Permit I ELECTRICAL PERMIT
CITY OF TIGARD
d� 4• PE RMIT #: ELC2005 -00277
DEVELOPMENT SERVICES DATE ISSUED: 4/25/2005
�`^" �' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 BC -02800
SITE ADDRESS: 10445 SW CANTERBURY LN ZONING: R -3.5
SUBDIVISION: LOT : 3.4 JURISDICTION: TIG
Project Description: Feeder rewire.
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: 1 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:
PRESBYTERY OF PORTLAND THE ENDERS ELECTRIC
CALVIN PRESBYTERIAN CHURCH PO BOX 1661
10445 SW CANTERBURY LN BEAVERTON, OR 97075
TIGARD, OR 97224
Phone: Phone: 503 - 626 -4813
503 - 646 -3871
FEES Reg #: LIC 00026728
Description Date Amount SUP 2028S
ELE 34 -265C
[ELPRMT] ELC Permit 4/25/2005 $80.30
[TAX] 8% State Surcharge 4/25/2005 $6.42 REQUIRED ITEMS AND REPORTS
Total $86.72
•
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: P�/ , �.,� . G * . i � L Permittee Signature: ..e- c � n
OWNER INSTALLATION ONLY r
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.
•
Flp14 22 05 O1:10p ENDERS ELECTRIC 503 -646 -3871 P.3
•
Electrical Pcirhait 'c
�i• FOR OFFICE USE ONLY • .
City of Tigard i v ED Received 97223
_
13125 SW Hall Blvd., Tigard, OR Date/By: T V ?8/7_',..._ - Permit Nn :�� - C 7 01
Plan Review -- -- sic �' �-
Phone: 503.639.4171 Fax 503.598.1 /4,,,,, a t\
Inspection Line: 503.639.4175 2 2 2005 �'P ; j� � � i . Date /By: - Other I'crnlic
Internee www.ci.tigard.or.us 'r` "' Notified/Method:
S See Page 2 fur I
. _ In uwrut Inl
ate ea
d/13
Y Y
1ri
�ili � � Su rte
�� � ' r
.`. ...,..._ '�hftC� ' �,`„ ,.r,.,�;!tz:':�:Ray'.•i.:.,..... ,. . /
�i:::..,yr,..,J�F. ? ;�;= .'rtsti`:r. + _,..,.:;PLAN.REVIEW.
New construction 13 Addition/alteration /replacement Please check all that apply:
❑ Demolition
❑ Other: ❑Service over 225 amps. cuntni'I J I to %at l us hi ;u lull
yt ,i ," i 4+ H ,a., � •a• 1 r ,� ..... •,,c,,` �L:. ,. ❑Service over 320 al
f,:: �i sS., (C r i..,, ,:w : `; ,..:> `TE t.(`E 6 11 I ( t , :� °; :r. :r amps • rating ❑ d t u, er 10.0
y =r:r I Bwl r UU so. It..
i = t V ' : �' „ 'r ' „ of I• and 2-family dwellings 4 or more new residcnlioI
❑ I - and 2- family dwelling al Commercial/industrial ❑ Accessory building ❑System Over 000 volts nominal units in One structure
❑ Multi ❑ Other: 13uildirtg over three stories
Y ❑Master builder ❑ c t ories ❑Feeders, 400 amps or ll
::v'c,rr�e la;ty , +( t,yi:i �01'� ITE ; any T t"t:'; ❑Occu>ant load over 09 p ❑ itlitol itrut:lo : „r
t `: f cyst n, Munula
+...... -. ❑L•gress /Iightingplan k\ park
Job no.: ! Job site address: 10445 SW Canterbury Lane ❑llealth•care facility ❑'thee
Submit 2 sets ul'plans with any of the above.
City /State /ZIP: Tigard OR 97223
g The above are not applicable to temporary construction :evice
-
Suite /bldg. /apt. no.: I Project name: Calvin Church FEE* SCHEDULE __________
Uescriptiar' I Qty. Fee. 1 - 7 1 7 ‘;71 - 7: - .. 'I'ir
Cross street/directions to job site: New residential single- or multi- cannily dwelling unit.
Includes attached garage.
I 900 sq. 0. or less 145.15 4
Subdivision: l Ea. add'I 500 sq. II. or porton 33 40
�_ I
Tax map /parcel no.: Limited ever
I Lot no.: Limited energy 75.00 -- __.. ...
--
4,'a P,i. '•,7 .. tr �n \Ii`::, . o Liid nun- - ___ .. -
h "\ energy, residential 75.00 2
wi . t ;>#isr:. Ir;: <..a., ':, sV. ., �r L'lp � n ° !( ,i':';:;r- l.:;.. •
Each manufactured or modular -
Feeder rewire dwelling, service and /or feeder 90.90 7
-' i
- - - -- Services or feeders installation, alterat and /or relocation
200 amps or less 1 80.30 80. 30 L _ _ .. �
•
ft ,.; }SM1 ' ^ e : r,r .. 4' .. r : �Ct •M t }I ... / lFM1'f7e -.•.T<...r _ J
,, ;�;��, 7' d' amps it) R00 amps
f+?I,... :; } ®: , J! „ �� ' ' �'R it`:�,,;`�;4� ;�,• �3`� ��r��{{ �;�� s ,,J.�r 'rkjJ w'•,,�p � 201 p" P IOG.85 �
Name: 401 amps to 600 amps 1 G0 - I
Calvin Presbyterian Church 601 amps to 1,000 amps 240.60
Address: 10445 SW v - - - ] 2
W Canterbury LA NE Over 1,000 amps or volts 454.65 2
Cit /State /ZIP: Tigard, OR 97223 Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and /ur
Phone: 603 ) 639 -3273 J Fax:( 503) 603 -0703 relocation - -4
or Owner installation: This installation is being made on property that I own which is not 20 amps to less 00.3 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
201 amps to 400 amps 100.30
401 amps to 600 amps 133.75 '
-
Owner signature: Date:
Brandt circuits - new, � alteration, or extension, per panel ^�
"�?� -�,� ��+ � �. k4 kl ,,�� tV ''. <�!S �xf �` t 1"ir,;'t , r utr r. -- - - --
c ` + v Mal iy4 qt 'r�,3,�c,QN, .(,�, C "� `= A. Fee for branch c ircuits with
.• Y.i6't,. �:t�?�'TaS.pFr ;� "�'s�::.r,.;�> �,h � i
Business name: service or feeder fee, each
Endel-„5 Electric Inc branch circuit 6'65
Contact name: Allen G Robertson B. Fee for branch circuits
- without service ur leeder lee,
Address: each branch circus 4 6'85 2
P.O. Box 1661 r _
Each add'I branch circuit 6.6j , 1
City /State /ZIP: -
Beaverton OR 97075 Miscellaneous (service or feeder not included)
Phone: (503 ) 626 -4813 l Fax:: (503 )646 -3871 Puntp or irrigation circle 53.40 2 j
Sign Or outline lighting � .7 L• - mail: 6 6 b 5).40
c1'r?ra ii' '.`?rG "4 n ", �..,r:> .s; Signal circuits) or limited-
+ -. .:r:,a.„ .. g�;.+1:,,; ''' energy panel, alteration, or
Business name: extension. Describe: Page 2 2
Enders Electric Inc
Address: P0•'Box 1661 Each additional inspection over allowable in airy of the above 1
City /State/ZIP: - Per inspection I 62.50
Reave t" t OR 9707.5 Investigation per hour (1 hr min) 02.50
Phon503 ) 626 - 4813 1 Fax: (503) 646 -3871 Industrial plant per hour 73.7;
. ..' .3 .'‘ . EL CT1tCAL' PERMIT FEES*
CCB Lie.: 26728 l Electrical Lie.: 34 65C I S j up�, 6853
'% `►' Subtotal 80.30 _
Suprv. Electrician signature, required:
Plan review (25% of permit Ito) ~^
f
Print name: Allen G Robertson Date: 04/22/2005 - State surcharge (11% of permit fee) 6.43
Authorized signature: TOTAL PERMIT FN;E 86.
This permit application expires it a permit is not oirtaiued within f sn ..-.
Print name: days after it has berm accepted as complete
Date: • fee methodology set by Tri- County Building Industry Service Huard
" Nurturer of inspections per permit allowed.
i: \Permits \Lt_C•PermitApp.d 12/03 44o- 4ri15T I Wits
( J(:OM /Wtill
CITY OF TIGARD
BUILDING DIVISION - -. a PERMIT #: ELC2005.00277
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2005
Phone: (503) 639 -4171 7afilitill'I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 106
SITE ADDRESS: 10445 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: LOT #: 3 ' 4 n ty TYPE OF USE:
PROJECT NAME: CALVIN PRESBYTERIAN CHURCH `�
DESCRIPTION: Feeder rewire. •
OWNER: PRESBYTERY OF PORTLAND THE, 0(
PHONE #:
CONTRACTOR: ENDERS ELECTRIC PHONE #: 503 - 646.3871
Inspection Request Scheduled For: Date: 4/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005533-01 503 - 793 -5196 N
Corrections /Commen s /Instructions:
Ili 4
i
•
r . ,..
EV PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� --- "6/ ✓
Inspector: 4 � 67------I 67------I Date: �` L Phone #: (503) 718-