Permit C ITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2005 -00858
DEVELOPMENT` SERVICES • DATE ISSUED: 11/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102A B -03600
SITE ADDRESS: 122.7.; SW MAIN ST ZONING: CBD
SUBDIVISION: / o? o Z q7 LOT : JURISDICTION: TIG
Project Description: Electrical Upg ade. Addresses: 12255 - 12297
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: 7 W /SERVICE OR FEEDER: PER INSPECTION:
r 201 - 400 amp: 0 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: 1 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:
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: Phone: 503 - 274 -4653
FEES Reg #: ELE 5 -55C
LIC 151939
Description Date Amount SUP 3305S
[ELPRMT] ELC Permit 11/2/2005 $722.70
[ELPLCK] ELC Pin Rev 11/2/2005 $180.68 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 11/2/2005 $57.81
Total $961.19
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 -8 33 - 344. _
Issued By: � ���� 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 - 6394175 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.
•
t'`lov 01 05 02:41p GOLD STRR ELEC 5035434025 p.1
Electrical Permit v , l oli orEl( 1. I:sl_ o`l.ti
a
City of Tigard 1 //vac' #3Pj Pt No. 5 ' of '
13125 SW Hall Blvd, Tigard, OR 97223 Plan Review r ,i-....-/ c
Phone: 503.639.4171 Fam 503.598.19140V 1 2005 .`i-F I � �" Date/By Other Permit
Inspection Line•. 503.639.4175 i r 'I .. Date ReadyBy: !®s: la See Paget foe
Internet www.ci.tigard.orus CITY OF TIGARI Notified/Method: r1 Supplementallnfo>matlen
BINGAN PLAN REVIEW
❑ New construction fir Addition/alteration/teplacement Please check all that apply: •
❑ Demolition ❑ Other: ®'Service over 225 amps, connn'l ❑ Hazardous location
❑Service over 320 amps - rating ❑ Buildng ova 10,000 sq. IL,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2-family dwelling IN Commetcia]/mdustrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ®Feeders, 400 amps or more
❑ Multi-family ❑ Master builder ❑ Other:
❑Occupant load over 99 persons ['Manufactured strucdues or
JOB SITE INFORMATION AND LOCATION RV
❑EBross/liP�g P�
Job no.: 2 1 /} Job site addr p.a..{. ` ` : ❑Health-care facility ❑�Cr
j ` i e .aen <' � ..' A i ! , { 1 /1 Submit 2 sets of plans with any of the above. •
City/State/ZIP: -- l 6 et.4 6 ., , (r) t i ` . The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: • .1 [ Project name: �fa " C /_� + r; ./ � Q ..
L �f rrlp • J = j:h r vl Description ( Qty. 1 Fea I Taal I
Cross street/directions to job site ' New residential single- or multi -family dwelling unit.
a Includes attached garage.
1,000 sq. ft or less 145.15 4 • Subdivision: I Lot no.: Ea add'I 500 sq. R 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
L ii L f 2 . / 6t7:4 d .c iz - e l' p fee a? !"-G b IA) Services or feeders brstafation, alteration, and/or relocation
200 amps or less 1 1 80.30 S( .02
• ❑ PROPERTY OWNER ❑TENANT
201 amps to 400 amps 106.85 2
401 amps to 600 amps f 160.60 t, • -: • 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/ZTP: 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 asps 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,
each branch circuit 46.85 2
Address: . . Each add'l branch circuit 645 2
City/ State / ZIP: Miscellaneous (service or feeder not Included) ..‘
Pump ( ) Fax :: ( ) mP 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: 6'0 ifiJ `" f.. e— �.r ") . C :
Address: X� Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: s ) cr Z! / ,e9 0 . (i„ (9j d 6, Investigation per hour (1 hr min) 62.50
Phone: (5.{..).:9 .9 /? q .. > ! 5 . I Fax (V ') EEt 3 -- 2�fa) & LIndustrial pleat per hour 73.75
� 3 Y ELECTRICAL PERMIT FEES*
d // CCB Lic.: / 6 4' 3CY I Electrical Lic.: ✓ 5 ( Suprv. Lic.: c on 33 Subtotal - ;-oro
/ tom' Suprv. Electrician signature, required: ' M.i :ftvt t,(. 0/ le ,
review (25% of paritit foe) _ �� • G 7f
Print name: f ! Date: State surcharge (8°/n. of permit fee)
TOTAL PERMIT FEE
Authorized signature r J > This permit application expires if a permit b not or ...ea watt-- 7 1":
days attar It has been ao as complete
Print j9 k���� � f - [ Date: //- �'. Fee methodology set by Tri- County Building Industry Service Beard
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CITY OF TIGARD
•
BUILDING DIVISION PERMIT #:tiS,ZIOESSIbeCiet
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �r°
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I I�
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1 227 S t MKS' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: tt J O6 Pour. Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ! r Date: 31 01, Phone #: (503) 718- illitrt
CITY OF TIGARD __
BUILDING DIVISION PERMIT #: ELC2U05- 008613
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111312005
Phone: (503) 639 -4171 �m°,p �
Inspection Requests (24 Hrs.): (503) 639 -4175 'I ��
INSPECTION WORKSHEET FOR DATE: 12/20/2005 TIME: 7:02AM PAGE: 7
SITE ADDRESS: 12297 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ESP PROPERTY
DESCRIPTION: Electrical Upgrade. Addresses 12255, 12259, 12265, 12271, 12205, 12289 & 12297.
OWNER: JOHNSON, WARREN W i BETTY TRS AN, PHONE #:
CONTRACTOR: GOLD STAR ELECTRIC PHONE #: 503274 - 41653
Inspection Request Scheduled For: Date: 12/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 024090-01 503 - 348.862.4 Y
Corrections /Comments /Instructions: 7 ____.
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L t, 5 ' eaei I z.z. : iZss 1A 1 0 et balovo .
❑ PASS %PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: " ) Date: ill 75 6 Phone #: (503) 718 - 11 04
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CITY OF TIGARD . - --
BUILDING DIVISION . . -
PERMIT #: ELC2005- 001358
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2005
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 Ja I..
INSPECTION WORKSHEET FOR DATE: 12/21/2005 TIME: 7:01AM PAGE: 63
SITE ADDRESS: 12297 SW MAIN ST CLASS OF WORK: I
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ESP PROPERTY
DESCRIPTION: Electrical Upgrade. Addresses: 12255, 12259, 12265, 12271, 12285, 12289 & 12297.
OWNER: JOHNSON, WARREN W + BETTY TRS AN, PHONE #:
CONTRACTOR: GOLD STAR ELECTRIC PHONE #: 503- 274 -4653
Inspection Request Scheduled For: Date: 12/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
isc. insee • 023833 -01 503 -348 -8624 Y
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o - • - s omments /Ins ruc ions:
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CO Lv t l0 C I't L L ' 1
TA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
f �,,/
Inspector: Gr2- ' Date: L4/O�� Phone #: (503) 718- ZI14t
NI
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00858
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2005
Phone: (503) 639 -4171 / ,�-�tp11 r
Inspection Requests (24 Hrs.): (503) 639 -4175 lit I
INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 7 :04AM PAGE: 73
SITE ADDRESS: 12297 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ESP PROPERTY
DESCRIPTION: Electrical Upgrade. Addresses: 12255, 12259, 12265, 12271, 12285, 12289 & 12297.
OWNER: JOHNSON, WARREN W + BETTY TRS AN, PHONE #:
CONTRACTOR: GOLD STAR ELECTRIC PHONE #: 503-2744653
Inspection Request Scheduled For: Date: 12/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 023521 -01 503-348-8624 Y
Corrections /Comments/ Instructions:
MAKI li' 5
N 'a L-401/4e14.... ,
❑ PASS IA PARTIAL APPROVAL ❑ CANCEL , ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N66 ( Date: 1 MI $;%-' Phone #: (503) 718 - 13A4S
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC2005.00858
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2005
Phone: (503) 639 -4171 / ,,4I i f*
Inspection Requests (24 Hrs.): (503) 639 -4175 °` ..
INSPECTION WORKSHEET FOR DATE: 17/14/2005 TIME: 7:01AM PAGE: 42
// ^7
SITE ADDRESS: SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ESP PROPERTY
DESCRIPTION: Electrical Upgrade. Addresses: 12255 - 122.97
OWNER: JOHNSON, WARREN W + BETTY TRS AN, PHONE #:
CONTRACTOR: GOLD STAR ELECTRIC PHONE #: 503 - 274 - 4653
Inspection Request Scheduled For: Date: 12/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 023445 -01 503- 348 -8624 Y
Corrections /Comments/ Instructions:
p 13 Si ci rAA ek
N 6 1_A9 ii t,
❑ PASS A PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSP TION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 12 I or Phone #: (503) 718- 2.416
l r