Permit ., CITY OF TIGARD ELECTRICAL PERMIT
. . .: •' COMMUNITY DEVELOPMENT Permit #: ELC2004 -00687
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/27/2004
TIGARD Parcel: 2S112BA11300
Jurisdiction: TIG
Site address: 7917 SW PICKLEWEED LN
Project: BONTIA TOWNHOMES Subdivision: Lot:
Project Description: Job trailor, temp power. 12/9/10, Reprint to correct street name spelling.
Contractor: ROSS ELECTRIC INC Owner: JLS CUSTOM HOMES
2870 SW 221ST AVE #203 16280 NW BETHANY CT
HILLSBORO, OR 97123 BEAVERTON, OR 97006
PHONE: 503 - 642 -2800
PHONE: 503 - 533 -4006
FAX: 503 - 642 -5815
FEES
Quantity Description Date Amount
1 [ELPRMT] ELC Permit 10/27/2004 $66.85
Specifics: 1 [ELPRMT] ELC Permit 10/27/2004 $5.34
Type of Use: SF
Class of Work:
Type of Const:
Occupancy Grp:
Total $72.19
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work wit
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 the 180
days. ATTENTIONL Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 r ough O • - 952-00,00•1. You may obtain a copy of the rules or direct questions to OUNC by callin . .1987 or 1.800.33 .2
Issued B : • � / � � / / Permittee Signature. Cl/` r �J
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
P.' Electrical Permit Application FoROFF _, `oavt, ..,;
, City of Tigard Received J ` //,(� P ^rrrvlNo 4 n
13125 SW Hall Blvd.. Ti aid, OR 97223 DateBy: /(/ 1 7 ° � L 2 Le-.1--A / 2)� p I
Tigard, Plan Review
ne: 503- 639 -4171 Fax 503 - 593.1960 t Other Permit:
�• 1its Date/By: I nspection Line: 503.639 4175 � �r Date ReadyBy: Jur. El See Page 2 for
Internet: www.ct tigard - - Notified /hlethod- i 1 -1( r Supplemental Information
- '� - TYPE' OF WORK - PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply
❑ Demolition Other: 1019 -4-1.4t1101"- ❑Service over 225 amps. comm'I Hazardous location
❑Service over 320 amps - ratine ❑ Buildng over 10,000 sq ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- far:ul_y dwellings 4 or more new residential
III I - and 2- family dwelling El Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal wits in one structure
['Building over three stones ['Feeders, 400 amps or more
❑ Multi- family ❑ Master builder '' Other,010 tlYAd1OY ❑Occupant load over 99 persons Manufactured structures or
JOB SITE INFORMATION AND LO CATION ❑Egressiliehtine plan R \' park
•
❑Health -care facility ['Other:
Job n0.• Job site address: --ion SKI D'G l 8 io: Submit 2 sets of plans with any of the above -
City /State /ZIP: o ^ � �-J. �� . S Tne above are not applicable to temporar construction service.
�Q SCHEDULE
Suite /bldg. /apt. no: Project name
Description 1 Qtr. I Fee. Total
Cross street /directions to job site: '�-�`I y h� � �6) New residential single- or multi - family dwelling unit.
�� --- Includes attached garage..-
1 sq ft. or less • 145 -15 i 4
Subdivision tA - ,_, Lot no.: 9' Ea add'I 500 sy ft or portion 33 40 i
(-)S 1 1 agl � � , Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy. non - residential 75.00 2
. DESCRIPTION OF WORK Each manufactured or modular -
dwelling, service and /or feeder I 90.90 2
Services or feeders installation. alteration. and /or relocation
• • 200 amps or less 1 80 30 i 2
_ PROPERTY - OWNER • 11 TENANT 201 amps to 400 amps j 106.85 I 2
�� -101 amps to 600 amps 160 -60 2
Name: Chem 601 amps to 1,000 amps 240.60 2
`6 ^ Q c C �... _ .. c k . Over 1 ,000 amps or volts 454.65 —
Reconnect only 66 85 2
C1ty /Sta /ZIIP cia %.5234 ' Q ( � � . � �(� Temporary services or feeders installation. alteration. and /or
't7�3 ) � -9 �� J `e g ` ^ ► 'Ws) 5 3 a '_ 1 relocation
Phone: t x , ' Fax: ' ? __ 0
c]
2 �0 amps or Icss / 1 66 -85 1
Owner installation: This installation is being, made on property that 1 osvn which Is not 1 201 amps to 400 amps 1 1 100 30 2
intended for sale, lease- rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 1 1 133.75
. Owner signature: - Date. Branch circuits - new, alteration. or extension, per panel
' , ❑ APPLICANT XCONTACT PERSON .A Fee for branch circ 1 iii 1
service or feeder fee, each
Business name: c � '� branch circuit G 65
_ B. Fee for branch circuits
Contact name:
without service or feeder fee, 46.35 2
Address: each branch circuit
3 �' l� Each add'I branch clrcult 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( S)C e / ° le 2 Fax:: ( ) 5 MB Pump or irrigation circle 53 40 2
` v Sign or outline lighting 40 2
E -mail: - Signal ctrcuit(s) or limited-
. CONTRACTOR ' energy panel, alteration. or .
r . I extension Describe Page 2 _
Business name: I< �1� ^^ �, e c _-}- X i C
Address: a.AS 1 c r`1� ` , \ {? Each additional inspection over allowable in am of the above
__1)_ Y6 // �� / 9 1 Per inspection 62 0
} s
City, State/ZIP: R. ` e cO (� O/ 7_ - _ ('7 Investigation per hour (1 hr min) 62.50
Phone: (SQ3) �q ` Ec),(. , `
Fax l � � l 2 ( _ 5 �s Indusmal plant per hour I 73.75
t ELECTRICAL. PERIMIT FEES*
CCB Lic.: l ( gaz Electrical ,c.: q - Supry Lic.: Subtotal � / 6�g� •
Suprv. Electrician signature, required: i ( Plan review (25% of permit fee)
Print name: 5 Cv� DA�_ 1 Date State surcharge (8% of permit fee)
`�
/ s I TOTAL PERMIT FEE 72 / q
Authorized si: attire: • r A... This permit application expires if a permit is not obtained within 180
L � — days after it has been accepted as complete
Print name: , 1 c_k_ G - � q Date: • Fee methodology set by Tn-County Building Industry Service Board
"� " Number of inspections per pemvt allowed
1 \BuiidmgrPermits PrrmitApp doe 12/03 440- 4615Tf(10 /02 /COM /',VEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date equested ° -2 AM PM BUP
Location 7q/ 7 / _LG%e. t LJ € Suite MEC
Contact Person CA Ph ( ) (-(2- - Z PLM
Contractor Ph ( ) SWR p
BUILDING Tenant/Owner
�b Yvt4fr l' 71 ELC X0 L -- 30 60 7
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes:
Post & Beam Pt �� N a s t Qn 7
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
•
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS ,• - FAIL
Ro n
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA PART FAIL
SITE Please call or reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA C
Approach/Sidewalk Dat C — 6 Inspecto i - //� Ext
Other:
Final DO NOT REMOVE this Inspection record rom the,/ , site.
PASS PART FAIL
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT it: ELC2004 -00687
I DEVELOPMENT SERVICES DATE ISSUED: 10/27/2004
r�' I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S112BA-BT049
SITE ADDRESS: 07917 SW PICKELWEED LN
SUBDIVISION: BONITA TOWNHOMES ZONING: R -12
BLOCK: LOT : 049 JURISDICTION: TIG
Project Description: Job trailor, temp power.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
JLS CUSTOM HOMES ROSS ELECTRIC INC
16280 NW BETHANY CT 2870 SW 221ST AVE #203
BEAVERTON, OR 97006 HILLSBORO, OR 97123
Phone: 503 - 533 -4006 Phone: 503 - 642 -2800
Reg #: LIC 157891
ELE 34 -436C
FEES SUP 4232S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/27/200' $66.85
[ELPRMT] ELC Permit 10/27/200' $5.34 Elect'l Service
Elect'l Final
Total $72.19
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 qrstions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
\
Issued By: Permit Signature: \ 111 , L
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 7:00pm for an inspection the next business day
", Electrical Permit Application FOR OFFICE USE ONLY, -
V City of Tigard Received // / ' 'n 1 .Pf:tn,itNO., �.C. ,Za G / ri //'
v In
Date,By: IU /A- ��
13125 S ' Hall 13tvd.. Tigard, OR 97223 Plan Review
-me: 503.(1:9.4171 Fax: 503.598.1960 l + Date/By Other Pe - our:
Inspection Line: 503.639.1! i5 e ! !J Date Ready /By: Juris El See Page 2 for
Internet: v.'ww.ci.tigard.or.us NutifledMcthod _1 f 1 r so Informotion
. FY'1 O ' WORK PLAN REVIEW -
❑ New construction ❑ Additionialte •ration /replacement Please check all that apply
❑ Demolition Other: J �' a— ra110> ❑ Ser:ice over 225 amps. comm n'I ❑Hazardous location
❑Ser:icc over 320 amps - ratios EBuildng over 10.000 sq ft.,
CATEGORY OF .CONSTRUCTION of 1- and 2-family dwellings 4 or more new residential
❑ I - and 2-family dwelling ❑ Commercial industrial ❑ Accessory building
❑S over 600 volts nominal units in one structure
❑I3uildmg over three stones ❑I Ceders. 400 amps Or more
❑ Multi- family ❑ Master builder - Other .,)o TA.1lOY I ❑Occupant load over 99 persons ❑`•tant:facrured snucunes or
. JOB SITE INFORMATION AND LOCATION ❑Egress%lighling plan RN' park
•
Job no.: I Job site address: — 1 G /{ 7 5w p l � 1,A ❑hlealdDeal e' facility ❑Other:
--
v - , Submit 2 sets of plots .pith any of the above
City/State/ZIP: ' The above are not applicable to te:npo:ar• construction service
Suite /1?Idg.;a?t. no.: ri'to J ccl nantc: FEE' SCHEDULE
1 I _LXJ i _ - Desrril,tier, 1 miry-. 1 ler. 1 utal ..
Cross street /directions to job site:YAlt 01/4_ Ness' nsieltnl sinle mu it i - iambic dwelling unit.
c��)0 t•-�Qoc- Includes attached tia g g ara - se. . - —
1 000 sq. ft. or less I-15.15 I 4
: • �.(� ( p'� Lot no.. Ea. add 'm
'1 500 sq. ft. or • 33.40 { I
Sul?diyisic'n +e �� l ► ` �� ` -� - -- 0 Limited energy, residential 75.00 2
Tax mapiparcel no.: �S ` �j 1 n g,
Limited ener non - residential 75.00 2
. • DESCRIPTION OF WORK • Each manufactured or /nodular I - -- —
. • dsvell:ng, service and/or feeder I 90 90 2
• Services or feeders installation. alteration. amid /oI' I'elocaimUn
200 : or less I [S0 30 I 2
— PROPERTY OWNER ?G::r:11ocr -100 amps
, I06, I t
I ❑ TENANT -- - - -.— - -i— . -101 amps lo tx) ?:nnp:; I I 160.60 2 •
N;tme. 601 amps to I •000 :iriip> 3 . 1 9.00
Addl Lg - - - — Over 1.000 amps Or •/obis I •!;.:.n5
`'- -'^ -' 2 Reconnect only i I 66.35
l
(_�li): %SI:IIL' /L.IP'� M Temporary service. nl' feeders installation. alteration. and; or
Phone: r Fax:
sa3 a 33— 4Cp __ (51S) 533 — 3 Ok relocation
-
200 amps of less - -
/ 66.85 1 i
Owner installation: This installation is being made on property that I own which is nut I 201 amps w -100;u nips I I 100 0 _
intended for sale, lease, rent, or exchange. according to ORS 447, 449. 6 and 701. ;Ili amps to 60u :tines 1 — I 133.75 I —
Owner signature: Date: • Branch circuits - nest', atterario i. or extension, per panel
- - 't -
❑ AI L LICAN7 p CON'TAC'T PERSON :1 Fee for branch cncuits :cirri
Il
� service or feeder fee each
Business name: ' C - - - I branch circuit 6 65 `
_ 1 It Fee for branch encuus
Contact name: �• narhnur service or feeder fee. 16 55
Address: I r l V - -- each branch circuit
Each —
ch API branch circuit 6.65 2
City /Stale /ZIP: ■lisce•tlaneous (service or feeder not included)
Phone: (z3)9(0 1 - l 4 3-6 Fax: : ( ) 5R Pump or irrigation circle
Sign or outline IigM 5. a0 ing 53 40
E-mail: pupal circutl(s) or 'united-
• . . CONTRACTOR' i energy panel, alteration. 01
- r . -- I extension Describe Page 2 2
Business name: �; ��S F ,, Q ay ., c..
-
Address: a " `� ` E. c L_l L ,, Each additional inspection over allowable in any of the abu
rJ� �0''7 Pet Inspection I 1 6' SO
City. State /Z_IP: �.. , •� O C� - i � l T 1Z, lnvcstigation per hour (1 hr nun) ) 1 62.50
Phone: (503) (1rZ _ � O 1 I Fax. ( ) /_ /4Z , ` Industrial plant per hour ; 75
� ] w -�.� V ELEcriocAL 1.ERNIIT FEES*
CCI3 Lie.:,' 'Z Electrical I .c.: q — Supry. Lie.: Subtotal . 6 b:�
Sum Electrician signature, required: �A Plan review (25 % of permit fee) .o
Print name: Dare State surcharge (5 of penult fee) .
a �v _ - TOTAL PERMIT FEE 72 i9
Authorized sig ature. - = = — - _— This permit application expires if a permit is not obtained ssithiu IRO
days atier it has been accepted as complete
Print ironic: C I - C - (� �� - Dale: • Pee methodology set b.: Tri- Count; Building Industry Service Board
!� • • Number of inspections per permit allowed.
i Ubuild ,ng•.Pcrmns'EI.C- PennitApp doe 12'03 n0 -46 I'T >I0.'0 : /CO',Im,'tEir
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BUP
Received J Date equested oZ AM PM BUP
Location 7 q [ 1•-t;a Suite MEC
Contact Person C-1‘ie) Ph ( )(° %Z — Z 8 PLM
Contractor Ph ( ) SWR D
BUILDING Tenant/Owner �° �`' P 7q1 ELC ,2Do L -00 6D 7
Footing ELC I
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: t 1 SIT
Post & Beam !� o ,h N 0 , S (f�1C I @ (
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS - FAIL
.
ROT"! n 4/14
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call or reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA G' C
Approach/Sidewalk Dat Inspects /�� Ext
Other:
Final DO NOT REMOVE this inspection record rom the J ' site.
PASS PART FAIL