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Permit • CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00663 DEVELOPMENT SERVICES DATE ISSUED: 9/9/2005 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 2S101AC - 01800 SITE ADDRESS: 07585 SW HUNZIKER RD ZONING: I -L SUBDIVISION: LOT : JURISDICTION: TIG Project Description: (1) 200 amp service. 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: MOSTUL, TERRY A + DEBBI C ROBERTS ELECTRIC INC 7585 SW HUNZIKER ST 5759 SW 48TH AVE TIGARD, OR 97223 PORTLAND, OR 97221 • Phone: 503 - 519 - 7847 Phone: 503 - 244 - 7754 FEES Reg #: SUP 3886S Description Date Amount LIE 9388 ELE 34 -23C [ELPRMT] ELC Permit 9/9/2005 $80.30 [TAX] 8% State Surcharge 9/9/2005 $6.42 REQUIRED ITEMS AND REPORTS • Total • $86 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 : Permittee Signature: aj,,,sr_._„_<„ 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 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. • .Electrical Permit Application FOR OFFICEusE.o.NLY r Received / �; i� , i• City of Tigard Date /By. 9 D5 c-d Permit No.: Z- J 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 y ' ✓�'hx'F it I'` Date/B : Other Permit: Inspection Line: 503.639.4175 s �' Date Ready/By: lial ® See Page 2 for Internet: www.ci.tigard.or.us Notified/vtethod: Supplemental Information TYPE OF WORK PLAN REVIEW' ❑ New construction a Addition/alteration /replacement Please check all that apply: • ❑ Demolition ❑Other: ['Service m ❑ Service over 225 amps, com'l Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., • . , 'CATEGORY OF `CONSTRUCTION , ' of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure I=1 Multi - family ❑Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons ['Manufactured structures or ° ' JOB SITE, INFORMATION' AND .L CATION. ❑Egress/lighting plan RV park Job no.: Job site address: 75 �' S ., . l. � � -C ❑Health -care facility ❑Other: ( Submit 2 sets of plans with any of the above. City /State /ZIP: Z( ) The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: A -- (L .14. T A, y ,FEE* SCHEDULE Description I Qty. I Fee. I Total Cross street/directions to job site: New residential single - or multi - family dwelling unit. ,■ p Includes attached garage. 5 .,,t._1 72_ 1,000 sq. ft. or less 145.15 4 ' Subdivision: Lot no.: • Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 ' ' ` DESCRIPTION OF WORK - ' Each manufactured or modular dwelling, service and/or feeder 90.90 ' 2 Services or feeders installation, alteration, and /or relocation 200 amps or less . 80.30 O, 2 ❑ PROPERTY OWNER. , ' ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps X 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 • 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 exchange, 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 .' - I® APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with t service or feeder fee, each 6.65 2 Business name: i branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 Address: each branch circuit Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax :: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- , ' , _ - `: CONTRACTOR :. .' I - _ . ,., ,, energy panel, alteration, or extension. Describe: Page 2 2 Business name: t b,g ALT e ra L ZNe Address: Each additional inspection over allowable in any of the above • S S - ` � Per inspection 62.50 City /State /ZIP: p fric OR._ 522-2 I Investigation per hour (I hr min) 62.50 Phone: (S-o q 7754 Fax: (§-,, 3) c Liz( - v.S-6 Q Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES *' CCB Lic.: cl 3g1 g ' Electrical Lic.: 4-2_3 C Suprv. Lic.:S9e6 S Subtotal Suprv. Electrician signature, required: /6 �t_/a' Plan review (25% of permit fee) Print name: Q 1.4 27t C 0 id 4,0 Date: 1 A c)/0 State surcharge (8% of permit fee) I "' TOTAL PERMIT FEE ' ( ` 7L, Authorized signature: ' This permit application expires if a permit is not obtained within 180 days after it been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board " Number of inspections per permit allowed. i:\ Building 'Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB 0 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: lvIRESIDENTIAL WORK ONLY: _ _ .- Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* • ❑ Burglar Alarm • ❑ Garage Door Opener* ❑ Heating, Ventilation. and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COlVI1VIERCIAL WORK ONLY: _ —77-77 Fee for each commercial system $75.00 (SEE OAR 91 8- 260 -260) Check Type of Work Involved: • ❑ Audio and Stereo Systems • ❑ Boiler Controls ❑ Clock Systems • ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC • ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other • Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC- PetmitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005-00663 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2005 Phone: (503) 639 -4171 : Inspection Requests (24 Hrs.): (503) 639 -4175 ,..' INSPECTION WORKSHEET FOR DATE: 8! TIME 7 :0 PAGE: 102 SITE ADDRESS: 07585 SW HUNZIKER RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ARTISTIC AUTO BODY DESCRIPTION: (1) 200 amp service. OWNER: MOSTUL, TERRY A + DEBBI C, PHONE #: 503_519.78o CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 503-244-77 EA Inspection Request Scheduled For: Date: 9/14/2005 Pour Time: Code # Inspection Descriptimr . Confirm # Contact # Message 115 Electrical service v 015551 -01 503 -672 -7885 Y Corrections /Comments /Instructions: ----\ '3 h\ 1K — M 0 & R 61 (.0 NiNol.., c-Ko [4) L_,L,c D..,,D t t^ , N�, R\Z-h- D LA Lt. Il 4,t`'n I 1A 0 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Af � ^� • Date: / -----V Phone #: (503) 718- .CITY OF TIGARD BUILDING DIVISION PERMIT #: (.LC3006.x,,06 ;3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/9/20t.; Phone: (503) 639 -4171 ut oi,f, Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/27/2006 TIME: 7 :00AM PAGE: 84 SITE ADDRESS: 07586 SW HUNZIKER RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ARTISTIC AUTO BODY DESCRIPTION: (1) 200 amp service. OWNER: MOSTUL, TERRY A 4. DEBBI C, PHONE #: 603-619-7847 CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 503-24.1.7754 Inspection Request Scheduled For: ► ate: 1/27/2006 Pour Time: Code # Inspection Description - - . Contact # Message 1.99 Electrical final 026833 -0'I ,1)`3.639 -0200 N Corrections /Comments /Instructions: o N Pc�Viob NP8 6g. 4 M ', g4- 6 7 PAOL P►LA 0 Lo ► YVO N c•8 fuciJINO PiaNt112 .' VY\AJ t $ 2 CE b i 5 c. irk Ava `i `. PaAv i fl- 41 ;..IV M t . 10\qt esE i zo v&C w4CO N A v P 20ivt4 N I14( ` E -1-kig © e PAZ--. - '0(7. Rtzw■ bE e I, is(1- 11,cTE-‘i, I vki3 .AN& 1,1E 1 v 1 i\ 41- o. A W w 4rt,l&. Q - L.. \\.. 1--- ASS n PARTIAL APPROVAL 0 CANCEL fl NO ACCESS N, FAIL N CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: NESS US L'' Date: 1 Z 4 Phone #: (503) 718-2i ' CITY OF TIGARD - BUILDING DIVISION PERMIT #: ZDU5 (jo (p 63 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 04161(l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 75 gS v CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3-3-0(0 Pour Time: Code # Inspection escri ion Confirm # Contact # Message ' \ ��✓ 775 Corrections /Comments /Instructions: ` ) 9....Q0 10, 6 eaNN3 - s 3�L70 • • n PASS I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS SI FAIL ,CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G U `�°� Date: 313\ © b Phone #: (503) 718- 1..t4€ CITY ����~�����U��� ��n m n OF n n�m��nn�� BUILDING DIVISION PERMIT #: ELC2006'00663 ' 13125SVV Hall EUvd.. Tigard, OR07J23 DATE ISSUED: 9/9/2005 Phone: (503) 639-4171 |no���R�um�(�Hmj���6�41� ~�r�� /y r-- INSPECTION WORKSHEET FOR DATE: 13/17y2006 TIME: 7:01AM PAGE: 43 SITE ADDRESS: O7586 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ARTISTIC AUTO BODY DESCRIPTION: (1) 200 amp service. 3/1/06 ADD 1 Feeder with 3brao*h circuits. OyyNER: MOSTUL, TERRY A+QEBEN C. PHONE #: 503-519'7847 CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 603 Inspection Request Scheduled For: Date: 8/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 035161'01 503-572'3230 N Corrections/Comments/Instructions: . . . • ri PARTIAL APPROVAL El CANCEL 7 NO ACCESS || FAIL 0 CALL FOR INSPECTION �� ADDITIONAL FEES ASSESSED . -� �� /-� � Inspector: �� � Date: �� —/ //^- 6� Phone #: (503) 718-