Permit " CITY OF TIGARD ELECTRICAL PERMIT
t. PERMIT #: ELC2005 -00014
7:1` � � DEVELOPMENT SERVICES DATE ISSUED: 1/11/2005
---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S109DD -00100
SITE ADDRESS: 12635 SW BEEF BEND RD
SUBDIVISION: ZONING: R
BLOCK: LOT : JURISDICTION: TIG
Project Description: FUTURE TRACT "B" Private street lighting. Directions: Beef Bend, Rt. on 127th, Lt. tract "B ".
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: 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:
RIVERSIDE HOMES TODDS LIGHTING & ELECTRICAL
15455 NW GREENBRIER PKWY #140 19579 SW KARI ANN CT.
BEAVERTON, OR 97006 OREGON CITY, OR 97045
Phone: 645 -0986 Phone: 503 -742 -1899
Reg #: ELE 3 -510C
L1C 146666
FEES SUP 4434S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/1 1/2005 $93.60
[TAX] 8% State Surcharge 1/11/2005 $7.49 Rough -in
Elect'l Service
Total $101.09 Elect'l Final
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 iri 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: Permit Signature: cr)- -N
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 639 -4175 by 7:00pm for an inspection the next business day
JAN 10,2005 09:55A 5037921900 page 3
v v
.. . Electrical Perm A • >Y] FOR' OFFICE USE ONLY
Received �11•d Electrical /
,1 � Date /By; /— // —O S $ Permit No.: ,tit O --000/4-1 ?00I°7
City of Tigard Manning Approval Sign
est I 0S Date/By: Permit Nu.:
13125 SW Hall Blvd, ,A� Plan Review Oliar
Tigard, Oregon 97223 Patc/ny. Permit No.:
Phone: 503 -639 -4171 Fax: 503 -19f� CG 1. Post - Review Land Use
0 1 1 : l i Date /By. Case No
Internet: www,ci,tigard•or.us D 1 � I ... —
��1 ' r �� Contact Juris,: ❑ See Page 2 for
24 -hour Inspection Request: 501•11W•4175 Narne /Methud: "r I Oi Suphlemerrtal Information.
•
TYPE OF WORK _ ' PLAN REVIEW Please check all that a s Il •
N •
ew construction ❑ Demolition ❑ Scrvicc over 225 amps- • Health-care care facility
commercial ❑ 1lazardous location
❑ Additltln /alteration /replacement ❑ Other: ❑ Service over 320 amps - rating of ❑ lluilding over 10,000 square foci,
' • CATEGORY OF CONSTRUCTION : `'- . I & 2 family dwellings four i.11 more residential units in
g 1 & 2- Family dwelling U Commercial /Industrial ❑ System over 600 volts nominal one structure
ACCCSSOr )31111d1n n Multi -1 iimll El Building over three stories Q I ccdrrs, 400 amps or more
y g ` . r y — ._.... ❑ Occupant load over 99 persons ❑Manufactured structures or RV park
IV11ster Builder Othel ❑ Egress /lighting plan 0Other;
. .IOri SITE INFORMATION and LOCATION Submit _ sets of playas with any of the above.
- -- The atmye arc not applicable to temporary construction ter•vlre,
Job sift address: -
��'� � � s • - FEE* SCHEDULE
:.:,.s, /, cos Gf' B1r4h , /A t. #: ..d
Number of in spe ctions per p ermit allowed
Project N. --f ; rtsi r Zvc--f 5yr[,d - L , 4 ( ( 7A c teR
n srription _� - Qty Pre Tutii •
New re$idcatial -sin or per
Cross street/Directions to job site: %' rs Ill 1; Ic multi-family i •
included:
w
T t 1 P 4 7 • g a , I J z 7 h ' .. i_ dwelling unit. Includes attached garage.
0 /t f � G C Tv Serviee
-�+ y �� r / 1 i A I r 1000 sq, fL or less 145.15 4
I t'0. GA 15 • t om. A j . S eo l / vc- �' A 1 ; .a sh additionu1500 sq. ft. or portion thereof — 33.40 1
-- -
- " -'— .imited ener , residential 75.0
Subdivision: �zlla L' s f I Lot #: "" t
- -.... by si .-.
- -• Limited energy, non residential 75.00 2
al 75.00 2
Tax reap parceI II; Each manufactured home or modulai dwelling
DESCRIPTION OF WORK • .. • • service and/or reader 90.90 2
Services or feeders - Installation,
.P
-- °•.. S_ i u cv •-e. S !'t' ee. i- �l II A . k 2 /'
alteration or relocation: I _
V 200 ;imps (.1 less Y 80.30 15040 2
•
201 amps to 400 amps_ -_ 106885 2
401 amps to 640 am 160.60 2
_ H M O F❑ TENANT . ' • 601 amps to 1000 amps __— 2
� -" Over 1000 am a or volts 454,65 2
Name. R, C+4 1S /etc. flp,h,e. r Remnneet only _ 66,85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: -- 200 amps or less 66.85 I
Ph ne: Fax: 2t11 amps to 400 amps — 100.30 2
II APPLICANT • EONTACT PERSON . 401 to 000 amps 133.75 Z
• Branch circuits . new, alteration, or
Name: re ,t1( Jku extension per panel! I/
Address: A. Fee for brunch circuits with purchase o
- " - - - -- • , • service or feeder fee, each brunch circuit Z 6,65 H. D 2
City/State/Zip: ii. I'ee for branch circuits without auiclraae of
service or feeder fee, Grit branch circuit 46.95 2
Phone: 5 ` i /3.21tfY Fax: �6j 2y2 - /p Q h d _.
..- .. Each additional branch circuit 6.65 2
I; -mall: - -- Misc.(Service ur feeder not included):
CONTRACTOR '. Each pump or irrigation circle — 53.40 2
Each sign or outline light 53.40 2
Job No. - _ Signal ci cuit(s) or a limited energy panel,
r ( r t 1lera pr CX{C115lOn y 75.00 2
Business Nance: - 3 Lr�►trt, i i �� t /e4,g,� �
Address: 195 9 , - -- ,Cc.r.,' ,4/A C¢ .
Clt /State /Zl (Jr?. ach additional inspection over the allowable in any of the 4beve:
Y p :6 ce -yQI, ( ? ale. 97ef "` , (tier ) (?2.50
Per ins icctiOn pet hour • rain. I ho
Phone: 5 .7013 _ ,a/yy Fax: ,F5 - 79Z—/ *Pe Investigation fee:
C:CB I,ic #f: / treeG' Lic. #: ' -570 C. Other: -- __—
- ,
Supervising electrician Ele ct rical Permit )Nees* •
signature required: •• - ._• • • Subtotal q 3, t5 n
q Plan Review (25% of Permit Pee) $ _
Print Name: 73,44 e_ iAli, I Lie. #: ve y S State Surcharge es of Permit Fee) $ 7, %' '
_ TOTAL PERMIT' FEE $ /O /. 01 .. ....
Authorized l Notice= This permit application expires If a permit is not obtained within
Signature: ®_ I _ -a` �f /
Date: Glds' ISO days after it has been accepted as complete.
e6 . / 6 . S.c. * Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
CITY OF TIGARD ►- 24 -Hour • -
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received // Date Recuested c ( AM PM BUP
Location - a- ea 3 c / l �� /RC Suite MEC •
Contact Person Ph ( ) cj / 3- 2 '64 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner "Tra '! '�IrLC oZ dd S - b C6 I �j
Footing �� -PLC gi $ -lea /
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Ir$pecty oes: �Jo r _ ` � /� .�- r ) SIT
Post & Beam G.�► V� I J W� l .S
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
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
TR_ICAL
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
1 FAIL
Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line G ADA 1tq e ��
Approach/Sidewalk Date Inspector `�t� I� t �� d Ext
Other:
Final DO NOT REMOVE this inspection record fro the Job site.
PASS PART FAIL