Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00066
r a l DEVELOPMENT SERVICES DATE ISSUED: 2/8/2005
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171 PARCEL: 2S101AB 01606
SITE ADDRESS: 07357 SW BEVELAND RD
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT : 017 JURISDICTION: TIG
Project Description: Underground, (6) branch circuits. Job No. 6040
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: 5 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:
TOM CLARKE JARMER ELECTRIC INC
12448 SW ORCHARD HILL RD 5105 SW 45TH AVE
LAKE OSWEGO, OR 97035 PORTLAND, OR 97221
Phone: 503 - 293 -1226 Phone: 246 -5381
Reg #: LIC 6924
SUP 4044S
FEES ELE 26 -144C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/8/2005 $80.10
[TAX] 8% State Surcharge 2/8/2005 $6.41
Total $86.51
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 B / _ ti �;�
_ 1C
i Permit Signature: I (y�,,sZ,�
\\ 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 639 -4175 by 7:OOpm for an inspection the next business day
»ien
, gee Pernllt Application o12 orhlc"1: l til: u__
I
City of Tig rd `°d a e , '�
13125 SW Hall Blvd., Tigard OR 97223 Plan Review Q o /
Phone: 503.639.4171 Fax: 503.598.1960 '�, v • I'' \ Date/B . Other Permit % / �! G!
Inspection Line: 503.639.4175 __±i ' ' L D ate Ready/By: mss: ® See Page 2 for
Internet: www.ci.tigard.or.us NotifieNMethod: Supplemeatallnformation
:K: - TYPE OF. WORK - 'z; . ., st "s1,! P M: RE1..I t�� . + ?
�s•. 1
. s, l i
New construction ' ❑ Addition /alteratiorr/replacement
❑Other Please check alt that apply:
Demolition ❑Service over 225 amps, comm'l ❑Hazardous location
Servi
w �.. S _
❑ ce over 320 apps - rating ❑ Buildng over 10,000 sq. ft.,
;' '• t s j :�c' . t , :;1t,�: Ye,,C'l;,F.GORy . ( Q0 G��ICtd : r ' of 1 -and 2- family dwellings 4 or MOM new residential
❑ 1 - and 2 family dwelling i gl Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other ❑Building over three stories ❑Feeders, 400 amps or more
❑
,+� `Y Occupant load over 99 persons ❑Manufactured structures or
'!:', .:. 1. ' ;
f' - `= JOB SITE, INFORMATION• ANTI,;: LO tAttla ' ' " °•:'=! : - ... :_ ❑Egress/lighting plan RV park
Job no.: 6 o 40 I Job site address: 735-7 ( 3-2, 4 , 44, z 4704 ❑Health care facility Clover
Submit 2 sets of plans with any of the above.
City/State/ZIP: 7�., f-,, /i - The above are not applicable to temporary construction service.
`'A`�'`
Suite/bldg. /apt. no.: Project name: ej_ -/Q /C 164.4 FEE• SCHEDULE_ " " :.,..:W'.
' '°-',.`; ;` •
,anon I Qty. j t=ee. . [ Tow I ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
. • • DESCRIPTION OF. WORK .- . . .. Each manufactured or modular
Lt /LJQ..e ' c.lo0c-t iU 4 dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 - 2
• t -a ; g: 201 amps to 400 amps 106.85 2
.... 0 PROPERTY OWNER_ . ':" ' . l' Q TENANT ._�:` ``, i:t: : :.��;�
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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
r' i' . A . Fee for branch circuits with
: :. ` :. ❑ `APPLICANT'i ; : ❑ COIy " P E RSON ?:1 service or feeder fee, each 2
Business name: branch circuit 6.65 3� 2
B. Fee for branch circuits
Contact name: without service or feeder fee, / L/
each branch circuit 46.85 7(> 2
Address: ,
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
r,`f '. ;.. '•.. , CONTRACTOR' ::;� : energy Panel, alteration, or
'" extension. Describe: Page 2 2
Business name: Tf}2 M En_ EL.EC a Doc.,
Address: 3 , o s — csW Y cl Sr. D 0 Each additional inspection over allowable in any of the above
//�� t 2-0 Per inspection 62.50
City/State/ZIP: /6p-2. j L,9- #t) /I Q /. Gf 7 2 2 / investigation per hour (1 hr min) 62.50
Phone: ( s-5 3 ) 2 L/( - 5 E / I Fax: (So3) 2V q — ev 3 7 industrial plant per hour 73.75
;t' ELECPWCAI:_: PERSItil�,"fiti fISVXM ` V:
CCB Lic.: (pCjz y Electrical Lic.: Zoo / L ig Suprv. Lic.: yDyy5 Subtotal 0 /
Suprv. Electrician signature, required: �/ e -- --_ .ic'l 4 Plan review (25% of permit fee)
/ State surcharge (8% of permit fee) v
Print name: �j•t l 4 2 T %. %- i 2 /fi E 02._ ate. c(- 0 - S 57
TOTAL PERMIT FEE c ' to
Authorized signature: , lj°4 Th4 permit application expires if a permit Ia Dot obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building industry Service Board
•• Number of inspections per permit snowed.
is\Buildn Perrniu\ELC- PermtAppdoc 12/03 4404615T(I0/02/COM/WEB
,
CITY OF TIGARD . •_ . .
BUILDING DIVISION PERMIT #:
ELC2005-00066
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
2/8/2005
Phone: (503) 639 - 4171 "��� , �r:�h'
Inspection Requests (24 Hrs.): (503) 639 -4175 "I�
INSPECTION WORKSHEET FOR DATE: 9J29l�OO J TIME: 7 :OBAM PAGE: 77
SITE ADDRESS: 07357 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: CLARKE BUILDING LOT #: 017 TYPE OF USE:
PROJECT NAME: CLARKE OFFICE BUILDING
DESCRIPTION: U nderground, (6) branch circuits. Job No. 6040
OWNER: PHONE #:
CLARKE, TOM 503 -293 -1226
CONTRACTOR: JARMER ELECTRIC INC PHONE # : 246-5381
Inspection Request Scheduled For: Date: 9/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
191 Electrical final 016976.03 503 -246 -5381 Y
Corrections /Comments /Instructions:
C (
- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
1 I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ( -2/7 ,j5
Phone #: (503) 718-