Permit CITY O F TIGARD ELECTRICAL PERMIT
41 PERMIT #: ELC2007 -00816
COMMUNITY DEVELOPMENT DATE ISSUED: 12/4/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CC -14200
SITE ADDRESS: 10195 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT : 193 JURISDICTION: TIG
PROJECT: M &J REAL ESTATE
Project Description: (1) service, (1) feeder, (9) branch circuits.
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: 9 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:
MARTIN EDGELET CORNERSTONE ELECTRIC LLC
10195 SW HIGHLAND DR PMB 453 12042 SE SUNNYSIDE RD
TIGARD, OR 97224 CLACKAMAS, OR 97015
Phone: 503 - 280 -5959 Contact #: PRI 503 -775 -0880
FAX 503- 775 -6006
FEES
Description Date Amount Reg #: ELE 26 -1203C
[ELPRMT] LLC Permit 12/4/2007 $220.45 LIC 158917
[FAX] 8% State Surcharge 12/4/2007 $17.64 SUP 4199S
Total $238.09 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: 14, / ; p / Permittee Signature: y
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 •
•
SIGNATURE OF SUPR. ELEC'N :: i� _�_,,. / • f DATE: /02 —z i - 4° 7
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.
- Eledrical Permit A 411:.t' 01 -',4-.
e; ' - 1( - -
City of Tigard - - .. ir .: 2 - $ 7 = - LT 1 71;;-.=-,71:--=...;_-.1k:.-1,;:nali - ; 1 24:1-Itilii -- 77::-.4: 7 - --- f:::7 7 - , • -
- • . .. .
. .: ,„-- .:„.
',-, - • ,:. -,. Date/By: / de ep 7 te) I Permit N . oh .... Om t'f--• 01 :1 0::.
Phone : 503.639.4171 Fax 503.598.1960 ill 0 4 7n,,,, Date/By: Other Permit:
Ii .,p Line: 50.639.41 73 LAI .1..t. ' Date Read■ 1 iii. i 0 See rage 2 for
Internet: www.ci.tigard.or.us C11 y u
- IlUA Notified/Method: r I Supp information
kFM 4 V - 2Pt " .4 ,- 7, 1 1‘.+P , '-', '- , .' , _ - , :__ : : -.- "' :' 7,...,,,, ............... "'''. f'.' ' - - --' ,--,■. , _ --, ,.,: F .7-- - ,
0 New construction El Additioi alte i 4 . He check all that apply: I
0 Service over 225 amps, comml 0Hazardous location
El Demolition 0 Other:
0 Service over 320 amps - rating 0 Buildng over 10,000 sq. tl.. I
rargigaiM, of I _ and 2-family dwellings 4 or more new residential I
Ilsy over 600 volts not units in one xt ruu
ctre
0 1 - arid 2 ifly'elling 0 Ccrinnic ri Ac CeSSOry buildirig
['Building over three stories ['Feeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
['Occupant load over 99 persons 0 Manufactured structures or
I lMi 7 iikE4OWIlikillifitStill4:44N Fliti4 1i -',::; . DE plan RV park
._,
Job no.: Job site address: 10195 SW Highland Dr. 01 facility 0 Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service.
1 Suite/bldg./apt. no.: Project name:
• ! r.,-,,opa. j oty F
Cross street/directions to job site: New residential single- or multi-family dwelling unit.
Includes attached garage.
. i sr. ft or kivi I ! 145 15 I 1 4
.
Subdivision: Lot no.: Ea. adcfl 500 sq. ft. or portion 33.40
Limited energy. residential 75.00 2 I
Tax map/parcel no.:
limited ener non-residential , 75.00 , 2
IIIIIN413714;;;Z 1 Each manufactured or modular
1 1 1
r i slet...4.....4. i ez...:4C 34,...esi- k....4- , dwell:--g, service andku feeder i i 90.90 i 2 •
, Ce--114e'r*ed" Services or feeders installation, alteration. and/or relocation
I'rkt ',..6,'
4- V ,. d- k:tadt----- 0...4,,iems . 200 amps or less /
' / 80.30 i 4 0, kcl 2
`It pti,WifilA-40:144611: • a
:4„. 201 amps to 400 mps 1 1 106.55 1 i
47:- rna I 1 2 1 I
401 imps to .7.„._ :imps 1 16.0.60
Name: j g .4, ...t4..-(11+1" gesa.1 r36,4, droyl-LC.--601 amps to 1,000 amps 240.60 2
P-
Address:
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: (03) 7 g. ep - (. 5r7 S' I 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 I
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 21
Owner signature: Date: Over 1.000 amps or volts
454.65 2
i i
Reconnect only I 2
66.85
reloattion
I 1 I
Branch circuits - new, alteration, or extension, per panel
\
re
4%1;66 I A. Fee for branch circuits with 1 1
.-.'
, 1
esed 1 02.- I.4,-- ,
,.1"
M.WittYgati2.*'ZTYiP...,.....-...., ....
,....i.....i.-.-- ...-..i.... 7 .'trr' - '- ,72 -" . "' ?-..-'''';'# ..i.: :-- ....,,- ill.' - . ..... 1.4
---.' , service or feeder fee each I
1 6.65 i i i) 2
Business name: C .., branch circuit
c C' a
B. Fee for branch circuits
Contact name: n without service or feeder fee,
. 46.55 1 2
each branch circuit
Address: . - --- -
Each add'l branch circuit I 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or inigation circle I 5140
Phone: ( ?e ) 7 yr- 3e0 3? Fax: : (740 ) 0 t ' 0 s s - s
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
enere.y panel, alteration, or . .
extension. Describe: 1 1 Page 2 I
2
nsiness name: Cornerstone 1 .
tone Electric L.0
Fi
1 1 I i
I Address: Ends additional inspection over allowable in any of the above
City/State/ZIP:
1
Per inspection
I
hwestigaion per hour (1 hr mm) i 62.50
62.50 1 I
Phone: 9 e e ) 7 _ . _ 30 ..? Fax: (360) 604 Industrial plant per hour q 73.75 I I
I
CUB Lie.: / 5 27 I Electrical Lic.: 6 ) , Z _1• o3di S5ii 4199.S . .
Subtotal
Suprv. Electrician signature, required: )- - ,., 4%;',- -7:77) Elan review (25% of permit fee)
State surcharge (8% of permit fee) i i 1 „•• I/
Print name: ,0 , , ,,C ./(). ,„ I Date: j,. _4 7
ir, r $ 0 ....../
TOTAL PERMIT' FEE 0. 4,
Authorized signature: This permit application expires if a permit is not obtained within 180
_ __.------•_.
. flays after it hut: been accepted us complete
Print name: Date: 4' Fee methodology set by Tri-County Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI_t:7007.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1214/2 )07
Phone: (503) 639 -4171 imeprgpvI'lI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/30/2008 TIME: 7:02AM PAGE: 57
SITE ADDRESS: 10195 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO .4 LOT #: 193 TYPE OF USE:
PROJECT NAME: M &J REAL ESTATE
DESCRIPTION: ( service, (1) feeder, (9) branch circuits.
OWNER: EDCEL� t", MARTIN PHONE #: W3-280.5959
CONTRACTOR: CORNERSTONE I,IECTRIC LLti PHONE #: 503.475.0880
•
Inspection Request Scheduled For: Date: - i130/; 008 Pour Time:
Code # Inspection Description Contact # Message
199 Electrical final 064166 -01 360.798.3039 Y
Corrections /Comments /Instructions:
F No P\
•
\ \ N
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ CALL FOR INSPECTION (l ADDITIONAL FEES ASSESSED
Inspector: G . N O8 Lk Date: I ' 30\61 Phone #: (503) 718- ILK-
CITY OF TIGARD 4
BUILDING DIVISION PERMIT #: ELC2007.00816
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/4/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/26/2008 TIME: 7 PAGE: 26
SITE ADDRESS: 10196 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMh/iERFIELD NOA LOT #: 193 TYPE OF USE:
PROJECT NAME: (ALI REAL. ESTATE
DESCRIPTION: (1) service, (1) feeder, (9) branch circuits.
OWNER: EDGELET, MARTIN PHONE #: 603-280-6969
CONTRACTOR: CORNERSTONE ELECTRIC LLC PHONE #: 503-775-% 0880
Inspection Request Scheduled For: Date: 1/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electdcal final 063949.0 360-798-3039 Y
Corrections/Comments/Instructions:
CAu- (
CpoJNA)`
FL pko
oKtt s eN6 tfik •
%ml uNE.2, tbr F Aka ok5T t oca,
cAL
fl PASS PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL CALL FOR INSPECTION Ft ADDITIONAL FEES ASSESSED
Inspector: Q, Date: 'W 61) Phone #: (503) 718-1-1M
CITY OF TIGARD !`� ('-
BUILDING DIVISION � PERMIT #: ELGe0Cl7 -00 16
13125 SW Hall Blvd., Tigard, OR 97223 fi DATE ISSUED: 12141 2007
Phone: (503) 639 -4171 aitilp
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/13/2007 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 10195 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERI NO.4 LOT #: 193 TYPE OF USE:
PROJECT NAME: MU REAL ESTATE
DESCRIPTION: (1) service, (1) feeder, (9) branch circuits.
OWNER: EDGELET, MARTIN PHONE #: 603.280-6959
CONTRACTOR: CORNERSTONE ELECTRIC LLC PHONE #: 503 - 775 -0880
Inspection Request Scheduled For: Date: 12/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 125 Wall cover 061466-01 360-7913-3039 Y
1) ,,�4,vte eak( , k l i lfr
Corrections /Comments /Instructions:
M 1 4- 1; /0 2-' (-1 1./bN Pi;:
•
X PASS _ PARTIAL APPROVAL 7 CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
44 .
Inspector: Date: . Phone #: (503) 718-
.
CITY OF ��mn n v^pw TIGARD '�
BUILDING DIVISION
~~~,""~~~""~~" ~°"°"~,"~°"~ PERMIT #: ELC2OU7DO8'\6
| 131258VV Hall 8hd, Tigard, ORO7223 ^ �^
DATE ISSUED: 12/4/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 "��W- ^ �...
INSPECTION WORKSHEET FOR DATE: 17y13/2007 TIME: 7:08AM PAGE: 12
SITE ADDRESS: 1O195 HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUlWMERF|[]_DN{) LOT #: 193 TYPE OF USE:
PROJECT NAME: h4&J, REAL ESTATE
DESCRIPTION: (1) service, (1) feeder, (9) branch circuits.
OWNER: EDGELET, MARTIN PHONE #: 503-280-5959
CONTRACTOR: CORNERSTONE E_EC7R|CLLC PHONE #: 6O3-775~088O
Inspection Request Scheduled For: Date: 12/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 081466-02 960'798-3039 N
Corrections/Comments/Instructions:
PASS ri PARTIAL APPROVAL 0 CANCEL ri NO ACCESS
[ 'FA|L F CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
� / r� & | c Oate� (�' ( ~7 / �� Phona #� k�D3\ 718- '
61 / ' / `� ' /
_- ' ~- ''~ ~^",~,�^�-.