Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00115
DEVELOPMENT SERVICES DATE ISSUED: 2/28/2005
1r � " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135BC-00500
SITE ADDRESS: 10770 SW CASCADE AVE
ZONING: I -
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Connect dyno machine, (4) branch circuits. Job # 70952.
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: 4 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MIKE DURBIN L H MORRIS ELECTRIC INC
10770 SW CASCADE BLVD 7051 SW SANDBURG ST, #100
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503 - 924 -3700 Phone: 503 - 639 -2334
FEES Reg #: LIC 1838
ELE 20 -39C
Description Date Amount SUP 3006S
[ELPRMT] ELC Permit 2/28/2005 $66.80
[TAX] 8% State Surcharge 2/28/2005 $5.34 REQUIRED ITEMS AND REPORTS
Total $72.14
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: � 1 Permittee Signature:
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.
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 Ap c kW:- *tit / `FOR OFFICE USE ONLY
City of Tigard Received
�r �� Permit No.: r r �GCI
13125 SW'Hall Blvd., Tigard, OR 97223 �® yr� n, �� , - � SI
g � Pl an Review
Phone: 503.639.4171 Fax: 503.598.194 E6 2 aI Other Perm t'li � Date/By: it:
Inspection Line: 503.639.4175 _"14:1 C' I� D Date Ready/By: Juris. 0 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF Notified/Method: l / ( , Supplemental Information
� `,., , ,fir -�,,� �»._ � �'j ,ti, •.�,c, a �.;, � .�o -, , .;, P � .; .
J .��,.-tiAN:,. REVIEW xc; ' ° -; -n
❑ New construction Addition /alterationTt' lacement Please check all that apply:
❑ Demolition 111 Other: ❑ Service over 225 amps, comm'l ❑Hazardous location
b .•it° Ft ,:e ,' � �;:
,,, ,as., „ „_,, -, ,, ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
»>'°'`'t7�'"`�- 'CA'TEGORYi OF CONSTRUCTION r. o f 1- an d 2-family y dwellin s 2- it more new residential
g 4 or o
❑ 1- and 2- family dwelling l{Commercial /industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure
❑ Multi - family 0 builder ❑Building over three stories ['Feeders, 400 amps or more
;, *457, ., - .;-c::.:.:...,: a..- persons red structures or
Other ❑Occupant load over 99 e ['Manufactured
;JOBSITE INF®RMA`TI AND'IO'CATION_" ;`_ °" ='-` s " `' „, plan RV park
s.:,.,. _,.: .: • , ��„.,.,_�,.., � : ;�, E /li P
Job no.: 70952 Job site address: 10770 SW CASCADE AVE
❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: T IGARD OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name "; '' l : - k : ' FEE "SCHEDULE ; °,. " : ° % "r % :
P ARADISE HARLEY ARLEY
Description Qty. I Fee. n I - Total
Cross street /directions to job site: DAVIDSON New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less I I 145.15 I 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
' -� '` `�, �'�'> %�: ��F �:.,.�,:; ` ?s :sue:,-: <s��- ;: ";, 9
i ', DESCRIPTION- OF;KW,O4?,,'.E �r;•; ,,, • ,
._,,:;�,,;; �< ,� ,,,.. � 'sw .,. ,..,h. ,,,;,...., .. � ��„�, Each manufactured or modular
dwelling, service and /or feeder 90.90 2
CONNECT DYNO MACHINE Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
ri:' sF;�iia;. % . ;, � : ,, ! . 201 amps to 400 amps 106.85 2
®; ° - •OW NER; °� €p,r�; ' ; TENAN ,Tai" , ;,: %.y.::;
,-� ,, ,. r - , .., .... . . ... .......i.-
„ - � •..,,..., -.... . 401 mps 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: Fax: ( ) • - - - 200 amps or less 66.85 I
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
P t '``%`X' i< =`' A ' : : ;CONTACT- PERSON ',`'; ` <I A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: L.H. MORRIS ELECTRIC INC branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit 1 46.85 4 6 8 5 2
Each add'l branch circuit 3 6.65 19.95 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: (503) 631 -2334 Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
„' ; ._ l ,z;,;'4 €, , .:i..�,3, energy panel, alt r ion
�.;, - : �� COIVTRAC�'T > R _ � ' ' �_.� gY P e att , or
extension. Describe: Page 2 2
Business name: L.H. MORRIS ELECTRIC INC
Address: 7051 SW SANDBURG ST #100 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: TIGARD OR 97223 _ Investigation per hour (1 hr nun) . 62.50
•
Phone: (503) 631 -2334 .. Fax: (503) 620 -7405 Industrial plant per hour .. , 73.75
, ,.. 'ELECTRICAL „PERIVIILFEESj! `s , -
CCB Lie.:_ 1838 ._ __ _ Electrical Lie 20 Suprv. Lie.: 3006 S u b tota l 6 6 : 8 0 -
Suprv. Electrician signature, required: a , �, Plan review (25% of permit fee)
Print name (v\ D 14_0s State surcharge (8% of permit fee) 5 , 3 4
GARY PEOPLES a TOTAL PERMIT FEE 72.14
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 \Permits\ELC- PermitApp doe 12/03 440- 4615T(10/02/COM/WEB
CITY O F TIGARD
BUILDING DIVISION PERMIT #: ELC2006.00115
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/28/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' ..
INSPECTION WORKSHEET FOR DATE: 3/24/2005 TIME: 7 :09AM PAGE: 62
SITE ADDRESS: 10770 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PARADISE HARLEY DAVIDSON
DESCRIPTION: Connect dyno machine, (4) branch circuits. Job # 70952.
OWNER: DURBIN, MIKE PHONE #: 503 - 924 -3700
CONTRACTOR: L H MORRIS ELECTRIC INC PHONE #: 503 - 639.2334
Inspection Request Scheduled For: Date: 3/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002668 -01 603 - 8801319 V
Corrections /Comments /Instructions:
,AD %fig G G a - •, = -
1-)
•
Th
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 619,Y 1 /C7� Date: 3 U V/" Phone #: (503) 718-
•
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