Permit CITY TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00161
- DEVELOPMENT I SERVICES
(503) 639 -4171 DATE ISSUED: 3/31/04 Hall PARCEL: 1S135CD
SITE ADDRESS: 11461 SW 98TH AVE
SUBDIVISION: BURLWOOD ZONING: R
BLOCK: LOT : JURISDICTION: TIG
Project Description: Add (5) light poles for parking lot lighting.
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: 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:
SHARON DEVELOPMENT CO, LLC DOUBLE E ELECTRIC INC
5795 SW CRANBERRY CT 2626 SE SPRUCE ST
BEAVERTON, OR 97007 HILLSBORO, OR 97123
Phone: Phone: 503 - 807 - 5156
Reg #: L1C 152985
ELE 34 -267C
FEES SUP 4620S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/31/04 $46.85
[TAX] 8% State Surcharge 3/31/04 $3.75 Rough -in
Elect'l Final
Total $50.60
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"552- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct que tions to OUNC at (503) 246 -6699 or
1 -$00 432 -2344. •., ' , ' i..g.._...s.
I sued By: 1 ' _ - � - / thy.). Permit Signature:
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:
x CONT' • - •R I STALLATION ONLY
�l � I ,
SIGNATURE OF SUPR. ELEC'N: > DATE:
LICENSE NO: ` I'�r
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application FOR OFFICE t SF ONI.l
City of- Tigard Received 3/3/0d/ !O/ /l Permit No. :, d- 9 / -00 /6/
13125 S V/ Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
A p � ° Date/By: other Permit:
Inspection Line: 503.639.4175 '' �„ Date Ready/By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: '17 6.1 Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction [ Vj Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'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
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
� ulti- 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
- 7 ❑Health -care facility ❑Other:
Job no.: Job site address: ( - i 549 (rV ! 0 V /CV Submit 2 sets of plans with any of the above.
City/State /ZIP: T(1 in C20 o Q 91 zz3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: (i LAC l e a C_4 4- 4 (A .
FEE* SCHEDULE
A
Description I Qty. I Fee. Total 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 l
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
A Z � I 1 (5) Li 4(.4T au` - foe Fp _ ��N� (Art dwelling, service and/or feeder 90.90 2
t'nJ J l f f Services or feeders installation, alteration, and/or relocation
U (n 0-iiN • . 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER I ❑ TENANT
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 l
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
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, / 46.85 46 ' 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
1`` 2 LE , r Cie c-rR ( c. 71QC extension. Describe: Page 2 2
Business name: ( .JV t, C
Address: 2(021 SC SPi2 V G 't �T
. Each additional inspection over allowable in any of the above
n Per inspection 62.50
City/State /ZIP: j C.C..S'0 R0 O12 Investigation per hour (1 hr min) 62.50
\\Ph - $r-[ - ci c (p Fa ( 5-03) — 430 — C 510 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: ( 'S29 $ C Electrical Lic.• 4- ,c Su rv. Lic.: 4620 5 • Subtotal 4/6,
. 5
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: ci..00 7 K-S IZOil1 Date: 4 ft f_ State surcharge (8% of permit fee) - 7
TOTAL PERMIT FEE 0 , (00
Authorized signature: This permit application expires if a permit is not obtained within 1811
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri ^ County Building Industry Service Board
C Oil °
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION - Business Lirie: (5b3) 639 -4171 MST
BUP
Received c� Date Requested / 7 AM PM BUP
Location / / / /Q / ?0 ```�` Suite MEC
Contact Person Ph ( ) 7 /S PLM
Contractor ( ) SWR
BUILDING Tenant/Owner / ( / e./C ELC o dd C) q .&) 1 Ho f
Footing
Foundation ELC
Ftg Drain AcceSS:
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
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 r
P
Y ../
ASS PART FAIL 6
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PAR- FAIL
ELECTRICA
Service t V Rough In ` kC)
UG/Slab
Low Voltage \.);
Fire Alarm v
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date AI/05 Inspecto _ y `r Ext
Other:
O
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL