Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00669
. COMMUNITY DEVELOPMENT DATE ISSUED: 12/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AB -00300
SITE ADDRESS: 07350 SW LANDMARK LN 120 ZONING: I -H
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: WEST COAST EXTREME CHEERLEADIN
Project Description: (1) service and (8) 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: 1 W /SERVICE OR FEEDER: 8 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:
HICKS, PRENTISS C MASTER TECH ELECTRIC INC
PO BOX 23633 3581 7TH ST
TIGARD, OR 97223 HUBBARD, OR 97022
Phone: Contact #: PRI 503 - 679 -3640
FEES
Description Date Amount Reg #: ELE 3 -603C
[ELPRMT] ELC Permit 12/11/2001 $133.50 LIC 161525
[TAX] 12% State Surchar 12/11/200/ $16.02 SUP 4127S
[ELPRMT] Investigation F 12/11/200/ $133.50
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $299.04
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 d s u - 'n accordance with approved plans. This permit will expire if work is not started within 180 days of issuan -, or if work is suspended for
more th- • 80 days. • TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Ce ter. Those rules are set forth in
OAR • :2- 001 -0010 thro. gh • R 952 - 001 -0100. You may obtain copies of these rules or direct questions OUNC at 5/3.2.6.6699 or 1.800.332.2344.
l i,
Issu: d By: / / / A Permittee Signature: � 1 i
OWNER INSTALLATION ONLY .� I
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
,1 CONTRA OR INSTALLATION ONLY //
SIGNATURE OF SUPR. ELEC'N: , .! .4 ./ - - DATE: '/ // fi g
I
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.
l Electrical Permit Application FOR OFFICE USE ONLY
IN City of Tigard DEC EIVED Date/By: / // 6 Permit No.:ZACR'g. - 00& /P
. y.
q 13125 SW Hall Blvd., Tigard, O 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 2008 Date /By: Other Permit:
TI GARD Inspection Line: 503.639.4175 DEC 1 1 , 2008 Date Ready /By• 1u II See Page 2 for
Internet. www.tigard- or.gov Notified/Method• I /a. Supplemental Information
' ` ' TYPE OF. woUTY 0 T16A :. PLAN ' REVIEW
❑ New construction ❑ Addition /altel [1041Vi fl�tg11P191r ISION Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
' ' . CATEGORY OF CONSTRUCTION;"- ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
` ,, ' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
_' - _ JOB - .SITE INFORMATION AND LOCATION ,., ❑Emergency system. larger separately derived system.
, . ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
`� Q� % - 100HP or more. occupancy.
Job no.: Job site address:
(y 5 ) '1��f,�rl (f" ❑ Six or more residential units. ❑ Recreational vehicle parks.
Ci /State /ZIP: ', El Health-care facilities. ❑ Supply voltage for more than
ty l 4 Y-- ? !� Z ( (2 Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: / Project name: ❑ Service or feeder 600 amps or more.
CO `) Y-PWc "� ; . 1 -, ' FEE SCHEDULE -
Cross street/directions to job site: 7 7 ���J Description I Qty. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2 • ``° I _ OF W • , , ti . (with above sq. ft.)
Alp /� .l t � L e nergy, multi- family 75.00 2
�v Alp �� 1 I) G�� C , l �/`� fi(l S residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 26.56 2
' -,. , ❑ ..PROPERTY- OWNER, ' '' TENANT s` ' , ' 201 amps to 400 amps 106.85 2
Name: e �' /- m �� 7 �' < 7:r' -ems ‘..—e-- 401 amps to 600 amps 160.60 2
/ � 601 amps to L000 amps 240.60 2
Address: -73 5 $1✓J ko ly�a > II Ac ' 7 5 - / Zc Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
- relocation
Phone: (j e,p� 7 q34,---4z 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ , APPLICANT * - ' . ❑ CONTACT PERSON ' ' _° abov service or feeder fee, 6.65 j��w 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
„ 'CONTRACTOR :„ - Sign or outline lighting 53 40 2
Business name: i4h-�� 71 eG ( � � Signal circuit(s) or limited-
{ J �^ lL energy panel, alteration, or
Address: 3s^2/ 7 7k. s� extension. Describe: Page 2 2
City /State /ZIP: t�.61Z a ).J p i q 7 o3 2-- Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: 543 ) 6 7 qi 3 4 . l Q Fax: ( ) Investigation per hour (1 hr min) 62 50
CCB Lic.: Q /41 Electrical c. j'iP 6341 Suprv. Lie.: .1l Z ?S Industrial plant per hour 73 75
ELECTRICAL 'PERMIT FEES - , .
Suprv. Electrician signature, required: ' / l 1(',if t i J Subtotal: / c c ' ` � 4 0
- Print name: �7 /( S B Date: l Z �� d 75 I d " v� g - . .. _ . t 37 , �o
e - r / � State surcharge (12% of permit fee): /( O a 4 �l or
•
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not o All ed within 80
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per pennit.
1:\ Building \Permits \ELC- PermitApp doc 05/23/06 440 -46 t 5T(1 I /05 /COM/WEB
• • •
CITY OF TIGARD
Ble:DING DIVISION PERMIT #: Et.C200B.00669
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/11/2000
Phone: (503) 639-4171 4* Atiolp
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 212/2009 TIME: 1:00AM • PAGE: 8
SITE ADDRESS: 07350 SW LANDMARK LN 120 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WEST COAST EXTREMECHEERLEADIN
DESCRIPTION: (1) service and (8) branch circuits.
OWNER: t PRENTISS C, PHONE #:
CONTRACTOR: MASTER TECH ELECTRIC INC PHONE #: 603-679-3640
Inspection Request _Scheduled For: Date: 7/212009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 000186-01 603-679-3640
Corrections/Comments/ Instructions:
1 41
* PASS Ei PARTIAL APPROVAL 111 CANCEL El NO ACCESS
FAIL 1 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Z J 6 6 ug". Date: 2 -4'1 Phone #: (503) 718- 1%
CITY OF TIGARD
L ��
B ®�1VG DIVISION PERMIT #: 1=LC2008.0O6$9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/11/2008
Phone: (503) 639 -4171 L� it
Inspection Requests (24 Hrs.): (503) 639 -4175 s
INSPECTION WORKSHEET FOR DATE: 1/16/2009 TIME: 7:01Aivi PAGE: 12
SITE ADDRESS: 07360 SW LANDMARK L id 120 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MST COAST EXTREME CHEE - i Wical installation defects noted
DESCRIPTION: (1) service and (8) branch circuitwon this report shall be corrected and
an inspection request made within 20
OWNER: HICKS, PRENTISS C, calendar days per OAR 918- 271- 0030PHONE #:
CONTRACTOR: MASTER TECH ELECTRIC INC PHONE #: 503-679-3640
Inspection Request Scheduled For: Date: 1/16/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 079787 -01 503.7113-2426 'e
Corrections /Comments /Instructions:
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CIN ii\41• -7 tk.t \-\(\ft)bt 5 (c) CA Rt, %(12*--e-
(k_ 1.1 AI L b _ &.; 'tat_ 111, b ,:&:. A. ' & .:_____
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
F AIL ,CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: A &' LC Date: I. • (-6 ` 9 Phone #: (503) 7181-44
b
CITY OF TIGARD „. �,
Ut
B dING DIVISION PERMIT #: EL C2000 00669
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/•i 1/20013
Phone: (503) 639 -4171 ,I
Inspection Requests (24 Hrs.): (503) 639 -4175 " -
INSPECTION WORKSHEET FOR DATE: 1 2/15/2000 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 07360 SW LANDMARK LN 120 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WEST COAST EXTREME CHE:ERLEADIN.
DESCRIPTION: (1) service and (8) branch circuity:.
OWNER: HICKS, PRENTISS C, PHONE #:
CONTRACTOR: MASTER TECH ELECTRIC INC PHONE #:' 6
Inspection Request Scheduled For: Date: 1211512000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 079039-01 503 \ Y
Corr ctions /"omments /Instructions 503) g90-2.2_21
la - O, --1 U
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•
....
n PASS ❑ PARTIAL APPROVAL 4 CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: G . ®� Date: 11—' 1 b: Phone #: (503) 718- _VIVO_
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
r RESIDENTIAL WORK:ONLY: ... r
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
r COMMERCIAL. WORICONL : °". -
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
F l Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems: .
*No licenses are required. Licenses are required
for all other installations
1.\ Building \Permits \ELC- PermitApp.doc 03/23/06