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Permit CITY OF T I GAR D ELECTRICAL PERMIT V K PERMIT #: ELC2004 -00073 DEVELOPMENT SERVICES DATE ISSUED: 2/17/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115BA-00500 SITE ADDRESS: 16035 SW PACIFIC HWY ZONING: SUBDIVISION: BLOCK: LOT : JURISDICTION: KIN Project Description: Install 10 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/ SVCI 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: 9 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: TOIVA SEPP OWNER 16035 SW PACIFIC HWY KING CITY, OR 97224 Phone: 503 - 620 - 2185 Phone: Reg #: FEES Description Date Amount Required Inspections [TAX] 8% State Surcharge 2/17/04 $8.54 [ELPRMT] ELC Permit 2/17/04 $106.70 Rough -in Elect'I Final Total $115.24 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. 4 Issued By: 01, L am , / t r 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:OOpm for an inspection the next business day Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Date/By Received 7 v Permit No.:�0 l� • �� 73 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review � � � �j Phone: 503.639.4171 Fax: 503.598.1960 ...� r Date/By: Permit: Inspection Line: 503.639.4175 a - n t - :- � „ Date Ready/By: 155:,./ 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: • Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction At-Addition/alteration/replacement Please check all that apply: LI Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft, CATEGORY OF CONSTRUCTION of 1- and 2 - family dwellings 4 or more new residential ❑ I - and 2 family dwelling 'Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more El Multi - family ❑ Master builder 111 Other: DOccupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park ❑Health -care facility ['Other: Job no.: Job site address: / p� �f `� {k% !' �-- Submit 2 sets of plans with any of the above. 4 City /State /ZIP:. ; Z..• ,7 Gam- The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Pro name:�� / � ,) ,. / FEE* SCHEDULE •• 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 map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: /0 ,vv 7, - _r .4 601 amps to 1,000 amps 240.60 2 Address. /. �D y L G e./2 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State/ZIP4 . Temporary services or feeders installation, alteration, and /or Phone: (S 3 G -c:'°7 C 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 exclian e _ • a ' S 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: _..../ /_■ Date: 2. / ? - c / Branch circuits - new, alteration, or extension, per panel •EC] APPLICANT .CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: 7 U 7, s C7 branch circuit - B. Fee for branch circuits Contact name: s , e , without service or feeder fee, e - �c�R�t,EGL �•1 ./ ^ each branch circuit Address: // / 46.85 2 Each add'I branch circuit g 6.65 2 City /State /ZIP: Z, C'� Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (S:-f ) G3G -o 0 2 c- Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: 7 y d /, Sc s'io Address: 0 /, / - v �- Each additional inspection over allowable in any of the above l i v Per inspection 62.50 City /State/ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal / 0 6 • Suprv. Electrician signature, required: Plan review (25% of permit fee) J Print name: Date: State surcharge (8% of permit fee) p , J - 7 TOTAL PERMIT FEE // oZ 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. i:\ Building \Permits'ELC- PermitApp.doc 12/03 440- 46!5T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTL L1,WORK.,ONLY g..,_ _> ` .' Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: - . COMMERCIAL WORK ONLI' , F. , .. - Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical 111 Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Pentits\ELC -PertnitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION . • PERMIT #: ELC2004 -00073 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7117/2004 Phone: (503) 639 -4171 �o ` l i l 1l Inspection Requests (24 Hrs.): (503) 639 -4175 `___. INSPECTION WORKSHEET FOR DATE: 7/5/2005 TIME: 7:12AM PAGE: 37 SITE ADDRESS: 16035 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: SEPP PROFESSIONAL OFFI DESCRIPTION: Install 10 branch circuits. OWNER: SEPP, TOIVA PHONE #: 503 -620 -2185 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 189 Electrical final 010726 -01 503-620 -2185 N Corrections/Comments/Instructions: r ......_ r I , `‘..L, c .111, NsL j / 9 - )- chCJJ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / --- L3 Phone #: (503) 718- FTidemark Advantage [Hurshel Young - HFY] PI s File Edit Options Window Help Exit New open Task List QBE GIS CI ltii D p I ' Coe View Add Delete Sign off Print Document. - y—i `dame:TOIVA SEPP Updated: 2/17/2004 BLD General - Address:16035 SW PACIFIC HWY Jur: KIN Description: Master # IELC2002 -00429 Project: ( SEPP PROFESSIONAL OFFI Service Feeder Install 10 branch circuits. Misc. i - `, Activity for ELC2004 -00073 IN ' . Aenu Code Description Date? Date2 Date3 Disp Done By Notes € Cool Application received _- 2/17)2004 DONE BB . - - 0003 Permit created 2/17,2004 DONE BB C500 , (F)Issue permit 2_t1 7t2004 DONE BB 0510 (F)Reprint permit _ _ 9129/2004 DONE OWL For Clair Company M C775 Rough -in C799 Elect' Final _ )\ 1 P ....9 -2 te .... , 2 1,-' 7 / 0 C. - f . I t - -:i-c-, o lc).(3? -c-li . ..,- ps .,,,,,,/ .___.,)& V Eu At , p,e )R-1 0 (-- SA2/27c ii View /Add Activities i Start' I ® Tidemark Advant... « a 7:37 AM CITY OF TIGARD 24 -Hour BUILDING Inspection Line: ,(503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 • BUP Received - Date Requested D . i - -3 AM PM BUP Location I \n V A 5 5 W A L \.\ t Y\1t,oi v Suite MEC Contact Person S 1 �� YID SS Ph (5`0 3 ) 6 L 'k"� PLM Contractor Ph ( ) SWR .4___ BUILDING Tenant/Owner ELC — Footing ' Foundation Access: ELC Ftg Drain * ELle 6® _ e) G ° /3 Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors 1 O r, Ext Sheath/Shear r 1 --@ Int Sheath/Shear Framing 1. NY\V\ Ul $ ) 1 ..1. �Vr L 1 (� vA . RC� \Fs. Insulation y L A V>, \ � \z \� C- -30 -4 Drywall Nailing C Firewall _ ���V)S� L\, Yht �L 0� Fire Sprinkler '� L Fire Alarm L\ ' S--1 • \ - \) ' � . 'm ll� bp N) La D 4g 0 1406 Sic P Susp'd Ceiling y Roof -' 1.. � . fi,) L 0 to NW _ Other: Final ► • ,1 PASS PART FAIL ■ \ ��� PLUMBING .a Na .n b )-\- C-V\9 I.2. }- 11 00U � F S"\ I\ \ 2S 5 . k 1 c rq )30)(_. Post & Beam \ .. \-) (v �S " 11 1° t U+ 1k 1►a►°r17 Ir(cP B .1 l k t_. Under Slab Rough In-'Wy1, \,\ Water Service �1 n Sanitary Sewer 'f �' v A U „ ‘k, L \. T G �`)\N T pvi� �p us �� lt Rain Drains I i Catch Basin / Manhole Oa- PA \'' N 'v (° I. 3), S CtI V Storm Drain E r I ' n �, Shower Pan i,tr PIV1 Z� i \ 1 6 I S `N 1� e' \ CA L. . s J 1 V$A L\ II\ 9 Other: Final • , c 1 I In p pop (\) f., , PASS PART FAIL -_ h MECHANICAL "\ t S 1C�k NL,(, LiAl \f q e V Qi9 O Post & Beam �� �� d 11 o P1�°► L �'i I Rough -In l � ; � - S GU ( I (N c(� 0 (S ©� C� / 'a.S C F Hq (/ Gas Line C9` ) K S IL l,-,1 C. \V 1 1 V\ a N QLv\ LI s� W 11 Pr � a0 l ) Smoke Dampers t-� V--1'1.\\ ) J '< (�(� F PASS PART FAIL?' ��l�P g �� 4 LWl L1)� `� \ fi n' � �% r -( U t`LE� �L1�S�4r VA � � � �5 t ��� �� 1; � G l •�,1� Service Czc -e\ \� A l `tt LP 1 YY\■`�' UG/Slab a Low Voltage I • Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART F AI SITE 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA /' 9 Approach/Sidewalk Date � • � ' 0 cJ Inspector 4-, / --- Ext Other: Final DO NOT REMOVE this Inspection record from the ob site. PASS PART FAIL