Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00844
DEVELOPMENT SERVICES DATE ISSUED: 10/31/2005
--- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112BD-00700
SITE ADDRESS: •14655 SW 76TH AVE 12 ZONING: R -12
SUBDIVISION: MARCIENE 11 APARTMENTS LOT : JURISDICTION: TIG
Project Description: 4 branch circuits.
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:
BOOTH - HEYDON LLC ABC ELECTRIC
PO BOX 1185 135 NE 9TH AVE
LAKE OSWEGO, OR 97035 PORTLAND, OR 97232
Phone: Phone: 503 - 233 - 7551
FEES Reg #: LIC 26 -1226C
SUP 5096S
Description Date Amount ELE 161501
[TAX] 8% State Surcharge 10/31/200: $5.34
[ELPRMT] ELC Permit 10/31/200' $66.80 REQUIRED ITEMS AND REPORTS
Tofal $72.14
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-
Issued By: 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:
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.
OCT -27 -2005 11:27 AM P -02
1 I• Oul'il 1. I!SI 1)I`I.1
Electrical Per `� d ` R id o� t� - 00 50i Receiv : ( F P emutNod
City of Tigard Da Review Other pertltltc
13125 SW
5Q Hall Blvd., Tigard. OR 9722,3; r, 2 05 r. ? s a f .. ; { ,
Phone: 503.639.4171 Fax: 51V ,0'40 J _ "- -� �_ pate Reedy/BY: 121 See Pellet for
Ina tiers lute 503.639.4 -- Method, mental 1a o
pee Notified e mafoo
f r
Supplemental
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Internet: waw.cl hgard•or.us;;ITY OF TIG, ���
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y,:: : , : 4,:i; ;; :; ' l� t,: . .... , ,:: : 1; .. , ;I, u Please check all that apply:
❑ New construction i. Addition /tilteretion/replacement
°Service over 225 amps, comm'l °Hazardous location
❑ Demolition ❑ Other: n il , neiiE,eg = "R' -r;1 + ° 1i;i; =Ft;ii ❑ f11 an over 3 s-s rating ❑ 4 ogrever 10000.aft., new
.,:: I:. i: k�...... "�:,.�: ., " 0/1". Jr. k.'jlr- �. r i rl 1 . tti�IK.,�,: O Y
';:! : : :.yl'iial �i<;rm: :.. ::4Fi :F,. )_: . , y� - • . W :ifr - S' \-•• .- IA ••... I .r�'l".^.''. " ;i_I : , �L.�,.I ' ' " units in one structure 5 u ❑System over 600 volts nominal
❑ 1 - and 2 - family dwelling v "ISCommercial/industrial ❑ Accessory building ❑Building over three stories °1`eedetta, 400 amps or more
❑ Multi - famil h
C:1 Master Other. i 'r , upant load over persons Q anu c d cs or
actor builder ❑ (]Occ 1 99
.,r.. . ;�,(, ' - Iva ;" yy 1 ��•'-lri�e i l i- � F „f DEgress/1ight111 lan
y -, a . :: r u� i,� ' d ;. '' lit ; :i '� u�,e,c g {)
i ; d i t .:!EL4 -i ii!X A. I.: `..,.. i '? Iitt.. :. N ' 7 ' tt�l "" I' cal l�'" - F� . .r ... °Oter:
- RV park
;� , � ; r : , : :� 1, ;1iI: , -� stir, : � ,:1 -,,.. ", .,.,.. - � ,_ .. , � . ` ❑Health -care facility y
Job no.: ) l�•� :, Job site address: (y ( t ,c< 5 71 ry i Submit 1,. seta of plans with any of the above.
The above arc not applicable to temporary olnlstruetion service.
- City/State/ZIP: `t `� , :: ti= : • 721 �'� ' of l ,f � .71 r n. ' . e a � ', t�� 0iil °iii, ; � ; � 1 , 1f n `;' (
Suite/bldg. /apt no.: Prof= + name: - -,�. ai -i� Will t ,4pti _ Qty. Fee. Total "
Cross street/directions to Job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
•/ / 1 /1, h P 9 /I 1,000 sq. ft. or leas 145.15 4
�S/ �- C_ f Lot no.: Ea. add'i 500 sq. R_or portion 33.40 1
Subdivision: L Limited energy, residential '75.00 2
Tax map /parcel no.: , Limited energy, non-residential 75.00 2
'+ -� ' "� i 1� MAMMON Jr I `M H ach manufactured or modular
'�� i :dti , I s •II €; I �.. s Ih MI 0'l� °� fll. airs Li.,,,, 2
^'L :aG•, ' °' i - " fir 1 dwelling, service and/or feeder 90.90
- . 8 _ , ' . `C ' 1r _Services or feeders installation, alterndon, and/or relocation
• C 200 amps or Liss 80.30 ` 2
Vw ' ' `KA3.'1r 201 s 106.65 2
I , • , q •aesn p,- , r to 400 amps
:�.� r� , ) ,- i . , �� I i (� i ^ E U p�♦�` , r �r ' n 4.n;
401 s to 600 a
160.60 2
4 � i� 'in N " W II :1 : R , y N a
";.` t+uwra" ✓" .� � 63TU ' LI 75:MF'G3e.r. � 1• amps 2
Name: 601 alas to 1,000 amps , 240.60
over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
Ciry /State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation ^r
Phone: ( ) Fax: ( ) 200 amps or Ian 66.85 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 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, alteratiotl, or extension, per panel
.�. w,�. i91° — , r branch of uita with
.. • "r,• :; Y "„ . 16.. • :' i l- a ; . , - ;. . t K . 5 • =, r ¢ • u t .'t' 1! c:.. '= Elm?
Fee fo b
r� ?�+?'• A. tan m
r! �` sk � serv or feeder feo, each 6.65 2
Busincse name: branch circuit ,
r - B. Fee for branch circuits
Contact name: 13,... .ait... without service or feeder fee, ) 46.85 a Y 2
each branch circuit
Address: `)..1(3,, Each add'I branch circuit 1 3 6.65 , /g. 9 r2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) _limo! outline u ring 53,40 ` 2
$ mail: Signal circuitja) or limited -
, �M I - _ ml�. ::: :a+l� 'j' . ;i4Gv' TI"- t iI €g."!`' . iU��r�i�' l enerapanel
�: r.:i� -' 14�r•. iii ' " i.:.. - 4 !, • `Q, •! , ° , . In y'S1::7�m�7 -.J �Fl
.a cc t ��,.� , l i�I't'�rC' ��� Itp.: {��:��.75r., �'�..` •.3,v.0 " nf�yn%�, :. atl 2 2
: ��. ?;.�J�.m�9,',';(:._'i.; %4Y,i,Jwrs;; . 7„ ., r - : . -.. , extension, panel.
Describe: Page
Business name: 44 t .
Each additional impaction over allowable in any of the above
Address: � 7OJ` 5 r ' -)t t _ 1_ _ Per inspection 62.50
City/Stale/ZIP :.c�� \G qua Investigation per hour (1 hr min) 62.50
- Industrial plant per hour
73.75
Phone: Fax: (� "_ aw i€F `;' ICY: Fr�T1�G+ ��:. P] �1 it1 �� `•• ^, ^u:`aEie;i "'
CCB Lie.: Electrical Lic.�(p -i�j(p Suprv. Lic.: )Q (Q ...S , Subtotal G 44 G:r/
Suprv. Electrician signature, required: Plan review (25°ib of permit fee)
State surcharge (a% of permit fee) _ �
Print name' ` , • I I n Date' .� - TOTAL PERMIT FEE
Authorized signature: Tile permit application expires If • permit Is not obtained within 180
days after It has been accepted as complete
Print Hanle' Y v 1 - Date: 10 7 / 0 * Fee methodology pet by Tri- County Building Industry Service Board
`t 1 "• Number of inspections per permit allowed. Lrj
lot c�P
aul( dincrtnita)!31•c•p�}Eapp•dec (2103 4404ai5T((oro2/COMlwBB
CITY OF TIGARD
BUILDING DIVISION ` ` PERMIT #e-t45-0 ps — _Oo f (f_
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: T
Phone: (503) 639 -4171 °^��"
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: (ME()yv� PAGE:
SITE ADDRESS: f (4{:,S 7 b A e_ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #(5b1) .22-3 —75 S_
CONTRACTOR: PHONE #.
Lam) Zfo7 - 3G6
Inspection Request Scheduled For: Date: Pour Time:
Z e # Inspection Description Confirm # Contact # Message
f � 13 b Cc.� e-% „,k_s_e • cckAA !/_ �.. 6 1
�, L� Let
o r ctio /Commen /Instructs s:
0 (■, S1 ■ ' 63;R. pod A
C .... C____
PASS 1 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-6 � �� LS Date: 2• Phone #: (503) 718 - VIA
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC2005.00844
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/31/2005
Phone: (503) 639-4171 , � 6 .
I Requests (24 Hrs.): (503) 639-4175 14 .
INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7 :O4AM PAGE: 72
SITE ADDRESS: 14655 SW 76TH AVE 12 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II
DESCRIPTION: 4 branch circuits.
OWNER: BOOTH- HEYDON LLC, PHONE #:
CONTRACTOR: AE3C ELECTRIC PHONE #: 503- 233 -7551
Inspection Request Scheduled For: Date: 11/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 020069-01 603-233 -7551 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL KCANCEL El NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: II Q® Date: 1 L" 2 " C6 Phone #: (503) 718-