Permit C ITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2005 -00237
DEVELOPMENT SERVICES DATE ISSUED: 4/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S115AA-OTOOA
SITE ADDRESS: 16105 SW 108TH AVE BLDG B ZONING: R -25
SUBDIVISION: OAK TREE APARTMENTS LOT : OOA JURISDICTION: TIG
Project Description: Underground cable power supply. Job # 1331.
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: 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:
OT2 LLC EMPIRE ELECTRIC COMPANY
5437 ROSALIA WAY SUITE 100 2014 SE 9TH AVE
LAKE OSWEGO, OR 97035 PORTLAND, OR 97214
Phone: 503 - 620 -4373 Phone: 503 - 777 -3108
FEES Reg #: LIC 147727
ELE 3-521C
Description Date Amount
SUP 3192S
[ELPRMT] ELC Permit 4/6/2005 $80.30
[TAX] 8% State Surcharge 4/6/2005 $6.42 REQUIRED ITEMS AND REPORTS
Total $86.72
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 questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: ' A Permittee 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:
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.
FROM :EMPIRE ELECTR I C CO FAX NO. : 5037774152 Apr. 05 2005 12 : 17PM P2
RE
C IVED ._ ■ ......og •11,a. ,, . . ..■
• "
gairr_CALPig30,1611/Plifitgit l'Olt 011 1.S L 0■1..Y
City of Tigard APR 0 0 i Di,..,..: . /,,, _ A
R"lived ' -- ea Vi/
t3i 25 SW liallialvd, Tigard 2005 ' oR 92 1-,-, , Review
Phone! 503.639.4171 Fla: 503-594 OF TIGARD ' ilt, Datefli . Otkr Pantie •
Inspection Line: 503k39.4175 BUILDING DIVISI 0- ."- DlIc 7"7 ' Y: nal 121 See Page 7 tor
Intern al: werie.aLtigantorus isenscartviethrut se • erementat reformat:us
'• ...:';.: ilt .Hy 7:1 4 ,' :. • , ..t..... f■-•?.i k!!•;. *Arc itroive :,. ,. i, 1•: . . ; .I..: :, . :
0 Now construction ID)ddition/alteration/repIaccmcnt Please cheek all that apply:
°Service over 225 amp, comm'! InHazaltouS location
0 Demolition ' Other Inger/ice over 320 amps - rating CIBuildng OVer 10.020 sq. ft..
''','...':''.'• iis...: •il! ;; ... ':L • . : ::.: ' i'ft flf I and 2- for ^ lY dwlitint' 4 or more new residential
0 1- and 2-fbrAlly dwelling L • 'anemia/industrial 0 Accessory building 0System over 600 Volts nominal uniui in one structure
°Building over three rIIrict armlets- 4 00 amps er mere
121 Multi-fund 0 Master builder 0 Other: ,....._ °Occupant load over 99 persons OMalltrfactored structural' or
.. .• ...,. -... - • -4 • ;i .., -. :- - ! i ti ., • : ..1. • ... ltati i 1040- :ii::.1•0.1.1 Ma i ' ,• • .. :''
•:•:.i'::.. - i :V1 1
,;:!....• • • 0 • 4 , • ' II • l• ' • ,•:! •, ,••• • • . • • DEgresailightinS Plan RV park
ClOther;
Job no.:1:33 1 lob site address i .. a. ,. /ag _/.4 461 ii.z.y. ci /2 , plIcalth-cere facility
0 1' submit 2 see' ofplans with any attic above.
CitY/StattriIP: - 6/9 0:4 / 6•/,' as The above 'renal applicable 10 temporary construction service.
Ltilti Jr r
Suite/bldg./4A no •: PP:rj"t name fr rgeiC 407-, Pk95c, .
Cross anxt/difections to job site: • .2r N rev idaetiai attigle. or malti-femily dwelling unit.
includes attached gil rep-
-
1,000 sit ft ar less 145.15 4
_
, . . _
Subdivision: Lot BO,: Ea. add'! 500 eO• fl, or porcine - 3343 1
Limited energy, residential 75,00 • 2
Tax map/panel no.: ...,-„„... Limited enagy, non-tesidential 75.00 2
::••g,1 J.V.r1i'veli' 1 . iiieSedittil • :•:::-..' ' :•.:,.. i.. • • .:.!'....:1: :.., ad, „,,,,,, „,-,•„,,ducii,
....,,,,3,4.whii.. . - • . ......••• ... ;.- , • .4.. .,.., ,. .... - • , .•,. -Hi .-.. • - — . • • - • dwelling, service and/or feeder 90.90 2
I , :- , ,. ..,,. p.. , . •.... 1 ,s1 /e- AO e4. .. -.tat Services or feeders installation, attention, aitd/ur reloCetion •
' 200 amps or less - 1 80.30 fb, 2
. . ' ." • 4 • - '' ' ' '''"• 'AN : . .::.: .-i -ils;.•:..;-, 201 amps ro ago amps 100.35 2
1' 41L.,-La . — -' 401 TOOT= iv 600 ______....,_.—
arri4 160.60 2
1411211C: 601 amps to 1,000 an 240.60 2
Over 1,000 ems or volts 454.65 2
Address:
Reconnect only G6.85 2
City/State/ZIP: Temporary services or feeder. Inetalletion. alteration. end/Or
— relocation
Phone; ( ) ] Fax: ( ) .
20 amPa er lefS 66.85 1
Owner installation: This instillation is being mare on property that I own which is not 201 Amps So 4 00 once 10030 2
intended for sale, lease, rent, yr ocharsge, according to ORS 447, 449, 670, and 701. 401 &Min TO 4300 amps 133.75 2
Owner signature: Date: , Branch circuits - new, alieratki Or amictislOny per panel
..'i:-!: ' , - L VMMINIMIE::'4 :i:i::::.:: .::!.! Egl,. ,444
.,) a'. . . ...., . .. . ..:.....-1, , 4;"
. - *1,4001.'Ii1::-Ti i:': A. Fee for branch circuits werh
service Of retflef fee, feel+ 6.65 2
Business mune; branch circuit . ,
""
B. Fee for branch circuits
Contact name: wfthour service or feeder fee, 46.85 2
---......-- each branch circuit
Address; Each ad circuit —
2
"
.. .
'
City/State/ZIP: mheenerver.rvice or I r nut Included)
. . . POW or ini 'of TIcil_ _.
•cle12.E2_
Phone: ( ) I Pare ; ( )
•..........----- . ...„ ____
___.... _ — .. Sign or outline lighting 53.40, 2
Elnail: signal eireuit() or birthed
•
:1410 :1.,frAll . .;;•4 li IrRi • : . .:1 .. ,•,• " mitc"tiOn, 01'
extension, Describe! Page 2 2
Itgi_______E name: •
.....—
.
Each additional Inspection over allowable In any of the above
AddreSS: 2014 SE 9th Ave.
- Per inspection 62.50
COY/State/2 Portland, OR 97214 Invattiption per hour (I hi• fain)
...v..—
- 'Industrial plant hour 73.75
now; ( 503 777-3108 I Fax: (503 ) 777-4152 ••• ...1,! ultc-nucki; p .J : ,
...
MB Lie.: iy 77 1 Electrical Liv-: -- 5we Suprv. Lie.; 465 _ stance! '; 71.73
Suprv. Electrician signature, required: . 4---g Plan review (25% of pm t fee) ...-_,
State surcharge (8% of permit fee). 6.
Print name: Di nk Bnnid 1 n
TOTAL PERMIT PEE • a t... 7 1; 2d
_ , Date; 1,1"/.
Authorized ei • rsnature7 Tta4 permit opotivadoe ...Oki if a maul IF awe *Ombra v•iiiiin 150
.............
- Or atter It Li i been accepted incomplete
Print name! ,__ _2iite: ' Fes reetbodology act by Tr(-C-euaty Builitiug Industry Service Board
________ -----.-.---- mower or kismet/11S per Penman allowal
i:latailitianVeraitegt.C.Porianopoec IVO 44a
CITY OF TIGARD •- `'
BUILDING DIVISION PERMIT #: ELC2005 •00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2005
Phone: (503) 639 -4171 a
Inspection Requests (24 Hrs.): (503) 639 -4175 ,..4.141-
INSPECTION WORKSHEET FOR DATE: 4/15/2006 TIME: 7:00AM PAGE: 79
SITE ADDRESS: 16105 SW 108TH AVE BLDG B CLASS OF WORK:
SUBDIVISION: OAK TREE APARTMENTS LOT #: 00A TYPE OF USE:
PROJECT NAME: OAK TREE II APARTMENTS
DESCRIPTION: Underground cable power supply. Job # 1331. •
OWNER: OT2 LLC, PHONE #: 503 - 620-4373
CONTRACTOR: EMPIRE ELECTRIC COMPANY PHONE #: 503- 777 -3108
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 004600-01 503- 777 -3108 Y
Corrections /Comments /Instructions:
ir ,
(...., r
,..
PASS ❑ PARTIAL APPROVAL ri CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: kith ���� -"''^� Date: , ` /J if Phone #: (503) 718 -
w
r
.