Permit C ITY QF TIGARD ELECTRICAL PERMIT
JA K PERMIT #: ELC2004 -00604
DEVELOPMENT I . SERVICES DATE ISSUED: 9/21/2004
13125 (503) 639 -4171
PARCEL: 1S135BC-01100
SITE ADDRESS: 11131 SW GREENBURG RD
SUBDIVISION: ZONING: I
BLOCK: LOT : JURISDICTION: TIG
Project Description: Replace terminal "CT" can.
Job # 80830.
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: 3 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:
ROBINSON, E LEE + EVELYN L OREGON ELECTRIC CONST /GROUP
PO BOX 91305 1010 SE 11TH AVE
PORTLAND, OR 97291 PORTLAND, OR 97214
Phone: Phone: 503 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/21/2004 $240.90
[TAX] 8% State Surcharge 9/21/2004 $19.27 Rough -in
Elect'l Final
Total $260.17
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: Sl Permit Signature: c \f .�
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
SEP -21 -04 01 .31 PM FROM - Oregon El iOg 5032313587 T -477 P.001 /002 F -474
City of T,talyd � Received
13125 Sw /1 ' Ha1I Blvd., Tigard. OR 9 TO , Dare/l3 07 YcrmitNo.:� � C� d601,
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 SEQ (a, � sr !(nsFl,l + + DateB Other Permit;
Inspection Line: 503.639.4175 ` :: O. -„ Dare Ready/Br ® See Page 2 for
Internet: www.ci.tigard.Or.us `, O* j1 a Is 7 , NotifierllMethod: Supplemental Information
1 • TY1?E:a',,i, }. - PLAN REVIEW •
•
Q Ncw construction ® Additi l altcration/replacement Please check all that apply:
0 Demolition Q Other: ❑Service over 225 amps, comet'[ ❑Il: 7ardous location
CATEGORY OF CONSTRUCTION ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq, ft.,
of 1 -and 2- family dwellings 4 or more new residential
Q 1- and 2- family dwelling 0 Commercial/industrial 0 Accessory building ❑ System over 600 volts nominal units in one structure
❑Building over three stories ❑Fccden, 400 amps Or more
Q Multi- family ❑ Master builder ❑ Other:
JOB SITE iNFO 2MATION AND LOCATION ❑Occupant load over 99 persons ❑Manutacturcd structures or
❑Egress/lighting plan RV park •
Job no.: 80830 I Job site address: 11131 Greenberg Road ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard The above are not applicable to temporary construction service.
Suite/bIdg. /apt. no.: Project name: Orowheat FEE SCHEDULE.
—
Description Qry, rea Total
Cross street/directions to job site: - ! Yew residential single - or multi-family dwelling unit.
Includes attached garage.
_ 1,000 sq. A. or less 145.15 4
Subdivision: l Lot no,: Ea. add'! 500 sq. ft. or portion 33.40 1
fax map /parcel no.: --- — Limited energy, residential 75.00 2
D>ESCRIP2ION OF W RIB Limited energy, non - residential 75.00 2 • Each manufactured or modular
Replace terminal "Cr' can _ dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 V-y0 02
❑ PROEER,'1 y' OWNER •. . 1. ❑TENANT- • 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Reconnect only 66.85 2
Temporary services or feeders Installation, alteration, and/or
Phone. ( ) C Pax: ( ) relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less _ 66,85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 4 01 amps to 400 amps 100.30 2
401 amps to 600 amps 133.75 2
Owner signature: Date:
Branch circuits - new, alteration, or extension, per panel
C
.
0 AFPIIANT: ' .
•. ( ❑, 'CONT;A;CT•':EERSON : 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,
Address: each branch circuit 46.85 2
Each add'! branch circuit _ 6.65 2
City /State /ZIP: — Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) — Pump or irrigation circle _ 53,40 2
E-mail: — Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
• . .CONTRACTOR , . 1 .. energy panel, alteration, or
Business name: Oregon Electric Group extension. Descnbc: Page 2 2
Address: 1010 SE 11th Ave Each additional inspection over allowable in any of the above
City/State/ZIP: Portland, OR 97214 — Per inspection 62.50 _
Investigation per hour (l hr min) 62.50
Phone: (503) 535 -2652 Fax: (503) 231 -3587 Industrial plant per hoar 73.75
CCB Lic.: 203 Electrical Lic.: A95 -95 Su ry lc.: 44605 I, ELECTRIGAL:PERMIT. FEES
Subtotal ,C.10. yo
Suprv, Electrician signature, required - c ' , 4 �� - p . + , , Plan review (25 /, of permit fee) ..---- -
Print name: ifh d t 1 - >'. I MM" f `/ / State surcharge (8% of permit fee) f 9 Z 7
�j �
Authorized signature. 7i�� / TOTAL P EIiMIT FFF
This permit application expires If a permit Is not obtained w � ithin ttl
Print name: L,/2 Dat e: G/ days utter It bas been accepted as complete
- fee methodology set by I'd- County Building industry Service Board
•' Number of inspections per permit allowed.
■ \BuildinEoPenaur c.PermaApe.d 12/03 440- 4ah3Tt)0 /O2/COM,wBa
CITY OF TIGARD 24 -Hour
BUILDING Inspection (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date equested AM PM BUP
Location 1 / Suite '' // MEC
Contact Person
'//(1 Ph ( ) Fcf 9 — 7.3� PLM
Contractor Ph ( ) SWR
BUILDING t/Owner V fdk ELC
Footing ELC o' 6
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT — _
Post & Beam /
Shear Anchors
Ext Sheath/Shear LW/
Int Sheath/Shear
Framing
Insulation • 1)/4"5 n "" 5� t G g_ on/ i
Drywall Nailing
Firewall /1
d\ F
Fire Sprinkler /,
Fire Alarm I
Susp'd Ceiling 0
Roof
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
oug -In
UG/Slab
UG/Slab
. Low Voltage
arm
°' Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
cia PART FAIL
S 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
Approach /Sidewalk Date �� o Inspector l wJ 1 Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL