Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00095
�.�� DEVELOPMENT SERVICES DATE ISSUED: 2/26/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 2S112BD
SITE ADDRESS: 07520 SW BONITA RD 004
SUBDIVISION: TIFFANY COURT APT. ZONING: R-12
BLOCK: LOT : 065 JURISDICTION: TIG I
Project Description: Alteration of (10) branch circuits in Units #4 & #8. Installation of (1) GFI, (1) heater and (1) smoke
detector in each unit.
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: i9' / 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:
WASHINGTON CO. HOUSING AUTHORITY SYLVANIA ELECTRIC CO
111 NE LINCOLN ST 5328 SE 109
#200 -L, MS63 PORTLAND, OR 97266
HILLSBORO, OR 97124 -3082
Phone: 503 - 846 -4794 Phone: 503 - 762 -2714
Reg #: ELE 26 -1086C .
LIC 110400
'
FEES SUP 4830S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/26/03 $106.70
[TAX] 8% State Tax 2/26/03 $8.54 Rough -in
Elect'I Final
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 th41 da'js1-.4TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in AR 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- 32 -2344.
Iss ed By: , /, ; t -- A , l � , I' .' / Permit Signature: Allifil
OWNER INSTALLATION ONLY ir _
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
C a TRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �:.� l�� DATE: 2— �Z(? (-0
• LICENSE NO: +'
Calls • 4175 by 7:00pm for an inspection the next business day
` FOR OFFICE. USE ONLY'.
Electrical Permit Application Received e'5 per �0"� 3 ���
,1I
Date/By:
A o.:
'
Cit o f Ti and Planning Approval Sign
Y g Date /By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post-Review Land Use
m fP t Contact Case No.:
Internet: www.ci.tigard.or.us, i� �� ' I I l
Contact Juris.: Z See Page 2 for .
24 -hour Inspection Request: 503-639-4175 Name /Method: Supplemental Information. 1
psi i x a * 'r . ,.*x :e § , , r " `. r ,. r .• s` i i i fiIs ,, tm f : : ;4
�.,� .:•,�•�� .' �.�> ��TYPE�OFW,ORK: '�'�.��'.�,:t K. �; . �� � „�..,�z�.� � PLAN�REVIEW�(Please check1a11;that.:aPrPIY). -:���:�.� k
❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility •
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
MiTIMMSILVATEcoavOrle'eNsTatirOriogriIc::1-01iTR' I & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
Q -�, r , -. „^, Submit sets of plans with any of the above.
,,,,JOB SIT:EINFORMATION and..LOCATION�,;
The above are not applicable to temporary construction service.
Job site address: ' 75A0 5 (4 go N 11-F} - 'LFEE SCHEDULE `rl`” '
Suite #: Bldg. /Apt. #: 1l 1 g , _ Number of inspections per permit allowed
Project Name: Ca W 17 .�" vet-t---a iv. Description Qty Fee (ea.) Total f
Cross street/Directions to job site: A New residential - single or multi - family per 1
m d� dwelling unit. Includes attached garage.
04\1{T8 n - c rrr " Service included:
W 1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
� . a - DESGRIPTIONiOF4WORK � : "` ;,, ' service and/or feeder 90.90 2
�m -rA.." �� / /� r'�
/ ,t04. l_ i 1 (5
Services l alteration or feeders - installation,
j alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
5i 1PROPERTY S N ER r Wr41 . el TFNANT„ i i ' -' E .,_ 601 amps to 1000 amps 240.60
Over 1000 amps or volts 454.65 2
Name: Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: 200 amps or less 66.85 I
Phone: Fax: 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
APPLICANT r,` ', <. ❑ CgNTACT PERSON.;= U Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of , /
service or feeder fee, first branch circuit / 46.85 7 fi 2
Phone: Fax: Each additional branch circuit 9 6.65 ,5 p. k5 2
E-mail: Misc.(Service or feeder not included):
Each p or irrigation circle
{. 53.40 2
c , „ itIsT ,:._ ` ge ` �w;k ^ ... V. Each sign or outline • lighting 53.40 2
J 5 sit- i e N( 6 � G C. 1 Signal circuit(s) or a limited energy panel,
Business Name: Description: or extension Page 2 2
_ • t ,il Descri p tion:
Address: h 3 2 S 5 E /G e/ 1 -
City /State /Zip: ?a r fl (i./C -L\ O / Q b LG Each additional inspection over the allowable in any of the above:
J Per inspection per hour (min. 1 hour) 62.50
Phone: (co?) el (3 -- 2 00'5 Fax: ( Investigation fee:
Other
CCB Lie. #: 110 0 0 Lic. #: Z6 ° f o$ 6 C _ _ ree a xm- - * :. xt
/ ,: � °,��,Electrtcal,PermitFet;s�, _,,.;a,, �,,,, � .
Supervising electrician Subtotal $ /t t$ ' .7D
signature required: ♦' , ..."--- _ Plan Review (25% of Permit Fee) $
Print Name: / : Lie. # : '�j 3O State Surcharge (8% of Permit Fee) $ 6.5y
i U M . TOTAL PERMIT FEE $ / / ,�j •
Authorized Notice: This permit application expires if a permit is not obtained wi ?in
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set.by Tri -County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information - -
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Burglar Alarm
n Garage Door Opener
n Heating, Ventilation and Air Conditioning System
n Vacuum Systems
❑ Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
I T Audio and Stereo Systems
n Boiler Controls
•
n Clock Systems
n Data Telecommunication Installation
Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control
n Medical
n Nurse Calls
n Outdoor Landscape Lighting
n Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations -
i: \Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested Z7( /O AM 5 a' _ PM BUP
Y FF''
Location 7 D 0,411 I
� Suite �f 6 MINA
MEC
Contact Person Ph ( ) 7 / 3 34 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner l A (A--L ELC 3 - D v D
Footing
Foundation ELC
Access:
Ftg Drain . ��y� ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
' Ext Sheath/Shear
Int Sheath/Shear t� _
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling — 1
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 C
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam J 5
Rough -In / - J
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
V PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA Date' / 0 '5 Inspector - Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL