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Permit CITY TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00330 . 4 .1,7 1 451Z , DEVELOPMENT SERVICES DATE ISSUED: 6/9/2004 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 - 4171 PARCEL: 1S135BC - 00201 SFTE ADDRESS: J117.65 SW GREENBURG RD I I SUBDIVISION: �(p3 ZONING: C-G BLOCK: LOT : JURISDICTION: TIG Project Description: Install (7) circuits. 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: 6 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: BUSINESS POPERTY DEVELOPMENT VIKING ELECTRIC INC BY SOUTH LAND CORP 4326 SE WOODSTOCK 2202017TH AVE. SE STE 200 STE 518 BOTHELL, WA 98021 PORTLAND, OR 97206 Phone: 425 - 483 -1811 Phone: 775 -3479 Reg #: LIC 00056527 SUP 3088S FEES ELE 26 -569C Description Date Amount Required Inspections [TAX] 8% State Surcharge 6/9/2004 $6.94 [ELPRMT] ELC Permit 6/9/2004 $86.75 Rough - Elect'I Final Total $93.69 • 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 -33 2344. Issued By: / CA ZAA0 , Permit Signature: � OWNER INSTALLATION ONLY 1 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 • Electrical Permit Application _ ' . FOR OFFICEUSE ONLY - M , City of Tigard Receive. g Date /B :do' 64/ 0 / Permit No. ..2e {,7033&I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi: Phone: 503.639.4171 Fax: 503.598.1960 a�Nl i j Date Other Permit: Inspection Line: 503.639.4175 , R ` .F! B Date Ready /By: WM ® See Page 2 for .Interitit: www.ci.tigard.or,us Notified/Method: Supplemental Information ,[r1:�9'rwy"2+�t msatV..,,t��. ,•„5✓" ii4`p'•N•� 1hvlNAp'�TP8stt�",I;M1.55?4- " - K ,':. l �,•�, - � �.i f +..r,.V:,. «� ' moo,. •''x�+S.�;,: _ tk' RS,... `; :� �. � t : , ' 4 >i' ' =f: � �a ' p..:,•r.., l;t'. FI .. _.i.-. s�„ rvA ,.TrYEE., WORK. tr ,Iti, ., *:; w' `; �' . �`;.�. ,, ,, ��;,<�:,.` .PLAN <REVIEW,;: ��`trr���rrr �= „._�- -” "- ,:.i�a�;'4a :- ��2'i4f �_ • °;;u�{" as r... .''- ^'..�`,. -; . m . .. . �- ,��a,. -.�. . � ��_;;:'''- •; '�• E] New construction Addition /alteration /replacement Please check all that apply: El Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location .,- y; , $ , _ i, iytcry ,° ,,., „ „�;� Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., , ,” '' GOR2Y = r., - E �,,,,'r ..r, 7 7 -11 % r3 a , OF CONSTRUCTI � 't: , rr i ' ` - and 2-family dwellings � GATE„. ,. ,.. _ A:. =tom:,„ ,. �' ,, , „J� of 1 y g 4 or more new residential ❑ I - and 2 family dwelling VI Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi famil ❑Master builder ❑Other: ['Building over three stones ❑Feeders, 400 amps or more . _ ? ^' ,},t ::: :: K, >x ; .� -,,„ NEORi1'IAT , ,, F , i,,, a, ,r , rA , ,,,, ❑Occupant load over 99 persons ❑Manufactured structures or �, ^ L i, a , ' V ` IION11AND EQUATION „� r` ,. ; .,,, gat °rr ❑Egress /lighting plan RV park 6'3 ❑ Health -care facility ['Other: Job no.: I Job site address: p GR E CN �u R 6 R� Submit 2 sets of plans with any of the above. City /State /ZIP: 7' 16. / l D © a 67727. 3 The above are not applicable to temporary construction service. Suite/bldg. /apt, no.: ' V Project name: �r M ' ' :.l am:" F EE; * = '='SCHEDULE' ; ' ,` 7 Z Sl i �. .. � Description Qty. Fee. Total Cross street/directions to job site: 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'l 500 sq. ft. or portion 33.40 1- Tax map /parcel no.: Limited energy, residential 75.00 2 . t. ;,° t „ =•. „9'st < :rat t „Ma,,,,� rt :,,,r Limited energy, non - residential 75.00 2 b y (1' „..;' to y IDESCRIP�TIO O F'WORI{�t l x;.:' ,t ete at Each manufacture t � ,� .�. � ., ,.,_�, .�,� _ ��. � .na�?ti;��' ��..��>to z_ ... manufactured or modular � dwelling, service and /or feeder 90.90 2 - r T a N (= 1 6 -57 - iQ hi ) Q-Kr5 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ^'mss *:�,� � `:,t' �4 ", .��, �,� �__rA�:;�'�.�,. 2 1 amps to 400 am I`; r '-�, ..z ' a® RO PER +TY�OWNER5., , Q Ia ' k; . t ❑. TENANT. t g- a P amps 106.85 2 "'"" " ”" l �'” '' ° ' ` rt - �” ' 401 amps to 600 amps 1 60.60 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 Phone: ( ) I Fax: ( ) relocation 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 t .aa;l'!er,, ,;3 ".'_` - - '?r; .its :'" gam u�a _k=� +�' .,� ';.tfiv3 s et r : 4:44ICAx -p , mei i ,° 7❑ CONTACT ", „' A. Fee for branch circuits with Business name: service or feeder fee, each branch circuit 6.65 2 Contact name: B. Fee for branch circuits without service or feeder fee, r each branch circuit 46.85 (� /' ,�j 2 Address: Each add'l branch circuit 6 6.65 3 ,�Q 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I F ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - ;rs = i�°° ri�vcn': „,= ^ <;`r,t.” R ; �,, S : c.,, : } "" t ta:�:� ..:y,�. _ . � s "..n �, I : � ,- , ,. . .- IENSTR i . >,.;ka,�=�_ Lei. , , .. € ., i. ° (;.,.. energy Panel, alteration, or Business name: vi I( J IJ 6 C rG I R J C extension. Describe: Page 2 2 Address: 4.3 6 S C woa.O5 -1 D C I- 1' )14 S c/ e Each additional inspection over allowable in any of the above /� Per inspection 62,50 City /State /ZIP: fD a 7 L ,tw_0 , ©VC- 0/ , 7 2 B Investigation per hour (I hr min) 62.50 Phone: (5-n3 )775:3 4 7 Fax; 3! ) 6� q� ie� Industrial plant per hour 73,75 5 7 ® Electri �6 Sd /t r' ; ro '. 3ELECTRICAI PER1V IT3.aFEES :• _. . . CCB Lic.: :. cal Lic G� (� Suprv. Lic.: Q j � Subtotal $ 6 , Suprv. Electric si required: O� J" Plan review (25% of permit fee) ��� ` /1� I State surcharge (8% of permit fee) 6 g 9 Print name: 0 [9 N J c L Date 6 f - TOTAL PERMIT FEE q 3 6 9 Authorized Signature: This permit application expires if a permit is not obtained within 1S0 (lays 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.doc 12/03 440-46 1ST( 1 0/02/COM/WEB Electrical Permit Application - City of Tigard fi Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 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: 4 NCO .r_o..w.. ` RCTAMiWORtadaVO, . ; ' _ iit Fee for each commercial system $75.00 (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 is \ Building \Perntits\ELC- PermitApp.doc 04/03 CITY OF TIGA ' 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested Z-c AM PM �l BUP -.— Location i ' -AL__ ' l Suite =" // U MEC Contact Person • � s '. Ph ( ) 3/ ? - 8'66 6 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner �- / — (( ELC •0• 6 3 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof /-"/ ,./Ai A )1/%t —D 4# Other: �! Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service nv c Rough -In UG /Slab Low Voltage Fire Alarm VS' PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Other: Date L� �) t/ Inspector �� Ext r Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL