Permit ELECTRICAL PERMIT
CITY OF TIGARD
° PERMIT #: ELC2007 -00003
° . COMMUNITY DEVELOPMENT DATE ISSUED: 1/2/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102CB -03400
SITE ADDRESS: 09850 SW FREWING ST 51 ZONING: R -12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
Project Description: Reconnect.
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 1/2/2007 $66.85
[TAX] 8% State Surcharge 1/2/2007 $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.
12 4 1 .
Issued By: (AAJJ . 4jif_ 6 6 4:) Permittee Signature: n a
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 Applicati 1 I ECr r � � °� c � ( °) FIG * ' � �. ti
} � `L ' Received
j ; C i t y of Ti _ Date/By / — a' -0 , 166 Permit No. I e _ aco 7 _ OL .5 ' "� y
° 13125 SW Hall Blvd., Tigard, OR 9 N 2 2 � �7 Plan Review
, Date/By. Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
/ " 'k Inspection Line: 503.639.4175 CITY OF •j IGARD Date Ready/By: June: WI See Page 2 for
Irl C IZ D' p I Notified/Method: Supplemental Information
.1 .aa..-4 %U5F, Internet: www.tigard or.gov BULL DING DIVISION
. TYPE OF WORK .' . , .. PLAN REVIEW •
❑ New construction ❑ ddition/alteration/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 stories.
❑ Demolition 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
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
l e.-
Multi - family ❑Master builder ❑Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION r ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I - ",
Job no.: 7 Job site address: 8 3 •� C
0 s I•V �// N c� 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: �' � D �
, 7�A3 / ❑ Health-care locations. ❑ Supply voltage for more than
/! i „ L� /JQ_) ❑ Hazardous locations. 600 volts nominal.
e _
Suite/bldg./apt. no.: Project name: jJ� / / , J - ( � � ❑ service or feeder 600 amps or more.
FEE SCHEDULE ;
Cross street/directions to job site: 5 0,1 TA-�� r= 'e___ /� Description I Qn• I Fee- I Total 1 •
New residential single - or multi- family dwelling unit.
" ? h Includes attached garage.
Subdivision: ..._ / � Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential
DESCRIPTION OF WORK (with above ft.
( sq. ) 75.00 2
. Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
ROPERTY OWNER ❑ TENANT . 201 amps to 400 amps 106.85 2
Name: �� '-./ dill ic,C— 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: G, 2. 3 J7o d°�- ' r Over 1,000 amps or volts 454.65 2
City /State/ZIP: 7---,16.-7' ��� /o i , 7-d J / Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ±0 3) (72.././-q — 1 i . , F ax: ( ) 200 amps or less 66.85 1
Owner installation: This installatio eing made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, l nt, hangs, a ding to ORS 447, 449, 670, . d 7 ►, 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signal e: Date: Z O A Fee for branch circuits with
• ❑ APPLICANT' . . • 1 ❑ CONTACT ' E' ON : above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
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 k• 66.85 2
E -mail: Pump or irrigation circle 53.40 2
` ' - • CONTRACTOR •• . . Sign or outline lighting 53.40 2
Business name: ( i4'V l LJ` e p a ne i, a or t limited- o or
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
. ' ELECTRICAL PERMIT FEES -' .
Suprv. Electrician signature, required: Subtotal:
X a
-L ; - . / k:-:-----• Pl review (25% of permit fee):
f{
Print name: /l/ Date:
State surcharge (8% of permit fee):
. Authorized signature: \ TOTAL PERMIT FEE: 7a- AD
• i 0 This permit application expires if a permit is not obtained within 180
Print name: / ��'" Date: Dom- / days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pamits\ELC- PamitApp.doc 05/23 /06 440- 4615T(II /05 /COM/WEB
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
I COMMERCIAL WORK ONLY: • 7 !
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
❑ 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 \Permits\ELC- PermitApp.doc 0323/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ,_ 0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/3/2007
Phone: (503) 639 -4171 ����� .
Inspection Requests (24 Hrs.): (503) 639-4175 .414-
INSPECTION WORKSHEET FOR DATE: 1/4/2007 TIME: 7:00Am PAGE: 23
SITE ADDRESS: 098 SM1FREWING ST 51 CLASS OF WORK:
SUBDIVISION: CHARLOTTENHOF APARTMENTS' LOT #: 009 TYPE OF USE:
PROJECT NAME: CHARLOTTE APTS
DESCRIPTION: Reconnect.
OWNER: F=INKED, ALES''. AND LOTTE I, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1 14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # • Message
115 Electrica -rvice 041791-01 503-244-5824 I
Corrections /Comments /Instruct . ns:
PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: N � v Date: r °T7 Phone #: (503) 718- Z8"V"'