Permit A . CITY OF TIGARD " ELECTRICAL PERMIT
PERMIT #: ELC2004 -00201
DEVELOPMENT SERVICES DATE ISSUED: 4/20/2004
��' I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 114AC -00700
SITE ADDRESS: 17005 SW 92ND AVE
SUBDIVISION: COOK PARK ZONING: R-4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: 1 branch circuit to connect motor in panel for lawn sprinkler system. Panel in located in new soccer
field. Job No. 72004
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:
TIGARD, CITY OF OREGON ELECTRIC CONST /GROUP
13125 SW HALL 1010SE11THAVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Phone: 503 - 234 -9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 4/20/2004 $46.85
[TAX] 8% State Surcharge 4/20/2004 $3.75 Rough -
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
suspen for more t . • 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules re set forth in OAR 2- 001 -0010 a • • c ' R • 2- 001 -0100. You may obtain copies of these rules or direct ques 'ons to OUNC at (503)
246 699 or 1-800-332-23, 4.011•10.- I /
4 Permit i nat r- -#'
Is ued By: � •:&.!, t . � � Pe t S 9 u -�
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 INST LIBATION ONLY
SIGNATURE OF SUPR. ELEC'N: —.V _t - DATE:
LICENSE NO: q19 5
Call 639 -4175 by 7:00pm for an inspection the next business day
•
APR -16-04 03:57PM FROM - Oregon Electric Estimating 5032313587 T -933 P.001 /002 F -864
Electrical Permit Agjclicatio'a B /
OFFICE USE ONLY
1 _ City of Tigard 0N Date received: � /& o� Permit no.: e....2.6 13125 SW Hall Blvd Project/awl. no..
(� date:
.,,<9 1 Ph (503) 539 -4171, FAX: (503) 598-1 so Date issued: 1 >!j Recei.t no.:
Internet address: www.chtlg Case the no.: Pa meet .e:
24 -Hour Ins .ection R uest503 - -441 _
• 1 &2 family dwelling or accessory `c. C,Lbrri J .(tf: �T trial Multifamily ❑ Tenant improvement
❑ NewCensttuction G . 19 tratid`It alteration/re .lacement ❑ Other. ❑ Partial
JOB SITE INFORMATION
Job Address:: /7o as 6 -w 9a" 7 a E. 'Bldg. Tax map/tax lot/account no.:
Lot: iorocx: Subdivision
Pro octName: CI of TI: and Cook Park • Descrl •tlon and location of work on . remises: Connect Motor
Estimated Date of completion/inspection: ■ .9-N g0 0_ t� 1 1
Will ou call for Ins . ection within 24 hours? Yes 0 No ❑ Pro'ect Contact Rob Tea.ue 503) 535 -2672 Pho C
CONTRACTOR APPLICATION FEE SCHEDULE
• •x no.
Job No.: 72004 Dasaiptlon Q Fee (ea.) Total wp
ow res • e I : -nitro a or
multI-famlly per ewelling
Business name: Oregon Electric Group unit. Includes attached
garage. Service Included:
Address: 1010 SE 11th Ave. 1000 so. It or less $ 146,15 $ - 4
Cit: Portiand!State: OR p; 97214 Ea /WI 500 SF or Portion $ 33.40 $ -
Phone: (503) 234 -9900 Fax: (503) 234-1001 E -mail: Limited Engrgy. 52 Family $ 75.00 $ - 2
CCB no.: 203 Elec. • s. lie. no.: 26 - 95C Limited Eno . , Mull- Family $ 75.00 $ - 2
City /m o. - 5
Each manufactured home or
�� modular dwelling. Service
•��. n�n,P. , ..JiZl IImL,..,. vrM D a , 16/2004 endter feeder. 90.90 $ - 2
service or Feeders -
Su.. Elect. Name MINIM License no: 4460S InstalldtIon, Alteration or
Relocavon:
. PROPERTY OWN 200 amps or lase $ 60,30 $ - 2
Name (print): 2olamps- 4amamps $ 106.46 $ _ 2
Mailing Address: 401 amps - 600am•s $ Isom $ - 2
City State: 'Zip: 601ampy • to00ampe $ 240.60 $ - 2
Phone: Pax: IE -mail Over 1000A or Volts q
S 5465 $ - 2
Owner installation: The installation iS being made on property 1 own which Is Reconnect Only $ 36115 $
not intended for sale, lease, rent, or exchange according to ORS 447, 455, F eedeers rs ee - i services nstallation, , or
479, 670, 701. F
Alteration or Relocation;
Owner's signature: Date: . _ 200 am • s or Tess $ 56.es $ - 2
ENGINEER 201am•s- 400amps $ 100.30 $ - 2
Name:
over 401amps- BOOamps 5 133.75 $ - 2
:rand ircm.• - • ew,
Add res6: Alteration or Extension Per
- Panel: A. Fee for branch
CI : State: Zi.I circuits with purchase of service
or feeder fee, each branch
Phone: Fax: E -mail: circuit $ 6.5$ $ - z
B. Fee for branch circuits •
W /Out Purchase of Service or
PLAN REVIEW Feeder. 1.t Branch Ckt 1 $ 46.85 $ 46.85 2
❑ Service over 225 amps -comm ❑ Health -care facility Each additional branch circuit $ 6.86 $ -
❑ Service over 320 amps - rating of ❑ Hazardous location Miscellaneous - (service or
feeder not Included)
1&2 family dwellings ❑ Building over 10,000 square feet four or Each pump at irrigation cycle $ 63.40 $ - 2
❑ System over 600 volts nominal more residential units in one structure Esch Sirin or Outgne Ltpntin? $ 53,40 $ - 2
❑ Building over three stories ❑ Feeders, 400 amps or more signal Circuit(s) or Limited Energy
Panel Alteration or Extension
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park - s 75.00 $ - 2
O Egress/lighting plan ❑ Other:
- oescnption:
Submit 2 sots of plans with any of the above.
The above are not applicable to temporary construction service. Each Additional htspoction over
the Allowable In any of the
Notice: This permit application Above. Per ingpectlon
expires If a permit is not — 5 62.50 $ -
obtained within 480 days after It Investigation too;
has been accepted as Other
compare, _
Permit Fee % �-r $46.85
/ � O / /�� Plan review 25% � , `" $0.00 4,
(� V State Surcharge 8 °% \ $3.75
Total U , $50.60
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested. AM PM BUP
Location /7006-- $ 7‘ Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR �7
BUILDING Tenant/Owner L -------- ` -'
Footing 0 27)Qit -ooae
Foundation Access: 1v 2d_-
Ftg Drain ar - — = ,
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam ,nk
Sr Anchors
Ext Sheath/Shear
ear
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PA T FAIL
e• e
Rough -In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI _ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA I - D _ Z I
Approach /Sidewalk In spect or � �, Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL