5 •6 .
a > pR...N► C R C L (z∎ ( L Z fkwe s 8t1
' 1 1 S ��CZ- IN)o fE , ItN S V s .
!/i PASS T. 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
II" V IL ";' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • N �6 Date: 1i Phone #: (503) 718- 23/441