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Permit : �' '- CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT PERMIT : ELC2o07 -00589 DATE ISSUED: 8/21/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S126CA-00100 SITE ADDRESS: 09225 SW HALL BLVD A ZONING: SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: MR. FORMAL Project Description: Replace service /feeder. 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: 1 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: SVCIFDR >= 225 AMPS: CLASS AREA /SPEC OCC: ' Owner: Contractor: MENASHE, R BARRY SPARK ELECTRICAL CONSTRUCTION 621 SW ALDER, STE 605 4508 NE 123RD PORTLAND, OR 97205 VANCOUVER, WA 98682 Phone: Contact #: PRI 503 - 701 -7822 FAX 360- 891 -4760 FEES Description Date Amount Reg #: ELE 26 -997C [ELPRMT] ELC Permit 8/21/2007 $86.95 LIC 143886 [TAX] 8% State Surcharge 8/21/2007 $6.96 SUP 4394S Total $93.91 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 . work is . -pended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. rul= - e set forth in OAR 952 -00 -I. 0 through OAR 952 - 001 -01 ou may obtain copies of these rules or direct questions to OUNC at 503 . 699 • 1 :00.332.2344. yy Issued /ill,' Permittee Signature: �� 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 OFFICE USE ONLY - !?t! "' Received Q /y �� A I r� ���� —j��Q, 1 City of Tigard Date /By G Z/ o/ S` YV Permit No.: it��_ �0'T w5l 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �' Phone: 503.639.4171 Fax: 503.598.1960 Date /By Other Permit T I GARD Inspection Line: 503.639.4175 Date Ready /By: tui.in /� la See Page 2 for Internet: www.tigard- or.gov Notified/Method: LJ Supplemental Information ) JtPE OF WORK PLAN' REVIEW- ❑ New construction Addition/alteration /replacement Please check all that apply (submit 2 sets of plans whtems checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. . ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", ry j Sr v t ." . (( 496"c„ , l00HP or more. occupancy. Job no.: Job site address: 7 Or L ❑ Six or more residential units. ❑ Recreational vehicle parks. �, ❑ Health -care facilities ID Hazardous locations. ❑ Supply voltage for more than City /State /ZIP: / �� C �� �� 600 volts nominal. Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. .FEE: SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) ! /�+,Q/� ` �y �� / �/JYY , �f� L energy, multi- family __ / ( CSC/ j` C/� $ C S IC F ` I, I � ` J C_.t/ l residential (with above sq. ft.) 75.00 2 ` ,, Services or feeders installation, alteration, and/or relocation 200 amps or less / 80.30 RO.30 2 - ❑ PROPERTY OWNER . ❑ 'TENANT 201 amps to 400 amps 106.85 2 Name: �i c i-- 11-7 4' 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, / 6.65 40 , t j 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and /or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR " Sign or outline lighting 53.40 2 //�� C Signal circuit(s) or limited - Business name: Z'Cee. , ,, ( L�14^4 e energy panel, alteration, or Address: v � L^ /Z 3 r." �ee extension. Describe: Page 2 2 City/State /ZIP: V/ ,, („C , r9 9 61 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: TO3) 70/ 79 Z Fax: (g cPy /- )/76(--rJ Investigation per hour (1 hr Irvin) 62:50 t''' CCB Lie.: / y3 c p e rG Electrical Lie.: 26 99'7( t prv. . ic.: Yfg 5,,t.9 Industrial plant per hour 73.75 V ' Subtotal: - � , ELECTRICAL ,PERMIT FEES Suprv. Electrician signature, required: ! '6' eo . yS Vic a -z4it Date: PC//2/70 Plan review (25% of permit fee): Print name: State surcharge (8% of permit fee): C % Authorized signature: ;(ti--- . '.... TOTAL PERMIT FEE: q3 , 9 � f This permit application expires if a permit is not obtained within 180 Print name: V f " � 1 , �r41. Date: ©e/2/477 days after it has been accepted as complete. 7 * Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp doe 05/23/06 440- 4615T( I 1 /05 /COM/WEB Electrical Permit Application - City of Tigard •Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 260 - 260) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation ri Intercom and Paging Systems n Landscape Irrigation Control* • Medical n Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling • Other _ Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \BuildingTermits\ELC-PermitApp.doc 03/23/06 CITY OF TIGARD . • BUILDING DIVISION PERMIT #: ELC2Q07 -00S89 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/21/2007 Phone: (503) 639 -4171 / pINi�� �"II� Inspection Requests (24 Hrs.): (503) 639 -4175 �_ vd INSPECTION WORKSHEET FOR DATE: ' 8/22/2007 TIME: 7:01AM PAGE: SITE ADDRESS: 09225 SW HALL BLVD A CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MR. FORMAL DESCRIPTION: Replace service/feeder. OWNER: MENASHE, R BARRY, PHONE #: CONTRACTOR: SPARK ELECTRICAL CONSTRUCTION PHONE #: 503 -701 -7822 Ni■ CT Inspection Request Scheduled For: Date: 8/2312007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 064484 -01 603 -701 -7822 Y e1 'ice 6 ct ► c Corrections /Comments /Instructions: `+ II1000M. • • KPASS PARTIAL APPROVAL ❑ CANCEL P NO ACCESS I I FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Cr 4 t V L J Date: A+1 1 Phone #: (503) 718- 1-44