Permit .
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00419
DEVELOPMENT SERVICES ' ' DATE ISSUED: 6/17/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101 BB -01400
SITE ADDRESS: 12070 SW GARDEN PL BLD5 ZONING: C -G
SUBDIVISION: PARK 217 LOT : 002 JURISDICTION: TIG
Project Description: New panel. Job # 250600.
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: 4 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:
SPIEKER PROPERTIES LP CAPITOL ELECTRIC CO INC
4380 SW MACADAM AVE STE 100 11401 NE MARX ST
PORTLAND, OR 97201 PORTLAND, OR 97220 -1041
Phone: Phone: 503 - 255 -9488
FEES Reg #: LIC 048748
3132S
Description Date Amount SUP 26-49
ELE 26 -496C
[ELPRMT] ELC Permit 6/17/2005 $106.90
[TAX] 8% State Surcharge 6/17/2005 $8.55 REQUIRED ITEMS AND REPORTS
Total $115.45
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: Permittee Signature: (?),
V
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.
,. - . • FOR OFFICE USE ONLY
Electrical Permit y
Appl � + /� I Datei 4 % 7-0 J ( , n ermit no.:�C, f� { — O j /9 kia City of Tigard �� • Plan Review
!^,,,; � f► Other Permit:
13125 SW HALL BLVD., TIGARD, OR 97223UN All Date/By:
1111 (�
Phone: (503) 639 -4171 Fax (503) 598 -1960 6 2005 , CITY OF TIGARD Date Ready /By: Juris: / / / ❑ See Page 2 for
Inspection Line: 503- 639 -4175 Notified /Method: '( U Supplemental Information
Internet: www.ci.tigard.or.us rs , p .9 OF T!6Aun
Y . -
'�EbF'�'IRAMfflfcc.n .
❑ New construction ❑ Addition /alteration /replacement r t r.. PLAN
. Please check all that apply:
❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'l ❑ Hazardous location
CATEGORY OF CONSTRUCTION ❑ Service over 320 amps - rating ❑ Building over 10,000 sq.ft.
❑ I- and 2- family dwelling H Commercial /industrial ❑ Accessory building of 1- and 2- family dwellings 4 or more new residential
❑ Multi- family ❑ Master Builder ❑ Other ❑ System over 600 volts nominal units in one structure
JOB SITE INFORMATION AND. LOCATION ❑ Building over three stories ❑ Feeders, 400 amps or more
Job no.:F8l6 Job site address: 12070 SW Garden Place Rd ❑ Occupant load over 99 persons ❑ Manufactured structures or
aj OC,c)0 ❑ Egress /lighting plan RV park
City /State /ZIP: Tigard Or ❑ Health -care facility ❑ Other:
Submit 2 sets of plans with any of the above.
Suite/bldg. /apt. no.: Project name: New House Panel Bldg 5 The above are not applicable to temporary construction service.
FEE.SCHEDULE
Cross Street/Directions to job site: Description I Qty. I Fee. I Total I "
New residential - singie or multi - family dwelling unit.
Subdivision: Lot no.: Includes attached garage.
1000 sq. ft. or less $ 145:15 4
Tax map /parcel no.: Ea. Add'I 500 sq. ft or portion $ 33.40 1
DESCRIPTION OF WORK Limited energy residential $ 75.00 2
Install house panel to control bld lights Limited energy, non - residential $ 75.00 2
Each manufactured home or modular
❑ PROPERTY OWNER I ❑ TENANT dwelling, Service and /or feeder $ 90.90 2
Name: Service or feeders installation, alteration, and /or relocation
Rreef Management 200 amps or less 1 $ 80.30 80.30 2
Address: 720 SW Washington St 201 amps to 400 amps $ 106.85 2
401 amps to 600 amps $ 60.60 2
City /State /ZIP: Portland, Or 601 amps to 1000 amps $ 240.60 2
Over 1000 amps or volts $ 454.65 2
Phone: Fax: Reconnect only $ 66.85 2
503- 295 -5555 Temporary services or feeders installation, alteration, and /or
Owner installation: This installation is being made on property that I own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less $ 66.85 1
Owner signature: Date: 201 amps to 400 amps $ 100.30 2
401 amps to 600 amps $ 133.75 2
❑ APPLICANT I ❑ CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
Business Name: A. Fee for branch circuits with
service or feeder fee, each
Contact name: branch circuit 4 $ 6.65 26.60 2
B. Fee for'branch circuits
Address: without service or feeder fee,
each branch circuit $ 46.85 2
City /State /ZIP: Each additional branch circuit: $ 6.65 2
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 circuits(s) or limited -
CONTRACTOR energy panel, alteration, or
Business Name: CAPITOL ELECTRIC CO., INC. extension. Describe: Page 2 2
Contact name: Each additional inspection over allowable in any of the above
Per inspection $ 62.50
Address: 11401 NE MARX ST. Investigation per hour (1 hr min) $ 62.50
Industrial plant per hour $ 73.75
City /State /ZIP: PORTLAND, OR 97220 -1041 ELECTRICAL PERMIT FEES*
Subtotal 106.90
Phone: 503 - 255 -9488 Fax: 503- 257 -7121 Plan review (25% of permit fee)
State surcharge ( 8% of permit fee) 8.55
CCB Lie.: 48748 Electrical Lie.: 26 -496C 1Suprv. Lit 2865 -S TOTAL PERMIT FEE 115.45
Suprv. Electrician signature, required:
�AV Yi This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print Name: Richard Martin Date: 06/14/05 * Fee methodology set by Tri -County Building Industry Service Board
—
Authorized signature: * *Number of inspections per permit allowed.
Print Name: Richard Martin
14111 ' OF TIGARD
BUILDING DIVISION - . PERMIT #: ELC2005 -00419
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1712005
Phone: (503) 639 -4171 Jitppliit
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 81
SITE ADDRESS: 12070 SW GARDEN PL BLDG CLASS OF WORK:
SUBDIVISION: PARK 217 EKF Pi TYPE OF USE:
PROJECT NAME:
DESCRIPTION: New panel. Job # 250600.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503.255 -9488
Inspection Request Scheduled For: Date: 6/30/2005 Pour Time:
Code # I c ion ss ' tion Confirm # Contact # Message
116 Electrical service 010522 -01 971 -506 --3054 V
Corrections /Commen t ructions: Q /II
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ C L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / / Date: 90 N Phone #: (503) 718-