Permit CHAR I� ELECTRICAL PERMIT
CITY OF TI
V PERMIT #: ELC2006 -00605
DEVELOPMENT SERVICES DATE ISSUED: 10/24/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103DC -01100
SITE ADDRESS: 11075 SW GAARDE ST B ZONING: R -3.5
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Add (1) branch circuit. In Ministry Building. Job No. 80.1614
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: 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:
FIRST BAPTIST CHURCH OF TICE ELECTRIC
TIGARD, THE PO BOX 15009
11075 SW GAARDE PORTLAND, OR 97293 -5009
TIGARD, OR 97223
Phone: Contact #: FAX 503 - 872 - 8290
PRI 503 - 233 -8801
FEES
Description Date Amount Reg #: ELE 26 - 126C
[ELPRMT] ELC Permit 10/24/200( $46.85 LIP 166
[TAX] 8% State Surcharge 10/24/200( $3.75 SUP 2586S
Total $50.60 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 , orth- iq • -2- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of th-. - ,ules or direct questions to OUNC at
503 -2 -6699 or 1 -866 c
lssu d By: f/ = 1 49 Permittee Signature 17,
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 /
!Co - /'��--�— DATE: (1'de
SIGNATURE OF SUPR. ELEC'N <---�' •
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.
w
_ ..:
FOR OFF1Ch. USE ONLY /_ ,r
��® Received �� '( Penn ___ _ _
Electxical� Permit A Date/B 10
City of Tigard ? 2006 Flan Review Other Permit;
/? : c t fin T >atdB See Rage 2 for
13125 SW I�all Blvd.,'Iigaxd, Olt 97223 �C I � Ril•:I Date P.eadyBY'. SuppkmentalXnforzna
Phone: 503.639.b1 Fax: 503,598.196 �FTAOIARD r , �� Notified/Method;
"inspection Litre: 503.639.4175 C 1V1SIO L -- PLAN REVIEW
Internet; www.ci.itgard.or.us �C7
TYPE OF WORK Please check all that apply= Hazardo lo cation
[]Service over 225 amps, corrtm'a ❑
Q New construction ❑ Other: ►:. Addition/alteration/replacement Addition/alteration/replacement Qservice over 320 amps - rating ❑ Buildng oven 1 0,000 sq. •,
4 or more new resi
❑ Demolition of 1- and 2- family dwellings units in one structure
CATEGORY OF CONSTRUCTION psystern oven 600 Volta nominal ❑Feeders, 400 amps or more
Accessory building ❑ Tuilding o ver three stories
❑ 1 - and 2- family dwelling CD Commercial /industzial ❑ � pcoupant load over 99 Persons ❑Msinufactuzed structures or
❑ M aster builder ❑ Other 1--, park
O Multi faztaily ❑Egress/ligliting plan
I
JOB SITE INFOR]yIATION AND LOCATION ❑health -care facility ❑Other:
Job no. : 0 .1 61 4 Sob site address: 1 =5 7 5 SW Gaarde S tree t Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service.
City /State /ZIP: Tigard, OR 97224-3798 FEE* SCHEDULE
••
Qty tr Total
Suite/bldg./apt- no.: 6 Project name: Ti gard 1st Baptist pescript15n
If ow residential single- or multi - family dwelling unit.
Cross street/directions to job site Includes attached garage.
1,000 sq. ft. or less , 145.15 4
`
Ea. add'l 500 sq, ft. or portion 33,40 1.
Lot no.:
Subdivision: Limited energy, residential 75.00 2
Tax map/parcel no -
Limited energy, non 75.00 2
-
DESCRIPTION OF WORK • Each manufactured or modular 2
—Tr— dwelling, service and/or feeder 90.90
add (1) circuit — - Services or feeders installation, alteration, and /or relocation
0 200 amps or less 80.30 2
201 amps to 400 amps I 06.85 2
X1 PROPERTY OWNER 0 TENANT 401 amps to 600 amps 160.60 2
Name: Tigard First Baptist Church 601 amps to 1,000 amps 240.60 2
Address: 1 1 07 5 SW Gaarde Street Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Tigard, OR 97224-3798 Temporary services or feeders installation, alteration, and /or
relocation
Phone: 5 0 3 ) 639-3913 Fax: ( M ) _ 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 arzaps 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. Pee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
E.1'ee for branch circuits ~
Contact name: without service or feeder fee,
Address: each branch circuit 1 46,85 46 . 8 �
Each add'l branch circuit 6.65 I
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
-
Phone: ( ) Pax: ( ) Sign or outline lighting 53.40 2
$ mail: Signal circuits) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Tice Electric Co
Address: . Each additional inspection over allowable in any of the above
5405 N N. L a•oo n Avenue
Per inspection 62.50
City /State /ZIP Portland , O R 9 7 21 7 Investigation per hour (i hr min) 62.50
Phone: ( 503) 233 -8801 Fax: (503 ) 872 -8290 Industrial plant per hour 73.75
ELECTRICAL PEItIVIIT FEES* —
CCB Lic.: 166 Electrical Lic.: 26 --126C Suprv. Lic_: 25865 Subtotal 46.85
Supty. Electrician signature, required: /� �, Plan review (25% of pemut Cee)
Print name: John J. Maloney Date: 10/24/06 State surcharge (8% of pernut fee) 3.75
TOTAL PERMIT FEE 50.60
Authorized $igriature: This permit application expires ifs permit is our obtained within 180
days after it has been accepted as complete
Print name: - Date: * Fee tnethodoiogy set by Tn- County Building Industry Service Board
^^ Number of inspections per permit allowed.
is�B°l lalng�Pctcr ,itetELGPetntitAyp.00C )i /O7 4 0 -46 i5Tt I 0 /02/COMnvea
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC0 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2005
Phone: (503) 639 -4171 1pill
Inspection Requests (24 Hrs.): (503) 639 -4175 1
INSPECTION WORKSHEET FOR DATE: /211212008 TIME: 7 :01AM PAGE: 10
SITE ADDRESS: 11075 SW GAARDE ST B CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FIRST BAPTIST CHURCH
DESCRIPTION: Add (1) branch circuit. In Ministry Building. Job No. 801514
OWNER: FIRST BAPTIST CHURCH OF, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503-233-880-1
Inspection Request Scheduled For: Date: 121/2/2005 Pour Time:
Code # Inspection Description Co irm # Contact # Message
ir3 Electrical final 040972 -01 503-341 -7312 Y
Corrections /Comments /Instructions: '^ -- - 1 _) 3 Li 3
oil. 0 t
,PASS n PARTIAL APPROVAL n CANCEL I NO ACCESS
,, `` FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G Date: L 64 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2806 -00605
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/14/2006
Phone: (503) 639 -4171 i'`I
Inspection Requests (24 Hrs.): (503) 639 -4175 W__..
INSPECTION WORKSHEET FOR DATE: 12/11/2006 TIME: 7: OOAIrtI PAGE: 29
SITE ADDRESS: 11075 SW GAARDE ST B CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT. NAME: FIRST BAPTIST CHURCH
DESCRIPTION: Add (1) branch circuit. In Ministry Building. Job No. 80.1614
OWNER: FIRST BAPTIST CHURCH OF, PHONE #:
CONTRACTOR: TICE ELECTRIC, G,.ck,EG PHONE #: . 503 -233 B30I
Inspection Request Scheduled For: Date: 12/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040886 -01 503 -341 -7312 Y
�I
Corrections /Comments /Instructions: � (\A•7 3fl 13ti3
SIE t AJ I' Z V -- Po 67 CZ ■i Y(L Art D
s vwcafi`,f J( C- 0:37
sr'- Novi I6 N c.)0-- -estt. eA "v. L. C1
vlse I QN
n PASS 11 PARTIAL APPROVAL I I CANCEL I I NO ACCESS
FAIL . KCALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: G N tg L. Date: 12-4 t1[ '0 10 Phone #: (503) 718- 2-94-‘, 6►