Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00113
e-I. DEVELOPMENT SERVICES DATE ISSUED: 2/10/2006
'' ,= 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S1126D -00700
SITE ADDRESS: 14655 SW 76TH AVE 19 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer and heaters. Job #R -06 -187
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 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:
PYOUNG & J PARK ABC ELECTRIC
17514 NW COUNTRY DR 135 NE 9TH AVE
PORTLAND, OR 97229 PORTLAND, OR 97232
Phone: Contact #: PRI 503 - 233 - 7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: LIC 26 - 1226C
[TAX] 8% State Surcharge 2/10/2006 $5.34 SUP 5096S
[ELPRMT] ELC Permit 2/10/2006 $66.80 ELE 161501
Total $72.14 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 OLINC at
503-246-66 • or 10 -33 - 344. �
Issued ^ : _i , i . _ — ! , 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:
NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: C ----- ( X 1-1 DATE:
LICENSE NO: .5 - 096 S
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.
iii 4 ! t ^. - -
E_ _ a1 Permit Appii C%ililr� " ��`+tI[�11 p{t��;�1 ` :� � � ` r • olt ()i' ( 1,1_ S o hf� i , t
.sots ° F+sa iV Luca •- ,Y r !3-�_„ : 7 y 1r !1 "!E t:'tts Ma'•h5 iAaL,1 . `; �i.� ,iia
City of Tigard Received ' f I �r' "I Permit No.: li i ./� / / ,J
Date /B : % ' ., i
13125 SW Hall Blvd., Tigard, OR 97223 FEB !Y 8 2 ' � � r k Plan Revie Other Pe t:
Phone: 503.639.4171 Fax: 503.598.1960 , J tll�l Date/By:
Inspection true: 503.639.4175 _ Date Ready /By: /, Ei See Page 2 for •
Internet: www.ci.tigard.or.us
CITY OF TIGARD Notified/Method: ( (D• Supplemental Information
TYPigii PrVISIOiV : ,.. PLAN REVIEW
Please check all that apply:
❑'New construction ddition /alteration/replacemeni ❑Service over 225 amps, comml ❑Hazardous location
G.Demolition ❑ Other: ❑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
❑System over 600 volts nominal units in one structure
❑ I - and 2 family dwelling �CommerciaVindustrial ❑ Accessory building ❑ F ee d ers 400 amps or more
❑Building over three stories mP
❑ Multi- family 0 Master builder ❑ Other: DOccupant load over 99 persons ❑Manufactured structures or
3013 SITE INFORMATION AND LOCATION ❑Egtrss/fighting plan
RV park
❑Health -care facility ClOther:
Job no.: ) 7 Job site address: /%(, — 6 701- ,C 19 Submit Z sets of plans with any of the above.
5 Cr City /State/ZIP: c p 0 Th e above are not 7 applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: I Project name: = r,rt,zumui ' Description I Qty. I Pre. I Total
Cross street/directions to job site: )./4. % , / E,J ti 4P1-5 New residential single - ur multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 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
r dwelling, service and/or feeder 90.90 2
r) i , ° e.. I,(d J'- l' 1 r Services or feeders installation, alteration, and/or relocation
0 PROPE rs C t 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
TX' OWNER T ENANT ❑ 401 amps to 600 amps 160.60 2
Name: 601 amps to 1.000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address:
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or Tess 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
0 APPLICANT , . 0 CONTACT PERSON
A Fee for branch circuits with
service or feeder fee, each
Business name: NbC \- _ �c branch circuit 6.65 2
B. Fee for branch circuits
Contact name: 22 J i) without service or feeder fee, / 46.85 ,j $�' 2
each branch circuit U
Address: Each add'( branch circuit 3 6.65' j 9 V 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
'; CONTRACTOR extension. Describe or
g
energy panel, alteration, o
_ Page 2 2
Business name: k � C-�� ■ C
Address: ``� Each additional inspection over allowable in any of the above
3 � /mil l 9.��, Per inspection 62.50
City / State/ZIP; -:?mN \QI:n(` 1 r-ia Investigation per hour (1 hr min) 62.50
a, � Industrial plant per hour 73.75
Phone: 63n) a�� ( Fax: (� ✓ a ` 3 7' �p� ELECTRICAL PERMIT. FEES*
CCB Lic.: J(, /SO ) I Electrical L i c . 6 0 ( D _ / 0 7 : 7 2 ( p l Suprv. Lic. q (`� Subtotal 10 .xv
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name', �j h Date: 1 State surcharge (8% of permit fee) 5 , 3 V rula r) vhQ I � � �J �� �` TOTAL PERMIT FEE '., i 9
Authorized signature: This permit application expires If a permit Is not obtained within 180
days after it has been accepted as complete
Print name: ' C ) — , b,. n Date: 8/ C' • Fec methodology set by Tri - County Building Industry Service Boar
" Number of inspections per permit allowed.
i\ Building \Pamits\ELC- PennnApp.doc 12/03 440.4615T(10 /02 /COM/WEB
2'd 096T86S20SdT8:01 :WOi'ld 0172 :LO 9002 -6 -82d
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: f. 1.4. ":1006.0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/ 10/200;
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 "__.
INSPECTION WORKSHEET FOR DATE: 41117/2006 TIME: 7:0SAtd1 PAGE: 133
SITE ADDRESS: 1465:6 & 76TH AVE 19 CLASS OF WORK:
• SUBDIVISION: MARCIENE 1 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE 1 .PARTMENTI S
DESCRIPTION: (4) branch circuit for aviK;her dryer and haters. job AR 06;187
OWNER: PARK, PYOUNG & J NN PHONE #:
CONTRACTOR: ABC ELECTRIC PHONE #: 503-233-75',r1
Inspection Request Scheduled For: Date: 4/17/2006 Pour Time:
Code # Inspection Description •nfirm # Contact # Message
120 Electrical rough-in 02037 -01 60:-233 -755'1
i It�f4��
• rrections/Co ments /Instructions:
•
•
•
•
CC
1;11 PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: " Date: 11 0 1 0 Phone #: (503) 718- T"1 ) `