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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00259 � DEVELOPMENT SERVICES DATE ISSUED: 5/11/2006 '- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S101 AD -01400 SITE ADDRESS: 12700 SW 68TH AVE ZONING: MUE SUBDIVISION: WEST PORTLAND HEIGHTS LOT : 033 JURISDICTION: TIG Project Description: Electrical TI 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: 7 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: OREGON KI SOCIETY AERO ELECTRIC 12700 SW 68TH AVE 16828 MT VIEW LANE TIGARD, OR 97223 WOODBURN, OR 97071 Phone: Contact #: PRI 503 - 982 - 1044 FEES Description Date Amount Reg #: ELE 26 -492C [ELPRMTJ ELC Permit 5/11/2006 $93.40 LIC 48304 [TAX] 8% State Surcharge 5/11/2006 $7.47 SUP 2971S Total $100.87 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 1 TTENTIO • Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in 0 952 - 001 -001 thro s OAR • • I -0100. You may obtain copies of these rules or direct questions to OUNC at 50 - 246 -6699 or i 1 -800- 2 -2344. Issue By: i • , � j ■ Permittee Signature: � 4 rj (I / , 410// - 4� OWNER INSTALLATION ONLY T 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' . — " ' i _, (, 1 • - ' DATE: . r 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. Electrical Permit Application Foli OFFICE l'SF ONLY rs: Received �,� • City of Tigard Date/B . to �A'r,� IIIII . j NO l Permit No.: ...AI (0 -60._. 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' 13 ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Permit: T I C A R l7 Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction El Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ['Service ['Hazardous over 225 amps, cornm'l Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling El 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 ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park �� D© Sw / do ❑Health -care facility ❑der. Job no.: Job site address 7 / f / s A/� u ��4 y S u b mit 2 sets of plans with any of the above. City/ State/ZIP: ril..A� 9 72,23 / The above are not applicable to temporary construction service. Suite/bldg. /apt no.: P roject name: 67". k y SBc/ ��p FEE SCI Q E t D y ILE Fee T«.1 1 " tion 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 I Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular /� J /�i9N dwelling, service and/or feeder 90.90 2 � h i !Ail i /meet" /�r7v', Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 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 Tess 66.85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 an 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 ❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit 13. Fee for branch circuits Contact name: without service or feeder fee, first branch circuit 1 46.85 ` � G 2 Address: Each add'I branch circuit 7 6.65 /44). 55' 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 Iimited- CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: /.9/,! /� .��2� /r 'r! y Each additional inspection over allowable in any of the above Address: r'7 e / B ' Per inspection 62.50 City/State/ZIP: h/z9 4ri4 j �� / ,69 / Investigation per hour (1 hr min) 62.50 Fa \b� Industrial plant per hour 73.75 Phone: (3-03) eg DG_..� ( ) 1 \\ ELECTRICAL PERMIT FEES* CCB Lic.: 4/g 3 Electrical Lic.: - 2 � -qq2 L► Suprv. Lic.: a , /_S Subtotal: CM t 1 {c • Suprv. Electrician signature, required: t c 1 b Plan review (25% of permit fee): . Print name: � ,q-7'T���ye, Date: State surcharge (8%ofpermit fee): i. If '1 // s�io�o Q , (15-7 TOTAL PERMIT FEE / Authorized signature: This permit application expires if a permit is not obtained thin 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 allowed. I :\ Building \Pennits\ELC- PennitApp.doc 03/23/06 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: (RESIDENTIAL WORK ONLY: Fee for a ll residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other -- r. COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical El Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total. number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \ Building \Pamits'ELC- PamitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006 -00259 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ., . F .. INSPECTION WORKSHEET FOR DATE: 8/10/2006 TIME: 7:04AM PAGE: a SITE ADDRESS: 12700 SW 68TH AVE CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: Q33 TYPE OF USE: PROJECT NAME: OREGON KI SOCIETY DESCRIPTION: Electrical TI. 5/17/06: Added Low voltage for data/telecommunication. OWNER: OREGON KI SOCIETY. PHONE #: CONTRACTOR: AERO ELECTRIC PHONE #: 503 -982 -1044 Inspection Request Scheduled For: ,Date: 8/10/2006 Pour Time: Code # Inspection Description Con ' m # Contact # Message 199 Electrical final 034746 -► 503 - 318 -6632 Y Corrections /Comments /Instructions: �o M- Ii Q. 'V PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v 't O. E)© Date: $ .1d-0; Phone #: (503) 718- 2-"i W • CITY OF TIGARD 4 .. BUILDING DIVISION PERMIT #: ELC2000 -00269 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51111200E Phone: (503) 639-4171 4 11 I ,i` Inspection Requests (24 Hrs.): (503) 639 -4175 ''I �� INSPECTION WORKSHEET FOR DATE: 6/2212006 TIME: 7:01AM PAGE: 6 SITE ADDRESS: 12700 SW 68TH AVE CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE: PROJECT NAME: OREGON KI SOCIETY DESCRIPTION: Electrical TI. 5/17/06: Added Low voltage for data/telecommunication. OWNER: OREGON KI SOCIETY, PHONE #: CONTRACTOR: AER . . ECTRIC PHONE #: 503 - 932 -101'1 Inspection Request Scheduled For: Date: 6/22/2006 Pour Time: Code # Inspection Description Confirm # i, ontact #�`-\ Me age 199 Electrical final 032179-02 11-T° ► ' 18 -6632 4r-4, � Corrections /Comments /Instructions: , 11 A ,'T0 tkobN 4 / 7 v) 44-KJ , ❑ PARTIAL APPROVAL • C Ill NO ACCESS CALL FOR INSPECTION AL FEES ASSESSED h-') Date: o 22 ' 046 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC20OS-O0269 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006 Phone: (503) 639 -4171 N Inspection Requests (24 Hrs.): (503) 639 -4175 . .� INSPECTION WORKSHEET FOR DATE: 5/17/2.006 TIME: 7:06AM PAGE: 47 SITE ADDRESS: 12700 SW 68TH AVE CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE: PROJECT NAME: OREGON KI SOCIETY DESCRIPTION: Electrical TI OWNER: OREGON KI SOCIETY, PHONE #: CONTRACTOR: AERC) ELECTRIC PHONE #: 503 - 982 -1044 Inspection Request Scheduled For: Date: 5/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 030019-01 503- 318 - - 6632 Y Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Givz_.6 ' V (A Date: S l I Ill() 6 Phone #: (503) 718- M • CITY OFTIGARD BUILDING DIVISION " � • PERMIT #: ELC2006.00259 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2066 Phone: (503) 639 - 4171 ,,�� ��� . Inspection Requests (24 Hrs.): (503) 639 -4175 `__.. INSPECTION WORKSHEET FOR DATE: EJ16/2006 TIME: 7:O2AM PAGE: 22 SITE ADDRESS: 12700 SW (68TH AVE CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE: PROJECT NAME: OREGON 1 <l SOCIETY DESCRIPTION: Electrical TI OWNER: OREGON KI SOCIETY, PHONE #: CONTRACTOR: AERO ELECTRIC PHONE #: 503-982-1044 Inspection Request Scheduled For: Date: 5 /1&2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough- in 029960-02 503- 318 -6632 Y Corrections /Comments/ Instructions: 1--bQA4 • 2,2 to ft Ft), ‘47.• NI seg onl- ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL .NO ACCESS FAIL PA CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: (b Phone #: (503) 718- 24L