Permit �., CITY OF TIGARD ^ w p`^ ® ELECTRICAL PERMIT
N nyl- V H■
a ° PERMIT #: ELC2007 -00671
c COMMUNITY DEVELOPMENT DATE ISSUED: 9/26/2007
TICARg 13125 SW Hall Blvd., Tigard, OR 97223 .503.639.4171 PARCEL: 2S102C6 03400
SffE ADDRESS: 09800 SW FREWING ST 40 ZONING: R -12
SUBDIVISION: CHARLOTTENHOF APARTMENTS LOT : 009 JURISDICTION: TIG
PROJECT: CYPRESS CREST
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:
CANTAS LLC
4223 GLENCOE AVE STE #A -220
MARINA DEL REY, CA 90292
Phone: Contact #:
FEES
Description Date Amount Reg #:
[PLPRMT] PLC Permit 9/26/2007 $66.85
[TAX] 8% State Surcharge 9/26/2007 $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
suspende• • mo - han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r es are set fo i =AR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copie • - - - rules or direct questions to OUNC at
503.246 6699 • r 1.800. .2.23
Issued = : / / / / �L ; � L Permittee - ' • nature: .4
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 A 1 ' i eat i"'� � � ; 'FOR o u oNLY'�„ * ry�
;'w Received
City of Tigard 4P 2 6 200 Date/By: 7 .ot (P 07 PermitNo.: eAt_
UPI a' 13125 SW Hall Blvd., Tigard, OR 9 Plan Review
®.;: Phone: 503.639.4171 Fax: x598.19§0 p� Date/By: Other Permit: ABB
lI
' Inspection Line: 503.639.41 Y k-1 I. � �_ sate Ready /By: h ' ® See Page 2 for
Internet: www.tigard -or is - �� �� ' � �® d ot ified/Method: (C Supplemental Information
• It ` t DING
' OF WOR PLAN REVIEW
❑ New construction ❑ Addition /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
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
dulti- famil ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or
JOB" SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: �� � /�f� 100HP or more. occupancy.
J lJ�t�l(� 1 U ❑ Six or more residential units. ❑ Recreational vehicle parks.
/State /ZIP: r ❑ Health -care facilities. ❑ Supply voltage for more than
Cl
ty ( �C�G Vc r Q CZ q 7 2 Z 3 ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: at � s _ - ❑ Service or feeder 600 amps or more.
+ FEE SCHEDULE
Cross street/directions to job site: C -, 4 4, '�j,,
p Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
'F��, f (a. k- 4-O 1700 - f (A V t& v Id Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
' DESCRIPTION OF: WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or Tess 80.30 2
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ��� L��
1 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: L/aa,2 cL-E J E . f J4, § /- -g Over 1,000 amps or volts 454.65 2
City/State /ZIP: MA p__, - -• IEy CA- 90 ?- (� Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fix: ( ) 200 amps or less 66.85 1
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, . er panel
Owner signature: Date: A. Fee for branch circuits with
. , 4 APPLICANT I ❑ CONTACT PE R above service or feeder fee, 6.65 2
� YVtS 4 S3P S Fee circuits
,,)' /I 1 ' without service or feeder fee, 46.85 2
Contact name:
Wl tL �t � 14 "' (rt.,- Q first branch circuit
62
Address: 1 lV OVvtc�� (c ( Each add'l branch circuit 6.65 2
"1 Miscellaneous (service or feeder not included)
�
City/State /ZIP: T&t a ,� D 4 Each manufactured or modular 90.90 2
� ,, / " � �L dwelling, service and/or feeder
Phone: (' ) ZZ = 4 3 F ax:: (53,) 2. Fj 213 C. . Reconnect only ?,c 66.85 ‘4,1f 5 2
E -mail: /44112ali NOYtr$Fev GAM 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
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:
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): 5,53'—
Authorized signature: TOTAL PERMIT FEE: Q ` zo
This permit application expires if a permit is not obtai within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05123/06 440- 46t5T(11 /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:
❑ 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
❑ 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 03/23/06
CITY OFTIGARD
BUILDING DIVISION PERMIT #: 1.=1 02007.00671
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9126,000/
Phone: (503) 639 -4171 � " .,.'�, �
Inspection Requests (24 Hrs.): (503) 639 -4175 -!i
INSPECTION WORKSHEET FOR DATE: 9/27/2007 TIME: 7.00AM PAGE: 45
SITE ADDRESS: 09800 SW FRE:WING ST 40 CLASS OF WORK:
SUBDIVISION: CHARLOT TENHOF APARTMENTS LOT #: 009 TYPE OF USE:
PROJECT NAME: CYPRESS CREST
DESCRIPTION: Reconnect only
OWNER: CANTAS t LC, PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description ' Confirm # Contact # Message
199 Eioc.t+ical final 056463 -02 503-684-0624 N
Corrections /Comments /Instructions:
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�►2 ' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ilk II AIL 1 1 CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: ZS 116e) Date: gj Phone #: (503) 718- .2-11LN