Permit :, 1
. ' CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006-00269
a �1 41 DEVELOPMENT SERVICES DATE ISSUED: 5/15/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111 BC - 02600
SITE ADDRESS: 10310 SW CANTERBURY LN ZONING: R - 3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT : 005 JURISDICTION: TIG
Project Description: (1) 200 amp service & (1) 100 amp generator.
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: 2 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:
CITY OF TIGARD RED HILLS ELECTRIC & TOWER SERVICES
13125 SW HALL PO BOX 490
TIGARD, OR 97223 DUNDEE, OR 97115
Phone: 503 - 639 - 4171 Contact #: PRI 503 - 554 -8244
FAX 503- 554 -1735
FEES
Description Date Amount Reg #: ELE 36 -84C
[TAX] 8% State Surcharge 5/15/2006 $12.85 LIC 134593
[ELPRMT] ELC Permit 5/15/2006 $160.60 SUP 43905
Total $173.45 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at 03- 246 -6699 or
1- 800 - 332 -2344.
Issued By: 11 j ... < Permittee Signature: 1i1,,Z._ d
ki
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
L.
. r
,Electrical Permit Application FOR OFFICE. USE ONLY •
P
City of Tigard EC Date/B �_ 0 k:., )./ Permit No.: 'L U
' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' , ®? . Phone: 503.639.4171 Fax: 503.598.1960 r- C Date /By. Other Permit:
• T` I G A R D Inspection Line: 503.639.4175 1 5 2006 Date ReadyBy: ®see Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WO_I$kI Y L) r; I IGAR5 PLAN REVIEW
ew construction elO DTV!SION P lease check all that apply:
❑ Addition/altera o r ep acement pp I y
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
1:1 1- and 2- family dwelling c;ommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ['Building over three stories ❑Feeders, 400 amps or more
0 DOccupant load over 99 persons 0 Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lightingplan RV park
,� ,/I ❑Health -care facility :Other:
Job no.: Job site address:
Jo 3 //J Suy L''l4z isRR u r y 6t) Submit 2 sets of plans with any of the above.
City / State/ZIP: i t A p er-y .9.- if The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: FEE* SCHEDULE
a i ec A q Description I Qty. I Fee. I Total I ""
Cross street/directions to job site: S , f_j L , i 44 to 4,4 g_ i>. , . 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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/� � _ / S dwelling, service and/or feeder • 90.90 2
2tY U 0 .S ! w- 4/fe,r d /9 Ay. Csi 'tr` . //.[ tbji— Services or feeders installation, alteration, and /or relocation
— c) R 0 v ��� T¢ En....- 200 amps or less 80.30 M p .f 2
1 :❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City / State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
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
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: ( r r iS
Address: Each additional inspection over allowable in any of the above
P d ( 13i-K 4 Per inspection 62.50
City/State/ZIP: ci,u bt9 6 `r),/ Investigation per hour (I hr min) 62.50
Phone: X6,3) 1 �-�_ 2 4 Fax: c 3) 5:54--4 _ i 7 7,s-' Industrial plant per hour 73.75
ELECTRICAL PERMIT FEE*
CCB Lic.: /34,4•-q3 Electrical Lic.: `_g‘ e prv. Lic.: 43cfd S- Subtotal: ifr 6 6
Suprv. Electrician signature, required: . 6 , Plan review (25% of permit fee):
Print name: / G
^ State surcharge (8% of permit fee): J2
X j t I/ j„, g , p, e- ,/ Da e: , yi �/� TOTAL PERMIT FEE
i 7 3 y5
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.
1:\ Building \Permits \ELC- PermitApp.doc 03/23/06 440- 46t5T( I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL' WORK
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door "Opener*
•
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: -
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD . e.
BUILDING DIVISION PERMIT #: ELC200&.00269 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/15/2006
Phone: (503) 639 -4171 A II °1 V
Inspection Requests (24 Hrs.): (503) 639 -4175 ..'W °`
INSPECTION WORKSHEET FOR DATE: 6/5/2006 TIME: 7:02AM PAGE: 73
SITE ADDRESS: 10310 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WCCCA 911 MONOPOLE TOWER
DESCRIPTION: (1) 200 amp service & (1) 100 amp generator.
OWNER: CITY OF TIGARD, PHONE #: 503 - 639.4171
CONTRACTOR: RED HILLS ELECTRIC & TOWER SERVICES PHONE #: 503-554 -8244
Inspection Request Scheduled For: Date: 6/512006 Pour Time:
C.. # Inspection Description Confirm # Contact # Message
VD— . -..- ' • I service 031045 -01 503-969 -4064 Y
.. ecti ns /Comments /Ins • ctions:
S CAI ', Q.�� 1 o - i,YV`�
NI _
' A t $ % 1 S A VSIL1'4" i
a_
- 1 -%'s• ° . N obi,
C .,t ...... pf n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V -4 0 L Date: 4 / 6 166 Phone #: (503) 718 - 2 410
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200S -00269
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/15/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/2/2006 TIME: 7:08AM PAGE: 24
SITE ADDRESS: 10310 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WCCCA 911 MONOPOLE TOWER
DESCRIPTION: (1) 200 amp service & (1) 100 amp generator.
OWNER: CITY OF TIGARD, PHONE #: 503-639 -4171
CONTRACTOR: RED HILLS ELECTRIC & TOWER SERVICES � SCO ' IT PHONE #: 503- 5b4-0244
Inspection Request Scheduled For: Date: 61212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 031016 -01 503 -969 -4054 Y
CALL
Corrections /Comments /Instructions:
L
n PASS 1 PARTIAL APPROVAL ANCEL NO ACCESS
FAIL ' ❑ CALL FOR INSPECTION NAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-