Permit r1
ELECTRICAL PERMIT
CITY OF TIGA PERMIT #: ELC2006 -00367
�0& DEVELOPMENT SERVICES DATE ISSUED: 7/6/2006
4 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101BC -02300
SITE ADDRESS: 12530 SW HALL BLVD ZONING: I -P
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Reconnect only.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JEWELS BEADS BECK ELECTRIC INC
12530 SW HALL BLVD 9318 SE CHURCH ST
TIGARD, OR 97223 CLACKAMAS, OR 97015
Phone: Contact #: PRI 656 -7396
•
FEES
Description Date Amount Reg #: ELE 3 -5C
[ELPRMT] ELC Permit 7/6/2006 $66.85 LIC 2629
[TAX] 8% State Surcharge 7/6/2006 $5.35 SUP 5024S
Total $72.20 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 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: f ���i� Permittee Signature: _ L c)
OWNER INSTALLATION ONLY C
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 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.
Jul... 06 06 08:08a p. 1
Ei`ei`.t ical Permit Ap �1 if": Qp �+ FOR OFFICE USE ONLY
City of Tigard _AK e `-� Permit No.: ��
Dale /Bea / a (/ CJ d -� •
t J �
13125 SW Hall Blvd., Tigard, OR 97223 �� 6 Plan Review
■
Phone: 503.639.4171 Fax: 503.598.1960J 0 U 2006 �, � :'' ¢Illj4i Date/B : O1herPemtil
Inspection Line: 503.639.4175 1 11 Date Ready /By: 61 See Page 2 for
Internet: www.ci.tigard.or.us ITV )F i• Notified/Method: • Supplemental Information
: . l
.ti ' Rkli 's'Yf'J{# {..: ;.,: . . :_ :•: : ::..::..:.: .. ._: PLAN' R
n ° ., ' `" u ` Please check all that apply:
y
El New construction �' Addrtlon /a ltera' ti on %replacem ent PP Y:
❑ Demolition ❑Other: ❑Sery ce over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
. . CATEGORY OF' CON ;;.,. : - :: of 1- and 2- family dwellings 4 or more new residential
V I- and 2- family dwelling ❑ Cornmercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi fami ❑Master builder ❑ Other:
0 Building over three stories ['Feeders, 400 amps or more
p 99 persons s red structures or • ' .:JOB SITE .INFORMATION •/).1•11) i;OOCA'ilON . . • ❑ ss /lighti E plan RV park
e to
Job no.: Job site address: .1 Z 5•• 0 5L t -iP Lu ( L\ .I L ❑Health -care facility :Other:
Submit 2 sets of plans w any of the above.
City /State /ZIP: "r ' c G` t D i 9 7 3 The above are not applicable to temporary construction service.
. ° :Sf'EAULE .
Suite/bldg./apt. no.: Project name:
Description 1 Qty. Fee. ( Total 1
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. tt. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non-residential c -re 75.00 2
:.'... DESCRIPTION .. OF WORK
" ' " " °" " ' ' ( Each manufactured or modular
Re dwelling, service and /or feeder 90.90 2
Re C rrx) €iE ut.c L) L s V
I O 2 t lbt t nrj Services or feeders installation, alteration, and /or relocation
p 1. .frc t D/� 1 200 amps or less 80.30 2
' PitQrERTX Q! V►IC±f� R - :'. ❑ T'ENA `, , . : ,. •
401 amps to 600 amps 160.60 2
Name: J e & - 1 — % eJ S .6.e0.8 C 601 amps to 1,000 amps 240.60
2
Address: i 2_7 - 36 C u: t . -k� \\ IoM, Reconnect 1, amps or volts 454.65 2
Reconnect only ( 66.85 2
City /State /ZiP: i 9 fir- , p1,2 q '12 2. 3 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 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 exchan 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
Q APPI54C4T' ::'.: : ' ::. : :: : ::: . 's ❑;;CON'I'AT: PERSON`,: Fee for branch circuits with
service or feeder tee, each
Business name: eG1� E. Iec. 0 _, c. _ -4-- branch circuit 6.65 2
ti B. Fee for branch circuits
Contact name: oC 'rJ Gu(l✓) i without service or feeder fee,
each branch circuit 46.85 2
Address: I OG 5i,-- E_ "D • MDR C-1 S1 C: Each add'l branch circuit 6.65 2
City /State /ZIP: Cilct• - s 1 D A CO 1-) i'3 Miscellaneous (service or feeder not included)
Pump or in circle 53.40 2
Phone: (9 j3) ( . 73 q Fax: : ( 3) (p 7, i.43g Sign or outline lighting 53.40 2
E- mail: y. , e lec; C.D(...00.5 iY.7 Signal circuit(s) or limited-
C(1NTRAC'I't7It..: -::: .: . • .,: -.';.. . . nergY pane ,
e alteration o r
extension. Describe: Page 2 2
Business Warne:
CK E lute.' C TirLG
Address: t 5 L9�C) G roe 4 0 2 err 57,7---e-- Each additional inspection over allowable in an of the above
V Per inspection 62.50
City /State /ZIP: Ci Iotc lQS 02 "7 01 5 investigation per hour (I hr min) 62.50
Phone: ( 5 z') ( 73c 6, 7 Fax: (6 ') p 6, q . 3 q 7 Industrial plant per hour 7335
.'E ,ECTIOCAL:.P>CRMIT FEES?
CCB Lic.: 2622 Electrical Lie.: 3 — 5 c Suprv. Lie.: 5 244 . 5 Subtotal (pr .
Suprv. Electrician signature, required: . _ Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) 5 .y;"
�"t��� C5 P -t'wi 5% 7' 0 � TOTAL PERMIT FEE `7 • g0'' 2.
Authorized signature: \.. This permit application expires if permit is not obtained within 180
� y � _ days after it has been accepted as complete
Print name: C4 fit_ ; Date: • O CP * Fee methodology set by Tri- County Building Industry Service Board
CS �,�� l 5--ex - ** Number of inspections per permit allowed.
(\Building :Permits \ELC- Pe,mitApp.doc 12(03 440-4615T( I 0i02/CORE /WED
� CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2005 -00357
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/612008
Phone: (503) 639 -4171 Jail l l Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 7/18/2006 TIME: 7:03ANI PAGE: 51
SITE ADDRESS: 12630 SW HALL B CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: JEWELS BEADS
DESCRIPTION: Reconnect. only.
OWNER: JEWELS BEADS, PHONE #:
CONTRACTOR: BECK ELECTRIC INC PHONE #: 856%7398
Inspection Request Scheduled For: • Date: 7/18/2006 Pour Time:
Inspection Description Confirm # Contact # Message
199 Electrical final 033226 -01 503-858-7398 N
. Corrections /Comments /Instructions
—f<gr`V■ii■Mt■ , flp , itz, V A
41
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V\
,OPASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V o Date: 1 / if No Phone #: (503) 718 - 2.4Litt