Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00718
COMMUNITY DEVELOPMENT DATE ISSUED: 12/19/2006
o mnfoo 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 C B -03400
SITE ADDRESS: 10035 SW GARRETT ST 4 ZONING: R -12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
Project Description: Reconnect only.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
FINKE, ALEX AND LOTTE I OWNER
PO BOX 23562
PORTLAND, OR 97223
Phone: Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 12/19/200( $66.85
[TAX] 8% State Surcharge 12/19/200( $5.35
Total $72.20 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: 1 � ' Permittee Signature: 4 :r° . Prep
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.
:
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:°-'`, Electrical Permit A,t s licatio 1 - 1 '_, > i L,A - 01t OI 1 C,1 rI:�S ��i �.
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' City of 'Tigard De/ /By / _/ 9 ' Permit No.C� C .00410(12) I l —
'� ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �D
ri ® Phone: 503.639.4171 Fax: 503.598.1960 DEC 1 ! 2006 Date/BY Other Permit:
X k"v Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
falG �'(Kl�� p
al.a .mom Internet: www.tigard- or.gov , N tified/Method: Supplemental Information
_. TYPE 0 e. L ,, PLAN.REVIEW
oT� non 1TC,T1(1,R
❑ New construction ❑ Addition/. ti i replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition %'t Other: where the available fault current ❑ Marinas and boatyards.
' CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
X Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
- ` JOB SITE, INFORMATION AND. LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I - ",
Job no.: Job site address: / 00 3 5" ,$)," 6A g T r 100HP or more. occupancy.
❑
❑ Six or more residential units. Recreational vehicle parks.
City/State/ZIP: ' 7 , � ' /4-1Z) ❑ Health -care facilities. ❑ Supply voltage for more than
/l e 4�1 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 li���
- Project name: (/ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: $
4-1.....?
' , 1 ���r Desc ription 1 Qty. I Fee. I Tote I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK _. ` (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
Xj 200 amps or less 80.30 2
II(1 - ,PROPERTY . OWNER, ❑TENANT 201 amps to 400 amps 106.85 2
Name: AtL f, 'AkE 401 amps to 600 amps 160.60 2
f�6 v2 3 � Over 1,000 to 1,000 amps 240.60 2
Address: , r Over 1,000 ammps or volts 454.65 2
City / State/ZIP: / , '. C7 _ Temporary services or feeders installation, alteration, and /or
relocation _
Phone: (6 ) zl- Fax: ( ) 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
.
❑, APPLICANT - ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: l&- B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
S A- E o first branch circui
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only tt 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR • . Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
extension. Describe: Page 2 2
Address: ikt
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv. Lic.: Industrial plant per hour 73.75
`ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 6 ( , S l ' j
�-! /, " /' Plan review (25% of permit fee):
Print name: � - rt , f /V l-C Date:
State surcharge (8% of permit fee): : 3 .)
Authorized signature: r TOTAL PERMIT FEE: 0
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
i \ Building \Ptrmits\ELC- PermitApp.doc 05/23/06 440 4615T(1 1/05 /COM/WEB
Electrical Permit Application - City of Tigard - A
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENI'IALWORK
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 ONLY:
Fee for each commercial $75.00
system
(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.
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ 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 \Pamits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC280&- 00718
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121'1912006
Phone: (503) 639- 4171��I
Inspection Requests (24 Hrs.): (503) 639 -4175 , -_'
INSPECTION WORKSHEET FOR DATE: 12121/2006 TIME: 7 : 00AM PAGE: 30
SITE ADDRESS: 10035 SVV GARRETT ST 4 CLASS OF WORK:
SUBDIVISION: CHARLO IENHOF APARTMENTS LOT #: (20 3 TYPE OF USE
PROJECT NAME: €:HARI_a`? iT ':i` HOF APARTMENTS
DESCRIPTION: Reuonnect orEly.
OWNER: FINKE, ALEX AND LOTTE I, PHONE #:
CONTRACTOR: OWNER PHONE #:
•
Inspection Request Scheduled For: Date: 12/2 Pour Time:
Code # Inspection Description Confirm # Contact # Message
116 C°lectricAl rer +ic:e 041420-01 503244 -5824 l
1 -q �t
Corrections /Com structions:
•
•
•
) I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Icy
Inspector: r Date: 1 2%"2- 1 - -- 0:6 Phone #: (503) 718- 2-111-6