Permit CITY TIGAR ®' ELECTRICAL PERMIT
PERMIT #: ELC2006 -00110
�I�I DEVELOPMENT SERVICES DATE ISSUED: 2/9/2006
� = - `' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135CD
SITE ADDRESS: 11461 SW 98TH AVE ZONING: R - 12
SUBDIVISION: GLACIER LILY APARTMENTS LOT : JURISDICTION: TIG
Project Description: 2 branch circuits to light poles.
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: 1 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: Contact #: PRI 503 - 807 - 5156
FAX 503 - 430 -5966
FEES
Description Date Amount Reg #: LIC 152985
[ELPRMT] ELC Permit 2/9/2006 $53.50 ELE 34 -267C
[TAX] 8% State Surcharge 2/9/2006 $4.28 SUP 46205
Total $57.78 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 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the • egon 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 `„ direct q - .tions to OUNC at
503 - 246 -6699 or 1 -8� v 32- 2344.
Issued By: `_ Apr__ _� �' _ Permittee Signatur• � �, `� —
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 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.
+ e iv Er'
GE
. .
Electrical Permit A p Fa FO o FF lcl use ONLY
Received /�
City of Tigard Date/By ,- q, / , at5 Permit No.: _ A f ,(90 //a
13125 SW Hall Blvd., Tigard, OR 97223 FEB 0 9 2006 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' "' :. ipa; • "r I , 'A\ D Other Permit:
Inspection Line: 503.639.4175 I L'f ,, ^ Date Ready/By: ®See Page 2 for
Internet: www.ci.tigard.or.us CITY OF 1 A ' 7 Notified/Method:
B Supplem ental Informati
�zTO RK��Isiro� .
F ORK PLAN REVIEW
❑ New construction A ddition /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
❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
Multi family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
Dgi
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION 0 Egress/lighting plan RV park
Job no.: Job site address: ` l I 5i. G M yE . DHealth-care facility ❑Othe 61.,0 O ^ !,v Submit 2 sets of plans with any of the above.
City /State/ZIP: n c, 'j7 Q , The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: / r
FEE* SCHEDULE
� - - - _`._ -. 9 . / .Ifs Description I Qty. I Fee. I Total
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
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
ADD 2 L. I t- i POLES j CZ j dwelling, service and/or feeder 90.90 2
fit n / Services or feeders installation, alteration, and /or relocation
C t (2-05 200 amps or less 80.30 2
•
❑ PROPERTY OWNER ❑ 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 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
❑ 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 e - r 2
Address: first branch circuit GC
Each add'I branch circuit / 6.65 ( v - 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
. CONTRACTOR ' energy panel, alteration, or
Business name: ( g LC t c .LCC t extension. Describe: Page 2 2
Address: 2 4.2-6-) . 5 C ,SP 12A-1 L6. ST Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: 0 i Lf_5 6U 1 / COQ- Investigation per hour (1 hr min) 62.50
5 r plant Phone: ( - ��j S� " J i 5 1Cj Fax: (S� �' 3 o' �S �� Industrial er hour 73.75 P P
ELECTRICAL PERMIT FEES*
CCB Lic.: I S C Electrical Lic.: 3 4.('Z7c4 Suprv. Lic.: 4c,-Z435 Subtotal 3 �
Suprv. Electrician signature, required: ..A6 up Plan review (25% of permit fee)
Print name: REV 1) C le- 57 (2.i FYI Date: .Z /9 /b State surcharge (8% of permit fee) #,
TOTAL PERMIT FEE r' i r7
Authorized signature: This permit application expires if a permit is not 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 allowed.
i:\ Building \Permits\FLC- PemnitApp.doc 12/03 4404615T(10/02/COM/WEB
8 .
Electrical Permit Application - City of Tigard r -
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
LRRESIDENTIAL WORK , _
Fee for all 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:
I C W ORK ONLY —
Fee for each commercial system $75.00
(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*
❑ Medical
❑ 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 \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLC-1006 00110
13125 SW Hall Blvd., Tigard, OR 97223
/400 mm06
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 DATE ISSUED:
INSPECTION WORKSHEET FOR DATE: 2002006 TIME: 7:03AM PAGE: 20
SITE ADDRESS: 11461 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: GLACIER LILY APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GLACIER LILY APTS.
DESCRIPTION: [2. Nat rcf circuits to iitht ix ).
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #:
CONTRACTOR: DOUBLE E ELECT‘1C INC PHONE #: 503-807-5'156
Inspection Request Scheduled For: Date: Pour Time:
2/24/2006
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 027626 503
Corrections/Comments/Instructions:
PASS PARTIAL APPROVAL 0 CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
Inspector: 6 be) Le Date: 2-24 -06 Phone #: (503) 718- 2.446.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLC2006-00i10
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2i9/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 21 10 I 200 6 TIME: 7:04AM PAGE: 28 •
SITE ADDRESS: 11461 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: GLACIER LILY APARTMENTS LOT #: TYPE OF USE:
•
PROJECT NAME: GLACIER LILY APTS.
DESCRIPTION: 2 branch circuits to light poles.
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #: -
CONTRACTOR: DOUBLE E ELECTRIC INC PHONE #: 503-8w-6156
Inspection Request Scheduled For: Date: 2/10/200G Pour Time:
Code # Inspection Description Confirm # Contact # Message
106 Undergroundlslab cover 026677-01 EiO3-807-5156
•
Corrections/Comments/Instructions:
ViCiA. A L. t■) V5ViZtasbotJb -.
(t,) OT6)
tO et.. ...)1\pruw_ IA Wb\-ko‘-i
I'm 61 bvivzszil eta. v
6
A PASS n PARTIAL APPROVAL LI CANCEL fl NO ACCESS
I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 4,)C.t1 Date: Z. \b 0 6 Phone #: (503) 718- 2)446