Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00356
� DEVELOPMENT SERVICES DATE ISSUED: 5/26/2005
� J I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S101 AB -02201
SITE ADDRESS: 07117 SW BEVELAND RD 200 ZONING: MUE
SUBDIVISION: BEVELAND LOT : 2 -3 JURISDICTION: TIG
Project Description: (10) branch circuits.
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: 9 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:
ZIMMLER DEVELOPMENT LLC BOB'S ACTION ELECTRIC INC
7165 SW FIR LOOP 2700 NE BURTON ROAD
SUITE 100 /PO BOX 230698 STE A
TIGARD, OR 97223 VANCOUVER, WA 98662
Phone: 503 - 598 -3440 Phone: 360 - 254 -7200
•
FEES Reg #: SUP 4322S
Description Date Amount LIE 53136
ELE 37-431C
[ELPRMT] ELC Permit 5/26/2005 $106.70
[TAX] 8% State Surcharge 5/26/2005 $8.54 REQUIRED ITEMS AND REPORTS
Total $115.24
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: air Permittee Signature: 54). -(-- czy e
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.
,.
Electrical Permit Application - / - .— F O FF I C E, U S E O NLY -- -
City of Tigard y � � Q Date/By: d - r a O'' Permit No. /C = 'i 2033
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review LO I` Other Permit:
:it a "NPR ,\ B
Phone: 503.639.4171 Fax: 503.598.1960 Qd p� c� � (fir -. N� iu� Date
Inspection Line: 503.639.4175 1°1111 c �_ � J 6 Date Ready/By: H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
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- 7,..i'•: ` -r.„i :, ; ::s"trttr s e T , WO :r'. •,i~, , ,, gw , -$4, w as .,, 4 -.4...
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LI New construction ® Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition E] Other:
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> 'ter,: ..., ,.ra .gq,e;; :,,,•- ,, - '_:,. ;,,,,-•-,,..:=,.. = ^s, ;' ,
Service over 320 amps rating ❑ Buildng over 10,000 sq. ft.,
x . z ( _ C'AT CO TION °t. w "11 g ,, e ,, • . , i t 4c , of 1 -and 2- family dwellings 4 or more new residential
s e ' k..t :4it ":� .,.�., ,. .' d"•..° e5b-,.: +.:., �e ,». a�E�, �.:* s�;^.:;' n�c.' a.> z+.« i�' z~* .q�'ur�rr sa- q.+�.:4a.i: t:..xaa�s:sa >: a':t=:`s:.i:e. "s,�. c ac.� ^s+
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: Manufactured structures or
'L ` +.rz }= - ":t .� 1t��r t��� �rxx��'cn�. ,� i:„., >a��a�.�`w.�k'r.� s�.,w i �.:`,y��, i �.,? �w, .
['Occupant load over 99 persons ❑
#Nf -` "''i e�IO ' S1TE.i31kO ION�AND 0�1� tw � ❑Egress /light plan RV park
Job no.: Job site address:
El Health-care facility ❑Other:
7117 Beveland, 2nd Floor Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
; h�r .- .r � Ys" i •.;. y x E:,; S 'H'thAI -1,
Suite/bldg. /apt. no� ' Project name: Ewing —Foley Bldg. Description Qty. Fee. 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'l 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
Tax map /parcel no.:
�� �1 '.�Y a u - -, r>., Y ' 5 - ' Limited energy, non - residential 75.00 2
zT r' ''�i re. e '� :I�'."'..':��'.:y [ 't/WOO
ors ;� t; , ;� ,' & CE S I,, l N w Q a k.WO .," -- R i; ., Each manufactured or modular
�^;a,.. : :kid ; .
dwelling, service and /or feeder 90.90 2
10 circuits for tenant improvements Services or feeders installation, alteration, and /or relocation
• 200 amps or less 80.30 2
'.�- v. ,v.t. ° ;ti ;, =m u r:r3s ,;k' ,'" { ,a,, l f> , as 1 ,,„,.. ,, -: zwrs :::r,.; ti t�...:+ 'i`' °r. *.:: 201 amps to 400 amps 106.85 2
to 'PRY�P ERT'Y g,OWNE Z i? ,.:..: •- -. !t , b ,® i
�• .,mss - �.�.:^ �,„,,�,., „;c�:,�, �.,. ��,� s.�- .,..._�.���.���.r�.��-'�a 401 am to 600 amps 160.60 2
Name: Ewing —Foley 601 amps to 1,000 amps 240.60 2
Address: 7117 Beveland, 2nd Floor Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( 503 630 - 6553 x105 Dalt ORiook 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
�''r ""' '"` "' " r' +''`•v" ` A. Fee for branch circuits with
t ' * f . ;.0 4,at;' yga. �•'z:: x> :,.; , x�'.A ,s�..
.�,. ...P. ;,,.kv, �, �. c's
•g � ® APPT GA 1& z: , a; +d ,,2 GAO A:C „ 1' RSQ1Y . 4 ",
v y S, �.,;v�:w.x:- a a �i,ti�_ ?t' n..... ..<ac,.,.3'uss�:.4.. :5;:.
service or feeder fee, each 6.65 2
Business name: . - branch circuit
B. Fee for branch circuits
Contact name: — • • - - • - without service or feeder fee,
each branch circuit 1 46.85 46. 8J 2
Address: - - - Each add'l branch circuit . 9 6.65 59 . 83 2
City /State /ZIP: • . - Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
.� , . - : i x - Y fv `a - .,, " a ?.' 'r4 a' r ,r 4 n .t ' Va -r ''e �$g ' . energy panel alteration, or
i O . " 0 TRAGMTOR' ., . .a:x i s rt t Ay,..” i i w, r
4E�rSri� �` ,., a " , . -> to n I :ae, '. k 't,a: >, t:. g Y P
extens Descr Page 2 I 2
Business name: Bob's Action Electric
Address: „ „ Each additional inspection over allowable in any of the above
2700 NE Burton Rd. A Per inspection 62.50
City /State /ZIP: Investigation per hour (t hr nun) 62.50
Vancouver, W 98662
Industrial plant per hour - - 73.75
Phone: (- 360) 254 -7200 -Fax: ( - 360) 254 -8219 ee.? "
y�,;,.,, . �+t�".r,`�*+�?t$��EIECTRICAL� �YE,I2IVIITn'i,FEES* � „.. 7 7 � -
CCB Lie.: 53 r36- - Electrical Lie.:- —431 Suprv. Lie.: 4322S Subtotal 106.70 '
- Suprv. Electrician signature, required:, . Plan review (25% of permit fee)
Date: State surcharge (8% of permit fee) 8.545
Print name:
Kevin Bro selle 5/24/05
TOTAL PERMIT FEE 115.24
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 \Pemuts\ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM /WEB
C,TY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 00366
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2005
Phone: (503) 639 -4171. .
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 6/14/2005 TIME: 7:'I0AM PAGE: 51
SITE ADDRESS: 07117 SW BEVELAND RD 200 CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 2 -3 TYPE OF USE:
PROJECT NAME: EVVING -FOLEY
DESCRIPTION: (10) branch circuits.
OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: 503- 598 -3440
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360-254-7200
Inspection Request Scheduled For: Date: 6/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 009195-02 360 -254- 7200 Y 421
Corrections /Comments/ Instructions: •
�en/
1P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: r Ii Phone #: (503) 718-