Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00974
e . 1 ���e Y DEVELOPMENT SERVICES DATE ISSUED: 12/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 30 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer & heaters. Job #1415.
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: Contact #: PRI 503 - 233 -7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: LIC 26 -1226C
[TAX] 8% State Surcharge 12/27/200' $5.34 SUP 50965
[ELPRMT] ELC Permit 12/27/200: $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 OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: Sp Q
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.
DEC-23-2005 05:40 PM P . 0 2
- ■-- -,', --- `.-' h%//V 0
. , Eiecirical Permit Appl tri: li Y ',=_, ._ mie um( r: 1: ()iNI,
City of Tigard
97223 ' 2J() ),.. I Permit No.: 6(.4^,,,wy 7 y
13125 SW Hall Blvd., Tigard, OR 1.; . , . 0 . : . H R ev i ew
. Phone: 503.639.4171 Pax: 503.598.1960 • , . 4 .3 1th iNiTi l i ". Data/By: Other Permit:
inspection Line: 503.639.4175 (7 IT s, ,/ C ■ .: A „...,. ' Date Ready/By: 'wiz: f -__ T Page 2 for
Internet: wwsv.ci.tiserctorU.S
J.Jii.)C2' Di \;;SN iO Notifserl/Method: T (3- Supplemental Informadon
CNZI WO, 11 141571243CO3**WMA:glig1 ilkg
0 New construction hi Addition/alteration/replacement Please check all that apply:
In Soviet over 225 amps. comm'l 1:Hazardous location
0 Demolition 0 Other.
Service over 320 runps - rating 1:IBuildng over 10,000 sq. ft.,
l'IrTM:Mr,Til'AiNI:igiallgilt400,0.0..04044100010:014.15MERM In
itaigig of 1- and 2-family dwellings 4 or more new residential
0 1- and 2-family dwelling 13 Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
DBuilding over three stories OFeeders, 400 amps or more
0 Multi 0 Master builder . 0 Other:
.. D Occupant load over 99 persons I:Manufactured structures or
0:04 glaggi Degcss/lighting plan RV park
Job no.: '/Vi c Job site address: //I/ SW 1C0 . .,/ari it, ' [Wealth facility Pother ,
submit .i. sets of plane with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service,
- ippokliNst01,5ii018101:041ggiONI.VEq;;;Eatpii,Figi,
Suite/bldg./apt. no.: Project name: ,.Ir
n.riatkut ) Qty. I Fee. Total I "`
Cross street/directions to job site: tiet Ar New residential tingle or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 - 4
Subdivision: 1 Lot no.: Ea. addl 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy. non-residential 75.00 2
_
PIM'AilIEt Each manutIctured °modular
dwallin:, service and/or feeder 90.90 2
... -
• e- r
.. .0_, ' / L_ w . Services or feeders Installation, alteration, and/or relocation
d 12 i .. ' . 200 amps or less 80.30 ,.. _ I 2
106.85 I 2
hr:„Ilek0... F u 7.UrP'''" Al i i/ 11 , Myrf.- . 1 i i TIMIN !NEI timeraltr 2 amps to 400 amps
amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Ova 1,000 amps or volts . 454.65 2
Reconnect only 66.85 2
City/State/ZIP: , Temporary services or feeders Installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps t_2amp 0.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 40 ___ amps to 600 amps 113.75 2
Owner signature: Date: Branch circuits - new alteration, or extension, per panel
AiriggS,4',;','F ItTrYrtlal %pr. !:',.' 1: ITIERME1717,11,:al,VVIvianii!,k q A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: Nbc t7 ,... 3 c _ branch circuit
— B. Fee for branch circuits
Contact name:
co., _... _ .. without service or feeder fee, / 46.85
2
each branch circuit
Address:
Bach add'I branch circuit Y 6.65 1 2 ,
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) c.233 7 s-s-.7 I Fax: : ( )
_ Sign OT outline lighting 53.40 2
E-mail: Signal oircuit(s) or limited
alEiirliallikail.t4agiik9:-.6i4E 4 ; i ..' ' . 'ii :o lelnoliimiteilriagavaniiiiiiig54 ay pannDesel. alteration, or
Page 2 2
Business name: k...,1t e:f i c . . _
Address:
Each additional inspection over allowable in any of the above
I 5 5 ki E Cl*avt nu. c) Per inspection 1 62.50
City/State/ZIP: 4 AiVI \z K_ qr?tD - , Investigation per hour (1 hr min) 62.50
Phone: (520 .... - - Fax: (8)5 , industrial plant per hour 73.75
-. -■- 1 . 4 X 1 R : :!' . . ; V:hetAlIi . tid . ECFRICAPEPOS'Itt ItitIgtiniipui
CCB Lic.: /e /,..c0 i Electrical Lic.6,V6), _4 Suprv. Lic.L ( .....S Subtotal titY I ii l ` .
' Suprv. Electrician signature, required: _ -Alla Plan review (25% of permit fee)
..-- State surcharge (8% of permit fee) ,)-.3
Print trainer ..... MMIAIIMIIIIMI Date: --- . ._
TOTAL PERMIT FEE -7,2_ _, ( 7
Authorized signature: -roe/ • 4 "
0 This permit application expires If a permit 11 not obtained within 180
e—
.../s. - --'-,
days after It has been accepted as complete
Print name: e•—• ..... ,
•
Date: c. • Fee methodology set by Tri•County Building Industry Service Board
_ t_
• II li
" Number of inspections per pannIt allowed,
imituadieroertelnTLC-1.creshApp.dee 12/03 440-461ST( I . .2/COMAVEA
CITY OF TIGARD
BUILDING DIVISION -. PERMIT #:QjC)-00s - 00c17Lf
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 '�L
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: ( TIM, : PAGE:
SITE ADDRESS: 1 4 Coss 76,V ftV e- -'} CLASS OF WORK:
SUBDIVISION: LOT 1C - - TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE )343 I °7
C f
CONTRACTOR: fri ` t+o ( -7 6 U PHONE #:
Inspection Request Scheduled For: ` Date: Pour Time:
Code # }Inspection Description Confirm # Contact # Message
P )D i ..z.___ yi,5 \
Correcti. • -':�—: is /Instructions: \
A pAss 1 1 PARTIAL APPROVAL CANCEL n NO ACCESS
lI FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
6 . 24 (2- 6 /d LE Date: 1 110 Phone #: (503) 718 - 7‘ _