Permit C ITY OF TIGARD ELECTRICAL PERMIT
V PERMIT #: ELC2006 -00112
°1 Ijk DEVELOPMENT SERVICES DATE ISSUED: 2/10/2006
' � ''' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112BD-00700
SITE ADDRESS: 14655 SW 76TH AVE 3 ZONING: R -12
SUBDIVISION: MARCIENE 11 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
[ELPRMT] ELC Permit 2/10/2006 $66.80 SUP 5096S
[TAX] 8% State Surcharge 2/10/2006 $5.34 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 • --. - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are --t forth in • .40: -1► • X1 0 through OAR 952 - 001 -0100. You may obtain copies of the or direct questions to OUNC at
503 - 246.6699 or 1 -800- 1 2 -2
Issued 6 Permittee Signatu --.:32._—�
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: i: DATE:
LICENSE NO: .5 S
CaII 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.
Elect JP'
ermit Application 9 y y 3 4 ol t , `� cii,l lc t i til 6N'4 i . ' '
p: c?i..wt ,lz. r.3ihick.,i tlii t_tk. ...tt..1._�,-,�.... ? .,),,,4,, s'ra sn,.s. ' 1,-,5 . _,. Yt! -.:
Cite of Tigard r ECE V ED Received e/ `, ,�
/
Date/B Permit No.: /o�- / / �-.
® a
131:.5. SW Hall Blvd., Tigard. OR 972 Ar Plan Review Other Permit
Phone: 503.639.4171 Fax: 503.598.1960 A. f .. ir
.. I . Date Ready /By: �' See Page 2 for
lntctinet: www.ci.tigard.or.us FEB 0 �{ 200 [ Notified/Method: Supplemental Information
1=11 7 tJl^ RK. PLAN REVIEW
❑ New construction iL7T
edMment Please check all that apply:
❑Stavice over 225 amps, comm'I ❑Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps- rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 - and 2 dwellings 4 or more new residential
❑System over 600 volts nominal units in one structure
❑ 1- and 2- family dwelling 'Commercial /industrial 0 Accessory building ❑guildin over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION: AND LOCATION ❑Egress/lighting plan RV park
,
�) ❑Health -care facility ['Other:
Job no.: • Q 7 Job site address: �y� h �5 - S W 7( 77 3 Submit 2 sets of plans with any of the above.
City/State/ZIP: a Q /2 l '- ( .O 0)(1.- The above are not applicable to temporary construction service. "
FEE"' SCHEDULE'
Suitelbldg. /apt. no.: Project name Description Qty. Fee Total
New residential single - or multl - family dwelling unit.
Cross street/directions to job site: M �L C�� `�
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 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
D.ESCRiPT10N. OF WORK Each manufactured or modular
q �� dwelling, service and/or feeder 90.90 , 2
d 4 Services or feeders installation, alteration, and/or relocation
00 amps or less 80.30 2
; . . - .. PROPERTY NER - ' TENANT .
201 amps to 400 amps 106.85
l ; 401 amps to 600 amps 160.60 2
/
Name: 2 yo Lt 4- V 1 a 601 amps to 1,000 amps 240.60 2
Address: 17 5I 1 _ \ � - \ -- r ' A ,/ � Over 1,000 amps or volts 454.65 2
J �J N R -T Reconnect only 66.85 2
City / State/ZIP: j]'L. A'� 2. 979- Temporary services or feeders installation, alteration, and/or
• V relocation
Phone: ( ) I 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
5, APPLICANT. i. I ❑ CONTACT PERSON for branch fee, each A. Fee circuits with
service or feeder ee, a 6.65 2
Business name: L� ,c S` c , branch circuit
B. Fee for branch circuits
Contact name: b, , without service or feeder fee,
each branch circuit 1 46.85 • //( D A5 2
Address. Each add'I branch circuit 3 6.65 T /".9 r " 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-
energy panel, alteration, or
extension. Describe: Page 2 2
_
Business name: - , ,Q CA(` 1 c.
�j.� �� �,> Each additional Inspection over allowable in any of the above
Address:
55 �� t tt `1 _-L Per inspection 62.50
City/ State/Z1P: --� : \G.'n(' 6 C‘ria5 investigation perhour(1 hr min) 62.50
Phone: (52)is ‘,25 7 >5, Fax: () 5 cQ 5 3 7,5-5-L-1 , industrial plant per hour 73.75
ELECTRICAL PERMIT FEES *:
CCB Lic.: )s / J o j l Electrical Lic.6969 _n77=249 I Suprv. Lic. )9 (0 Subtotal /„ t '8
Suprv. Electrician signature, required: Plan review (25% of permit fee) u �
Print namek3ho!4Vt 7), .1 ad a/9 Date: State surcharge (B ° /aofpenr►itt'ee) � j
r 1 TOTAL PERMIT FEE /a 1
Authorized signature: J _ This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: n � l �.n n Date: v i(' ( • Fee methodology set by Tri-County Building Industry Service Roan!
" Number of inspections per permit allowed.
i:\ nuildmg \Permits\ELC- PetnitApp.doc 12/03 4404615T(I0IO2/COM/WEB
1:' 096186S20Sdi8 :01 :WOZI.d H22:LO 9002 -6 -888
CITY OFTIGARD
BUILDING DIVISION PERMIT #:GOO 6 -DO 1 (
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 "'' I
Inspection Requests (24 Hrs.): (503) 639 -4175 "'-_L.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: L 7 Ave) - CLASS OF WORK:
SUBDIVISION: 7 r " LOT # TYPE OF USE:
PROJECT NAME:
`'
DESCRIPTION:
OWNER: PHONE s�3)233�'7SS1
CONTRACTOR: (93), G7 -- � R."- PHONE .
Inspection Request Scheduled For: Date: 3_ 2-E - 0 G Pour Time:
Code # Inspection Description Confirm # Contact # Message
0 -5 j I 0 Cdv'e -' c ,_,Li /61_, es.,,, li
C• ec ions /Comm UU nts /Instructions:
•
•
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(JrZ
•
■ PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL 1 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N681_ Date:.3JZ.+ 0 ( Phone #: (503) 718-2.106.