Permit 1 �� (:I OF TIGA ELECTRICAL PERMIT
1 ° PERMIT #: ELC2008 -00555
COMMUNITY DEVELOPMENT DATE ISSUED: 10/1/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AD -08806
SITE ADDRESS: 10790 SW MURDOCK ST D7 ZONING: R -12
SUBDIVISION: PACIFIC CREST APARTMENTS LOT : JURISDICTION: TIG
PROJECT: PACIFIC CREST APARTMENTS
Project Description: Electrical reconnect.
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: 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: , 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC CRESTS APARTMENTS
10695 SW MURDOCK ST
TIGARD, OR 97224
Phone: 503 - 639 - 0523 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 10/1/2008 $66.85
[TAX] 12% State Surchar 10/1/2008 $8.02
Total $74.87 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 18 s 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 otifi tion Center. a rules are set forth in
OAR 952 -• s -• • • • ough OAR 952 - 001 -0100. Y6u may obtain copies of these rules or direct question to OU C at 503.24 .66 or 1.800.332.2344.
Issued By. / , L All) Permittee Signature ( kV C (".i
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.
Flictrical Permit Application FOR OFFICE USE ONLY
C �>
City of Tigard Date/By: Received /0 / Gg' Permit No.: G 8
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: .
T I G A R D Inspection Line: 503.639 Date ReadyB luris� El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: _, f ' Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other: where the available fault current 0 Marinas 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
❑ 1- 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.
/ y� ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: / 7 .7 5 W 1 t `U f D oc k - 9' Six HP or more. c r eati on
t ❑ Six or more residential traits. ❑ Recreational vehicle parks.
City/State /ZIP: 7 0 } - 7 - ❑ Health -care facilities. ❑ Supply voltage for more than
/ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no 7- 7 Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Dereription I Qty. I Fee. I Tow I •
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.)
❑ Limited energy, multi - family
:1 G0-7 D/J L>} / residential (with above sq. ft.) 75.00 2
/ Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
PERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ( �i� tc t F 4e -ris 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: /Q g 95 5, W r Pa ( J roc C 47. s r Over 1,000 amps or volts 454.65 2
City/State /ZIP: T G-f OP- 5 7 d?,-/ Temporary services or feeders installation, alteration, and/or
relocation
Phone: (S-33) 63 c2 - Q 5-a 3 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
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 bl0 4 5 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Phone: Per inspection 62.50
hone: ( ) Fax:
( ) Investigation per hour (I hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES 411....95/.
Suprv. Electrician signature, required: Subtotal:
Print name: Date:
Plan review (25% of permit fee):
State surcharge (12 %ofpermit fee): 0
Authorized signature: Q _ TOTAL PERMIT FEE: ?4,'e 7
This permit application expires if a permit is not obtained within 180
Print name: 1 �d Date: id--/ 0 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pennits\ELC- PermitApp.doc 05/23/06 440- 4615T(t 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:
El Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
E l Heating, Ventilation and Air Conditioning System* •
E l Vacuum Systems*
El Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system -
(SEE 'OAR 918- 309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
❑• Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
- *No licenses are required. Licenses are required
for all other installations
l:\ Building \Pennits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E1.G1008 005'i5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 I/2008
Phone: (503) 639 -4171 '' il
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ' ..
INSPECTION WORKSHEET FOR DATE: 10/312008 TIME: 7 :00AM PAGE: 32
SITE ADDRESS: 10790 SW MURDOCK ST D7 CLASS OF WORK:
SUBDIVISION PACIFIC CREST APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CREST APARTMENTS
DESCRIPTION: Electrical reconnect.
OWNER: PACIFIC CRESTS APARTMENTS, PHONE #• 503633 -0523
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date 10/3 /2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 076176 -01 503 -639 -0523 N
Corrections /Comments/ Instructions:
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I pRO.pnit
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A FAIL 111CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CT' 1 vbe) Date: 10 3 Phone #: (503) 718- i r'V