Permit ..i
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00067
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��1 DEVELOPMENT SERVICES DATE ISSUED: 2/12/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DA
SITE ADDRESS: 11515 SW HALL BLVD
ZONING: C -
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: J 0 8 2 -3' (2 0
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: 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:
BRAHMAPREMANANDAASHRAM/TEMPLE CAPITOL ELECTRIC CO INC
11515 SW HALL BLVD 11401 NE MARX ST
TIGARD, OR 97223 • PORTLAND, OR 97220 -1041
Phone: Phone: 255 - 9488
Reg #: LIC 048748
SLIP 3132S
FEES ELE 26 -496C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/12/03 $66.85
[TAX] 8% State Tax 2/12/03 $5.35 Elect'I Service
Elect'I Final
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Code's 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: Permit Signature: __Al
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
.,
El Permit A ��.i I\ / ® Date received: Permit no . – — OEFICE_USE_ONLY_ -y_�
1 pp 1 . k '� L, �/ ,261D O 6 ,
Project/appl. no.: Expire date:
1 Ali' City of Tigard Date issued: By: Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, ORT97e12311 2003 Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960 CIT OF TIGARD
Land use approval: BUILDING DIVISION
• TYPE OF PERMIT
❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ff Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION •
Job address: 11515 SW HALL City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: N/A (Subdivision:
Project name: ASHRAM 'Description and location of work on premises: TEMP SERVICE TO EXISTING BLDG
Estimated date of completion/inspection:
- CONTRACTOR APPLICATION -- FEE SCHEDULE
Job no: 23 -120 Fee Max.
Business Name: Capitol Electric Co., Inc. Description . Qty. (ea.) Total no. insp
Address: 11401 NE Marx New residential - single or multi family per
City: Portland State: OR ZIP: 97220 - 1041 dwelling unit. Includes attached garage.
Phone: 503 - 255 - 9488 (Fax: 257 -7121 IE -mail: darrell@cepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.no: 26 - 496C 1000 sq, ft, or less $ 145.15 4
metro lic.no.: , Each additional 500 sq. ft. or portion thereof $ 33.40
ii ../ 5 e 2/10/03 Limited energy residential $ 75.00 2
Signature of supervising electrician (required) Date Limited energy, non- residential $ 45.00 2
Sup. elect. name (print): Darrell McNeel License no.: 3132 - Each manufactured home or modular dwelling
PROPERTY OWNER Service and/or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: State: IZIP: 200 amps or less $ 80.30 2
Phone: Fax: IE - mail: 201 amps to 400 amps $ 106.85 2
Owner installation : The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 _ 2
Owner's signature: Date: Reconnect only $ 66.85 1
ENGINEER Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less 1 $ 66.85 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E - mail: 401 amps to 600 amps - $ 133.75 2
PLAN REVIEW(Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel:
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress /lighting plan El Other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel,
alteration, or extension* $ 75.00 2
. - _. . - - - *Description:.. — .. - --- - — -
Each additional inspectionover th allowable in any of the above:
Per inspection I I $ 62.50 I I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 66.85
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained State Surcharge( 8% ) $ 5.35
Name of cardholder as shown on credit card
$ withing 180 days after it has been TOTAL $ 72.20
Cardholder signature Amount accepted as complete.
CITY OF TIGARD 24 -Hour
•
BUILDING Inspection Line; (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 2 4\o'-) AM PM BUP
Location . _ _ Suite MEC
Contact Person Ph _). s 6 d PLM
Contractor CA\ P L Ph ( ) SWR
BUILDING Tenant/Owner ELC o3-0o6lori
Footing ELC
Foundation Access:
Ftg Crawl ELR
Dr ain <`K \)`
Crl Dr
Slab Inspection otes: I , ` � ( ( SIT
Post & Beam , S N J >
ExtSreah /Sh 7 1 V( ,, 44/6 o�a�
Exf Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing J y�
Firewall l t is � l��1 !-� , I s P 4o. b )
Fire Sprinkler
( ,cam ,
Susp'd Ceiling ��qq �V v'9 �S
Fire Alarm �• _ r � � ^ � ,� ' ` ► . � ._}- G 01\)
C `./ � 1 A
Roof pz; �' \e) �h1 . cb YS Qb I 6 J A2-410 •
Other:
Final �-�( f N 0 ' )J - i; 101\J )
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
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Dat Inspector Ext
Other:
Final DO NOT REMOVE this inspe ion record from the job site.
PASS PART FAIL