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Permit r ELECTRICAL PERMIT CITY OF TIGARD PERMIT #: ELC2005 -00983 i DEVELOPMENT SERVICES DATE ISSUED: 12/30/2005 =mai 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S 102AB -03600 SITE ADDRESS: 12265 SW MAIN ST ZONING: CBD SUBDIVISION: LOT : JURISDICTION: TIG Project Description: 6 branch circuits. Compliance repairs. 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: 5 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: JOHNSON, WARREN W + BETTY TRS AN GOLD STAR ELECTRIC JOHNSON, REES C + MARYANNE G 51627SW 5TH 3112 SW SANTA MONICA ST SCAPPOOSE, OR 97056 PORTLAND, OR 97201 Phone: Contact #: PRI 503 - 274 -4653 FX .5v3 5 • slct- FEES Description Date Amount Reg #: ELE 5 -55C [ELPRMT] ELC Permit 12/30/200: $80.10 LIC 151939 [TAX] 8% State Surcharge 12/30/200: $6.41 SUP 33055 • • Total $86.51 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 11 -8 332 - Issued By: 47/.2. Permittee Signature: f)77 / 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 cans 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. • Dec 29 05 01:05p GOLD STAR ELEC 5035434025 p.9 Electrical Permit Application r FOR OFFICE_ USF ONLY City of Tigard C E I V E D �e/By , - ' r(eg Permit NO L � - � 5 - 00 95 13125 SW Hall Blvd., Tigard, OR Plan Review .,. Phone: 503.639.4171 Fax: 503.598.1960 :r' may Other Permit: Internet Inspection w ine: 503.639.4175 DEC 2 9 2005 = '' '11I � �R ( El See Pageafor . / ° (j ( Sapplem D PLAN REVIEW ❑ New construction riaiIeagab tegit 6n9aia B ement Please check all that apply: El Demolition ❑Other 0 Service over 225 amps, comm'l ❑Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. R, CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling Ej Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure ❑Building over three stories ❑Feeders, 400 amps or more ❑ Multi-family ❑Nester builder 0 Other: ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lightmg plan RV park Job no.: gG1 I? Job site address: I? Sit) /Y1 r //� �/ 1 ❑Health-care facility ❑Other. Submit 2 sets of plans with any of the above. City /State/ZIP: /� l The above are not applicable to temporary construction service. eiti 5 i / 4n • Suite/bldg. /apt no.: `- Project name: S p , re- / l ec �.1 rims. FEE SCHEDULE E Fee. w I •• Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. w Includes attached garage. 1,000 sq, ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular /)� n C !Gr tC / ` rf /�' dwelling, service and/or feeder 90.90 2 ( . ( f' . e ' / r ` t -ef 6 S - p c Services or feeders Installation, alteration, and/or relocation A r / 1 } / / --- /S 7 W c! d'r 200 amps or less 80.30 2 ❑ PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 106.85 2 401 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: ( ) I Fax: ( ) won 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 ❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, Address: first branch circuit 46.85. (., y 2 Each add'l branch circuit 5 - 663 - 33,,15 2 City/State/ZIP: Miscellaneous (service or feeder not included) °' Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 • Business name: 67Z /'/ <'T LLr ij/ f ' Address: P }� /t��� 3/0 Each additional inspection over allowable is any of the above C' Per inspection • 62.50 City/State/ZIP: se: `f np'osee - ()P, Q.7,_ Investigation per hour (1 hr mm) 62.50 Phone: ( j T e 3 ) ,,l C / ( ' „5 J Fax(5) 543 T l `) ' Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: /57 ii 3e, I Electrical Lic.: 73 7/ I Suprv. Lic.: -6 /S Subtotal i? Suprv. Electrician signature, required: �G . � 4 �f� Plan review (25% of permit fee) Print name: r - /c , G id-;191-0.`-7 `� State surcharge (8% of permit fee) / • (.// / r'� �, Bo rn e } te: TOTAL PERMIT FEE y i �.: 5/ a � Authorized Signature: 1 7// � y _,4j/7 permit pert application expires If a permit b not obtained within 180 ( -e " / s � G .1. days after It has been accepted as complete Print name: ()a/ /4m i i f f ,..2i2l4t I Date: /2x;- • Fee methodology set b y Tri_Co Build' u>ny mg Industry Service Board L� t. Electrical Permits Completed a/o 1/31/06, 12297 SW Main St., Tigard . Permit Address Scope EL '2005 -00858 12297 SW Main St. Service upgrade; meter relocations, installation of meter mains. — ELC2005 -00983 12265 SW Main St. 6 branch circuits and compliance repairs. ELC2005- 00984 12271 SW Main St. 6 branch circuits and compliance repairs. ELC2005 -00985 12259 SW Main St. 5 branch circuits and compliance repairs. ELC2005 -00986 12255 SW Main St. 4 branch circuits and compliance repairs. ELC2005 -00987 12285 SW Main St. 2 branch circuits and compliance repairs. EL '2005 -00988 12289 SW Main St. 2 branch circuits and compliance repairs. ELC2005 -00989 12297 SW Main St. 6 branch circuits and compliance repairs. All complete through final inspection approval. CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006.00f3g3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/30/2006 Phone: (503) 639 -4171 wyi14! Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/31/200 TIME: 7:01AM PAGE: 20 SITE ADDRESS: 12265 SW MAIN ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ESP PROPERTIES/VANS DESCRIPTION: 6 branch circuits. Complo nce repairs. OWNER: JOHNSON, WARREN W 4 _TTY TRS AN, PHONE #: CONTRACTOR: GOLD STAR ELECTRIC PHONE #: 503•274.463 Inspection Request Scheduled For: DM • 1131/2086 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 026027 -0 971-219.2t310 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6 O (,L, Date: V31 66 Phone #: (503) 718 - ZING • CITY OF TIGARD BUILDING DIVISION • PERMIT #: EI_t:200 &-0 993 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12130/2006 Phone: (503) 639 -4171 /uayp� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/3012006 TIME: 7:01AM PAGE: 41 SITE ADDRESS: 12265 SW MAIN ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ESP PROPER'TIES/YANS DESCRIPTION: 6 branch circuits. Compliance repairs. OWNER: JOHNSON, WARREN W + BE I IV TRS AN, PHONE #: CONTRACTOR: GOLD STAR ELECTRIC PHONE #: 503-274-4653 Inspection Request Scheduled For: Date: 1/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 025047 -01 971 - 219- 281() N Corrections /Comments /Instructions: C 2l a 541 / 41 t C W oR, K i 01, C- LZItit Iaiv - 1 ( ,) F- 1 Q E∎r t c_ fad . A, I I O - V) C -? c1 eV WN\ 'eN446`a3 05 bV pa& g�� 33 L Ci) V as:AIN 05 A st vO CiS r & A) c aet..< I�j �Z;' cAtlingg 6 tGL Act "Pc�v;Og o y `' Q�oX �Yt 0011 CAVER.S crdi- c/o is .. 1V1/42).1 • g r - tk6ovS 6 -� 0,01 a(L 1ry� P Liza - w i c.) Qov.) • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1KFAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' 68 Date: 1 "SO 4 Phone #: (503) 718- 411114k1