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Permit
CITY OF TIGARD ELECTRICAL PERMIT •■ PERMIT #: ELC2005 -00442 DEVELOPMENT I I SERVICES 503 - 639 -4171 DATE ISSUED: 6/23/2005 13125 SW Hall PARCEL: 2S104AD SITE ADDRESS: 12950 SW 129TH PL ZONING: R - SUBDIVISION: LOT : JURISDICTION: TIG Project Description: Temporary power for construction trailers. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 3 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: 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 AREAISPEC OCC: Owner: Contractor: LORENCE, WALTER P + DEBI D SUNDOWN ELECTRIC CO 12950 SW WALNUT ST PO BOX 129 TIGARD, OR 97223 FOREST GROVE, OR 97116 Phone: Phone: 359 - 0604 FEES Reg #: LIC 67442 tion Date Amount SUP 37 5 Description ELE 37 -445C [TAX] 8% State Surcharge 6/23/2005 $16.04 [ELPRMT] ELC Permit 6/23/2005 $200.55 REQUIRED ITEMS AND REPORTS Total $216.59 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 -tt1e Or on 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 o direct questions to UNC at 503 - 246 -6699 or 1-800 Issued By: ✓2 1Yf f Permittee Signature. 4 _,(At OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lea e, 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. CO • E lectrical PermttAplication . " " '—' — - Date received•, — '3 ar Permit no. • Le ' ADO Sly ...•1I City of Tigard 1! q oo � Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard; 97 Date issued: By: Receipt no.: Phone: (503) 639 -4171 CITY OF TIGARD Fax: (503) 598 -1960 BUILDING DIVISION Case fileno.: / Payment type: Land use approval: ---Th� TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory N. Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial • . . JOB SITE INFORMATION _ Job address: '12. 53 SL.. 1 29 i i c Bldg. no.: Suite no.: Tax map /tax lot/account no.: _ Lot: Block: • Subdivision: Project name: Description and location of work on premises: je At AA. ., r g, {3 Estimated date of completion/inspection:� w "- - -.` CONTRACTOR APPLICATION' ` _ FEE SCHEDULE Job no: I 0 Fee Max Business name: 6 , I A , G Description Qty. (ea.) Total no. insp t New residential - single or multi- family per Address: r, D , .,� e, 1 2.." dwelling unit Includes attached garage. City: F® 17 State W IZ ZIP: a ' 1 Service included: Phone:35— — .. tj G Fax:3ty) - ca.._ E- mail: 1000 sq. ft. or less 4 CCB no.: y El bus. lic. no: 3 � 4. T , G Each additional 500 sq. ft. or portion thereof ___— �� Limited energy, residential ___ 2 Cit /metro lic. no.: _ / 'L energy, non- residential ___ 2 - C - Z i , Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder ■■. 2 Sup. elect. name (print): License no:3'. _ Services or feeders –installation Z alteration or relocation: • • ., ! . PROPERTY OWNER • 200 amps or less 1111 2 Name (print): 201 amps to 400 amps ___ 2 401 amps to 600 amps ___ 2 Mailing address: 601 amps to 1000 amps ___ 2 City: . State: ZIP: Over 1000 amps or volts ___ 2 Phone: Fax: E -mail: Reconnect only Owner installation: The installation is being made on property I own Temporary n,alt ces o ,orre rs - ©. • which is not intended for sale, lease, rent, or exchange according to installation, alteration,orrelocation: 200 amps or less ORS 447, 455, 479, 670, 701. 201 amps to 400 amps ___ 2 Owner's signature: Date: 401 to 600 amps ME__ 2 ' . ENGINEER _ ' Branch circuits - new alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail: • of service or feeder fee, first branch circuit: ■. 2 • Each additional branch circuit: __ .,. -W, PLAN REVIEW: (Please check all that apply) PP b) '. ` Misc. (Service or feeder not included): a Service over 225 amps - commercial O Health - carefacility Each pump or irrigation circle ■■ ■ 2 ❑ Service over 320 amps- rating of 1 &2 ❑ Ha7arddus location Each sign or outline lighting ___ 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* ■■. 2 ❑ Building over three stories O Feeders, 400 amps or more O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan. ❑ Other. Per inspection __ Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: I / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $. Name•of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6 /00 /COM) i. Electrical Permit Fees: Limited, Energy Fees: ' TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) . Service included: Items Cost Total Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 . 1 . n Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 n Garage Door Opener* Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 n Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 n Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. n Audio and Stereo Systems Branch Circuits New, alteration or extension per panel n Boiler Controls a) The fee for branch circuits • ' with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 7 HVAC • Miscellaneous n (Service or feeder not included) Instrumentation Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 n Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over n Medical the allowable in any of the above Per inspection $62.50 7 Nurse Calls Per hour $62.50 In Plant . $73.75 n Outdoor Landscape Lighting Fees: n Protective Signaling Enter total of above fees $ n Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ • i:\dsts\forms\elc-fees.doc 10/09/00 • ,CITY OF TIGARD BUILDING DIVISION .,; PERMIT #: ELC200S -00442 j 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2q 05 • Phone: (503) 639- 4171 @�I�ii �� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/27/2005 TIME: 7:09AM PAGE: 50 ' SITE ADDRESS: 12950 SW 129TH PL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LORENCE • DESCRIPTION: Temporary power for construction trailers. OWNER: LORENCE, WALTER P + DEBI D, PHONE #: CONTRACTOR: SUNDOWN ELECTRIC CO PHONE #: 359 -0604 Inspection Request Scheduled For: Date: 6/27 /2006 Pour Time: ode # Inspection Description Confirm # Contact # Message 1 Temporary electrical service 010196 -01 603 -849 -5979 V Corrections /Comments /Instruction : Ni b 1 ). Pl_ 2 \ 0 0 1 1 (•)\A s r V PASS ❑ PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS Il FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �{ . Date. — 5 Phone #: (503) 718-