Permit A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00615
i. DEVELOPMENT SERVICES DATE ISSUED: 9/27/2004
'�� I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 AC -01400
SITE ADDRESS: 07125 SW HAMPTON ST
SUBDIVISION: BEVELAND NO. 2 ZONING. MUE
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Extending circuits for (9) condense units on roof.
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: 8 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:
SPECIAL DISTRICTS ASSOCIATION OF OR BECK ELECTRIC INC
727 CENTER STREET, NE #208 20 9318 SE CHURCH ST
SALEM, OR 97301 CLACKAMAS, OR 97015
Phone: 503 - 371 -8667 Phone: 656 -7396
Reg #: SUP 1326S
LIC 00002629
FEES ELE 3 -5C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/27/2004 $100.05
[TAX] 8% State Surcharge 9/27/2004 $8.00 Rough -
Elect'I Final
Total $108.05
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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:� ::70Per�f.l: Permit Signature: _J-&-
- . c s
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 23 04 02:54p beck electric 503 - 656 -4397 p.2
g etrieal Permit A licatioii ` FOR OFFICE USE ONLY
V ,ED ,vsii�
City of Tigard C Received �1 i / M _
C/ y P ermit No.:6
13125 SW Hall Blvd., Tigard, OR 9 2 ��
Phone: 503.639.4171 Fax: 503.598.1960 /•� i fi t \ Plan Review
2 q 200 i h� l. DateB : Other Penult: Inspection Line: 503.639.4175 SEp J ■ 1 Date See Page 2 for
Ready/By: Hi
Internet: www.ci.tigard,or.us y/Bo
14 ACI � Noufied/Method.
.....
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❑ New construction g: • ". - a ter ation /replacement Please check all that apply:
amps, comel
❑ Demolition El Other:
['Service over 225 am
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1- and 2 family dwelling PI Commercial /industrial I=1 Accessory building _ ° S over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or inure
❑ Multi - family 0 Master builder [] Other:
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nn till nine t,I l4 persons ❑M structures or
' =•r.:: - t, r� - ,Ya� i, a n� a, .:-;ej +ry sr:;i =n” `" °In;tkl " 'a;:a zi :e � �; ,ISM s:� ccupant load over 99 anuf
actured . , :M1:;i ^ire `.,....... c •, � e , . , � • nrgsie.,n •r - -:: I t i ::r: ' If Gi
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� vJ 5 - ' 7 L ?5 'u i [__ . k 5 1
['Health-care facility [I Other:
Job no.: 2255 Job site address J J-i�! ,r✓ vi i 7 Y
���ci 0� 70?� , The. 2 sets of plans
applicable ablsoy to temporary City /State /ZIP: Te above are piable mporary construction service.
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Suite/bldg. /apt. no.: Project name : �,..,,M
nn „:..,,.3'c S {c "�}yptu : ....... c� � �ii �,`• .h :is "2:'::`!S .
Description 1 Qty. I Fee. I Total I "
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'1500 sq. ft. or portion 33.40 I
'Fax map /parcel no.:
Limited energy, residential 75.00 2
1';iSil`:ii `IE.^,!'f!F! "�'- ;y.l;Yi °:idkdi r:.�> q�- ,>;,•, ::.•_.,_.,,,...,„ _ Limited energy, non- residential 75.00 2
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« reAfe a: r„;;„, h,. ��= 1���' n:, an:,.::,:. C;.„ a ., git,,,,, ,.a;,�,,,.,;:,,.:�a,.,�.1 Each manufactured or modular
Gi,� ,,,,,T, • _ 9 Caride.Vse S e orf ee and/or feeder
lga i , and 2
� � ` � ` Services or feeders installation, alteration, r relocation
/ — Se 'i r fe 'on a ' on, sad /o
•,n! ill ::�:::ts.. �:�l i.. � ' >..i
200 amps less 80 30 2
a_i= ia;e;:: _ 48 6ui n e u { #�;; °i• ` :. hnn,:,x^• t • u IO i , � ;x:; r.; -
_ rtg•,:r'n" 0 °i:i: .;;�5'�'t 'i:u.ec ura . -,.
. - --- ���:. i :, �� vanli:t,wl - stlr� iic :m� " -.. ri: n - ?rerilie' "`y " ait?ll,ii 201 amps to 400 amps 106.85 2
..
..-. „, -- - ,arme:nmrh. , ploge'u�r'F ieu'-, „,,a,,:,nl',oRtiaNha t lla,
: t : ,fl,J: - �
rl r ! : r 'in= . necnrx...;i,', „e Ew! 7xlgnrn.:s .(�',:,'Y�mi?'ll`1`•!
401 amps to 600 amps 160.60 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: ( ) Pax: ( ) 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:
: �-..::::: t. u :::::......:.:.:x....._.... .n aw - �.,uarri .. ^,;.,. � . — alteration, or extension, per pa
panel
. .
:.'._.... :: "'' , y 5 ' = s a' :ii! l i�'ai:uu�t�lY ^pY_i,;aii �,n arm:ri lt�; 9• .it 'y °i3'r - n t °�� '�ii° - - ' viii'i �iiu�;4l' iu:d Ar Fee fol'branch cncuils wuh t
� �,' r� r �rt� `� �ty�^� n o er
. : =7':':: -,is:l :'::i:: ;1 � 'i !,,Tdti0ti €41 i?: ilid 6,a!i t-ii!Pumii }? titARK —umi,,it?nT.':'!!a...t;.,..,,L.. -,-- ;hII itit
service or feeder fee, each
Business name: branch circuit 6 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address:
each branch circuit J 46.85 Ala • r 2
Each add'I branch circuit �' 6.65 53.2.0 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax: ( ) Sign or outline lighting 53.40 2
E-mail: -- ;Y;,.__,Ns.,,..... •, ,,.,.. a,t .L: _r, _ Signal circuit(s) or limited -
-: :i ' ::i3,...iz- — t +rsuai,:..zr ; l ;- ^•08:,5iiG: eiiE; t{:uao {i3 ?tine: F;•. e,: uiG'ai:ai,: iti :.:i• Cttt n ,Bn2' =c
r :: ; :: _,_t:,,: &;s:. ":.:!'.!' Jeri; as l•-::!;...�;:ilnlr; �a: s31niaiiiitaW��s x ^, "' is �,eti €i`g�a 3 111i energy panel alteration, or
Business name: � •, Gk 62(2 1-y/ C extension. Describe: Page 2 2
Address: / 5!o (X) 6e / . y 'y o � c -_ Each additional inspection over allowable in any of the above
�/ Per inspection 62.50
City /State /ZIP: alai, k ' 7'J C 70/5 Investigation per (1 )
Investi anon erhour 1 iv,niu 62.50
Phone: 3) ( 3Gt f Fax: (92 ) ���I i Industrial plant per hour 73.75
S� mot•' �^ - gi`+<e:'et"•s , .F trte airMi 1 ' , + s: ls l : � j , _ _
� ,co d Electrical --5( : • � S ubt ii� O _ _ .r ; `,:;
CCB Lic.: N al Lic.: � Suprv. Lic. S ubtotal /Ua', (),S
Suprv. Electrician signature required: # A: i Plan review (25% of permit fee)
Print name: Ck (As 6�v\ Date: 2.316.( State surcharge (8% of permit fee) O
tn�5 • i
/ TOTAL PERMIT FEE / 0 - 0 ��
Authorized signature:
•-......... ' - , • � This permit application exptres if a permit is not obtained within 180
days after it hae been accepted as complete
Print name: ate: c 1 . k/
�sF `, •� � �U\ to , S � Date: � p Fee methodology set by Tri- County Building Industry Service Board
•' Number of inspections per permit allowed.
i:l Building \Pe,mits\l?LC- Penmi,App doe t2 /O3 440.451 ST(10/02 /COM/WEB