Permit CITY OF TIGARD ELECTRICAL PERMIT
II Nil PERMIT #: ELC2006 -00708
COMMUNITY DEVELOPMENT DATE ISSUED: 12/13/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102AB
SITE ADDRESS: 12285 SW MAIN ST ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 2 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: 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: 1 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 RELIANT ELECTRIC LLC
JOHNSON, REES C + MARYANNE G 20200 SE OLDENBURG LN
3112 SW SANTA MONICA ST SANDY, OR 97055
PORTLAND, OR 97201
Phone: Contact #: PRI 503 - 701 - 4562
FAX 503 -668
190
FEES
Description Date Amount Reg #: ELE C59
[ELPRMT] ELC Permit 12/13/200( $53.50 LIC 162814
[TAX] 8% State Surcharge 12/13/200( $4.28 SUP 50675
Total $57,78 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: L et i ediswel... _& a. Permittee Signature: ey1, 1 C.€4,4
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.
DEC : 117096 011: 41P FROM: RELIANT ELECTRIC 5036685577 TO:5035981960 P. 1
Electrical Permit ApplicatiRECE jV, 0 FOR OFFICE IISF. ONLY
City of Tigard Receives ,3 Oh p Pert '' oltNo 4pp6. -ov Oa
13125 SW Hall Blvd., Tigard, OR 97223 DEC 1 •: I' Date/ft
Phone: 503.639.4171 Fax: 503.598.1960 Plan Re • Other Permit:
Inspection Line: 503.639.4175 CITY ()F.:44" .:-. -e Date Ready/By • hrr &1 See Page 2 for
w
Internet: ww.ci.tigard.or• us BUI I
- Notified/Method: Supplemental Information
zagy a -.'�+ 7 ' , S a CwL .. . !' ' YF - •r. :54 +' •. ;,t , :41` 7 41:.:'',8 . :- 'ikiPfs.+kilk rd!F 4 .
❑ New construction • tt Addition/alteration /replacement Please check all that apply:
❑Demolition E1 Other: ['Service over 225 amps, comm'I ❑Hazardous location
a ❑Service over 320 amps - rating ❑Buildng over 10,000 sq. ft.,
: a F . A7 .;. i r s.• r . , o cyo ttl a c of 1- and 2-family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling : i Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multifamily • Master builder ❑ Other: ['Occupant load over 99 persons [Manufactured structures or
T >' `' . r .� - d a x, - t ... °'�r1y'i e � il i .i o f r `(tr t 4'� '; RV
i?- .r.r'' t1:, r �: .�,�`>?��•��-� �'�� ^ av,. _- ���� *- t:�.�,,.° � ..�!��_, ❑Egress /lighting park
p
Job no.: Job site address: 1 2.2$ r) yy� ❑Health -care facility ['Other: S�v r 1r/./�/ Submit j sets of plans with any of the above.
City /State/ZIP: Till/41d/ a R. The above are not applicable to temporary construction service.
S ;.
Suite/bldg. /apt no.: Project name: . J -4 A - Description Qt Pee. Total ,•
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: I Lot no.: Ea. add'i 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
tAr4 3 r �( e7i !it�ag �..•�v- ' �. °� 'r'r�" '�
2- ?� ` . + �i ;! 2" I I r'1' ' i. o u ! �•`�fa`J��� r ;. '- " i', Each manufactured or modular
dwelling, service and /or feeder 90.90 2
a _ , . Services or feeders Installation, alteration, and/or relocation
L ,, i t�--• • l i `
G ( / o' 200 amps or less 80.30 2
r i i . ;:,,V ; e 5 v 5N i A t � t H i , MR t ti 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/ Statc/ZIP: Temporary services or feeders Installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 I
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: y,� E' � Date: Branch circuits- new, alteration, or extension, per panel
Fl si � L t` ] ' � „ _ " . �f+ ; �4r * sJ R' i ' �l`1,� :d � _ w . : { l A. Fee for branch c with
L
he . _'.. .., M L. r � '' � -
Business name: ° / ti .��` j �
. n C- service c suit fee, each 6.65 2
Contact name: 8 I ' Tram- ayy> B Fee o ur service circuits
es '
without service or feeder fee,
� 0 �� -h 46.85 l s 2
Address: t'J E ach add'I branch circuit � 6.63 6r 2
'9 City / State/ZIP: 6/ 0g_ 7. 3 I Miscellaneous (service or feeder not Included)
Phone: (� go C1 L //� ��� I Fax: (5) r�, G, D Pump or irrigation circle 53.40 2
Va �tV D P Sign or outline lighting -- 53.40 _
E -mail. 1 / (0.41.* - A ,/ / / , _ #) Signal circuit(s) or limited -
v tg ` l :•?; j4 ?i "p n x ._ , »7' a -- : o t • •� iT energy panel, alteration, or
i c t1il�...� ' extension. Describe: Page 2 2
Business name: P X � n - {
Address: 2-0 2.0 0 SE D ld vAivvJ u ,k- I p ti Each additional Inspection over allowable In any of the above
n �C Per inspection 62.50
City/ State/ZIP: + O,Q Cr2O Investigation per hour (1 hr min) 62.50
Phone' () (Jt(GD 4 I Fax ) ipLo U industrial plant per hour 73.75
i 1 y
CCB Lic.: , Z$ 4- Electrical Lic.: Suprv. Lic.5 4 Subtotal 5 3,50
Suprv. Electrician signature, required: , / . f ,.T t mi Plan review (25% of permit fee)
Print name: I *A A 1 L / �� = Date: I Z - 3 - State surcharge (8% of permit fee) 47 245
TOTAL PERMIT FEE 57, - 7
Authorized signature: / 7
i / 4 not obtained within Iso
5� �� I � dogyset nt Thl, permit application expires if a permit accepted complete
Print name: I \i�J u Date: Z' 3D F ee methodology set by Tri- Count Building Indus Service Board
/ e• Number of inspections per permit allowed.
is UBuildhng \PmnitdELC- PemriiApp,doe 12/03 440-46157( !0 /02/COM/WEB
"7 -
CITY OF TIGARD
• BUILDING DIVISION PERMIT #: EL_C2006 00708
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2006
Phone: (503) 639 -4171 M Inspection Requests (24 Hrs.): (503) 639 -4175 .,
INSPECTION WORKSHEET FOR DATE: 1/12/2007 TIME: 7 :04AM PAGE: 18
SITE ADDRESS: 12285 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STATE FARM
DESCRIPTION: 2 branch circuits.
OWNER: JOHNSON, WARREN W + BE I I Y TRS AN, PHONE #:
CONTRACTOR: RELIANT ELECTRIC LLC PHONE #: 503- 701 -4562
Inspection Request Scheduled For: Date: 1/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 -cal final 042092 -01 503-860.4240 Y
Corrections/Comments/Instructions:
Wsr i t∎i &. L L 5 382,!
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS.
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 Date: I ZI 6 / Phone #: (503) 718 -24
CITY OF TIGARD f
' BUILDING DIVISION PERMIT #: ELC200011708
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2006
Phone: (503) 639 -4171'
Inspection Requests (24 Hrs.): (503) 639 -4175 F'' L
INSPECTION WORKSHEET FOR DATE: /2129/2006 TIME: Tem PAGE: 38
SITE ADDRESS: 12285 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STATE FARM
DESCRIPTION: 2 branch circuits.
OWNER: JOHNSON, WARREN W + BETTY TRS AN, PHONE #:
CONTRACTOR: RELIANT ELECTRIC LLC PHONE #: 503.701 -4562
Inspection Request Scheduled For: Date: 12/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 041614 -01 503. 860.4240 Y
Corrections /Comments /Instructions:
L 1 2 4 8
‘Z"0 t�l 61 ( -t t U 4 L V i; 1 L % c
.3 04 , 0 \i 0'1 e-- OPq Nvprz;%\)4
P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N cC D ate: _1 "J W Phone #: (503) 718- �� YV
r
CITY OF TIGARD
BUILDING DIVI PERMIT #: ELC2006-00708
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2006
Phone: (503) 639 -4171 At'
Inspection Requests (24 Hrs.): (503) 639 -4175 "
INSPECTION WORKSHEET FOR DATE: 12129/2006 TIME: 7:00AM PAGE: 50
SITE ADDRESS: 12285 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STATE FARM
DESCRIPTION: 2 branch circuits.
OWNER: JOHNSON, WARREN W + BETTY TRS AN, PHONE #:
CONTRACTOR: RELIANT ELECTRIC LLC PHONE #: 503- 701 -A562
Inspection Request Scheduled For: Date: 12/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 04159401 503 -860 -4240 N
Corrections/Comments/Instructions:
" Do Nt 1 ( Q\ ect.. W A Li-6 tio ,,„c iv
1
A *u CIL NI e u --- z:1 RI,C L LAi .t\(
XPASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr . N 66 L Date: lid' Z$T(tti• Phone #: (503) 718- 14‘
CITY OF TIGARD
.
BUILDING DIVISION PERMIT #: ELC200E•00708 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2006
Phone: (503) 639 -4171w
Inspection Requests (24 Hrs.): (503) 639 -4175 411
INSPECTION WORKSHEET FOR DATE: 12/19/2(306 TIME: 7:00AM PAGE: •16
SITE ADDRESS: 12285 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STATE FARM
DESCRIPTION: 2 blanch circuits.
OWNER: JOHNSON, WARREN W + BETTY TRS AN, PHONE #:
CONTRACTOR: RELIANT ELECTRIC LLC PHONE #: 503 - 701 - 4562
Inspection Request Scheduled For: Date: 121191200E Pour Time:
Code # Inspection Description Confirm # Contact # Message
126 Wall cover 041281 -01 503 -860 -4240 Y
Corrections/Comments/Instructions:
C /6( G
'
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
( -/ 9'
Inspector: h..�� � Date: Phone #: (503) 718-