Permit C ITY O F I A ® ELECTRICAL PERMIT
PERMIT #: ELC2006 -00101
D 13 E 5 SW OP Hall BI Tigard, OR 97 503 - 639 - 4171 DATE ISSUED: 2/8/2006
PARCEL: 1 S135AA -AC001
SITE ADDRESS: 10428 SW 90TH AVE ZONING: R -4.5
SUBDIVISION: ASHBROOK CONDOMINIUMS LOT : 001 JURISDICTION: TIG
Project Description: Building 3: Unit 10 of a 5 -unit townhouse building.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 1.00 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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: X > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
RCM HOMES DMS ELECTRIC INC
12670 SW68TH PKWY #200 8502 SE STARK ST
PORTLAND, OR 97223 PORTLAND, OR 97216 -1140
Phone: 503 - 598 -7565 Contact #: FAX 503 - 252 -6611
PRI 503 - 209 -9298
FEES
Description Date Amount Reg #: LIC 118073
SUP 4542S
ELE 37 -742C
Total
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 f. •• OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 - 246 -669 or 1 -8S s -3
Issued By: !(1 Permittee 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 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.
'� s t 1 m F r ( h,ry v r' I4 ' e _ k yt s 1 -'s' t 4 Y r
Electrical Permit Application 4.51 ( ,t < 1 w a,4iG, _roR)O'FrIa CE�usF ON�Y �, , t °As # ' 4
1 A..4 h:Q�k'e44® 1{,'fi,4 7 : i t� 54 .'" i y 4, -41's` r 'hi - 1., J i :!.,. , Ilar l 1, W11 1:4 �.
Received o g 4 ��O / f
City of Tigard Date /By: $ / Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 i i
4 H p I Date /By: Other Permit
Inspection Line: 503.639.4175 ,,, l,p11.;;',, , Date Ready /By: Jnri ' ® See Page 2 for
Internet: www.tigard or.gov NotifiediMethod: /.. ( Supplemental Information
TYPE OF WORK PLAN REVIEW:
® New construction ❑ Addition /alteration /replacement Please check all that apply:
❑Service over 225 amps, comm'I ['Hazardous location
El Demolition ❑ Other:
['Service over 320 amps — rating El over 10,000 sq. ft..
. CATEGORY OF CONSTRUCTION of I and 2 family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building El System over 600 volts nominal units in one structure
❑Building over three stories ❑ Feeders, 400 amps or more
® Multi - family ❑ Master builder ❑ Other:
El Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
to ❑Health -care facility ❑Other:
Job no.: Job site address: 10428 SW 90 Ave
Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/ FEE* SCHEDULE *x
bldg. /apt. no.: Project name:
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 I
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or nodular
dwelling, service and /or feeder 90.90 2
Building 3: Unit 10 of a 5 -unit townhouse building.
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 I 2
401 amps to 600 amps 160.60 2
Name: RCM Homes 601 amps to 1,000 amps 240.60 2
Address: 12670 SW 68 Pkwy #200 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Portland OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)598 -7565 Fax:( )
200 amps or less 66.85 I
Owner installation: This installation is being made on property that 1 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
® APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Same as owner branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l 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-
- CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: DMS Electric Inc
Address: 8502 SE Stark St Each additional inspection over allowable in any of the above
Per inspection 1 62.50
City /State /ZIP: Portland OR 97216 -1140 Investigation per hour (1 hr min) 62.50
Phone: (503) 209 -9298 Fax: (503) 252 -6611 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 118073 Electrical Lic.: 37 -742C Suprv. Lic.: 4542S Subtotal
Suprv. Electrician signature, required: ),, EU' i5- Oo,5 g/ Plan review (25% of pemut fee)
State surcharge (8% of permit fee)
Print name: Date:
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 1811
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
m ** Number of inspections per permit allowed.
I: \Building \ Permits \ELC- PemiitApp.doc 12/30/05 440.4615T(10/02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2006- 00101
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2
Phone: (503) 639-4171 *440i
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6%13/2006 TIME: 722A1V1 PAGE: =12
SITE ADDRESS: 10428 SW BOTH AVE CLASS OF WORK:
SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: °° TYPE OF USE:
PROJECT NAME: ASHBROOK CONDOMINIUMS
DESCRIPTION: Building 3: Unit 10 of a 5•unit townhouse building.
OWNER: RCM HOMES, PHONE #: 503-598
CONTRACTOR: DMS ELECTRIC INC PHONE #: 503
Inspection Request Scheduled For: Date: U 13 / 2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 031638-01 503-209-7386
Corrections/Comments/Instructions:
-
PASS fl PARTIAL APPROVAL fl CANCEL El NO ACCESS
1 1 FAIL ALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Date: q ° Phone #: (503) 718-21
CITY OF TIGARD EZ_L
BUILDING DIVISION PERMIT #: a-- 606--60 16
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175 639-4171 4 40
Inspection
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
ITE ADDRES • I 425 `4 ' CLASS OF WORK:
UBD ION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3_ /5 —O Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 I / 0-0 5-73 c r io
,t ick. ale .
Corrections /Comments /Instructions:
•
f PASS ❑ PARTIAL APPROVAL ❑ CANCEL I1 NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� " � N L Date: 1 �� �� Phone #: (503) 718- 2
Inspector: ( )