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Permit - CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00331 DEVELOPMENT SERVICES DATE ISSUED: 7/11/03 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: Conversion & addition to exisiting SF to create an ashram. 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: 2 W /SERVICE OR FEEDER: 28 PER INSPECTION: 201 - 400 amp: 1 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: BRAHMAPREMANANDA ASHRAM/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 #: L1C 048748 SUP 3132S FEES ELE 26 -496C Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/11/03 $453.65 [ELPLCK] ELC Pln Rev 7/11/03 $113.41 Rough -in [TAX] 8% State Tax 7/11/03 $36.29 Elect'I Service Elect'I Final Total $603.35 This Permit is iss dsu•'ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be- e in accorda •- with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for mo than 180 days. ATTE , TION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set fort n OAR 952 - 001 -0010 throu:h OA; • 2- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1- 0- 332 -2344. Is ued By: . #� i/ % ! /� Permit Signature: w' / �� 4/ e 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: �►� � �... � .� � _.a. - DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day L 6 -/2- - p3 e i r - • _ 0FFICE_USE.ONLY_ - Electrical Permit Application Date received: Permit no.: �Ge'33/ I U t II V It J Project /app!. no.: e date: �1 City of Tigard Date issued: ' B i ' l' eceipt no.: CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR u72�23 Case file no.: Payment type: Phone: (503) 639 -4171 Fax (503) 598 -1960 Land use approval: ('.ITy of TIr A AD ■ CH Ill rilAi, r'stvtnr,,,,,, 1 - ; TYPE OF PERMIT / ❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement Q ® New construction 15 Addition/alteration/replacement ❑ Other: i ❑ Partial V1 JOB SITE INFORMATION . Job address: 11515 SW HALL City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot /account no.: Lot: (Block: N/A ISubdivision: Project name: HINDU HOUSE (Description and location of work on premises: NEW ADDITION ON EXISTING HOUSE Estimated date of completion/inspection: . CONTRACTOR APPLICATION ' FEE SCHEDULE , �. ' Job no: 23 -406 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. ( l Phone: 503 - 255 - 9488 (Fax: 257 - 7121 1E darrell@cepdx.com Service included: r }` CCB no.: 48748 [Elec. b . lic.no: 26 - 496C 1000 sq. ft, or less $ 145.15 4 r ' Cit /metro Iic.no.: N/A Each additional 500 sq. ft. or portion thereof $ 33.40 ' 5/14/03 Limited energy residential $ 75.00 2 Signature o supe tsing electrician (required) Date Limited energy, non - residential $ 45.00 2 Sup. elect. name (print): Darrell MCNeeI License no.: 3132 -S 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: (ZIP: 200 amps or less . 2 $ 80.30 160.60 2 t. Phone: Fax: 1E 201 amps to 400 amps 1 $ 106.85 106.85 2 Owner installation : The installation is being made on property 1 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 I ',: '.` ENGINEER - . , - Temporary services or feeders - Name: installation, alterations, or relocation: Address: 200 amps or less $ 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 l . t 't• ° that apply) Branch circuits -new, alteration, ❑ Service over 225 amps - commercial El 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 28 $ 6.65 186.20 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 ❑ 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 El MasterCard Permit fee $ 453.65 Credit card number: / / Notice: this permit application Plan review ( ) $ //3 Expires expires if a permit is not obtained State Surcharge( 8% ) $ 36.29 Name of cardholder as shown on credit card $ withing 180 days after it has been TOTAL $ Amount Cardholder signature accepted as complete. T 6003,35 CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (03) 639 -4171 BUP • Received q Date 4 71__ L quested `d — 3( AM PM BUP Location d II S /95#7 Suite. MEC Contact Person P— Ph ( q7( ) 5 0 7 PLM Contractor Ph ( ) SWR d U 3 3) BUILDING Tenant/Owner ELC 3 — dooit9 . Footing Foundation ELC Access: Ftg Drain ELR - Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear • Int Sheath /Shear Framing ((- Insulation \ �S ci-0 0 d R \ 1 � 6" 1 o n I Y(0 Drywll Nailing ( ` Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 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 ASS PART FAIL ECTRI' • L _ Service Rough -In < LCD 2 °' "' 3 . O C 2 UG /Slab Low Voltage larm •AS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date Inspe ® t Other: Final DO NOT REMOVE this inspection record fr . the job e. • PASS PART FAIL