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Permit A CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00559 i DEVELOPMENT SERVICES DATE ISSUED: 8/31/2004 13125 SW Hall Blvd., Tioard, OR 97223 (503) 639 -4171 PARCEL: 1S136AD -04000 SITE ADDRESS: 11535 SW PACIFIC HWY SUBDIVISION: VILLA RIDGE ZONING: C -G BLOCK: LOT : 007 JURISDICTION: TIG Project Description: Reconnect (2) air handlers & (2) condensors. 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: SIGNAUPANEL: 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: 3 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: SMITH, EDITAM HILLSBORO ELECTRIC 833 NW 170TH DR 21185 NW EVERGREEN PARKWAY BEAVERTON, OR 97006 HILLSBORO, OR 97124 Phone: 503 - 245 -1864 Phone: 503 -439 -9666 Reg #: ELE 34 -4399C LIC 134481 FEES SUP 4941S Description Date Amount Required Inspections [ELPRMT] ELC Permit 8/31/2004 $66.80 [TAX] 8% State Surcharge 8/31/2004 $5.34 Rough -in Elect'l Final Total $72.14 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: ZQ,i Permit Signature: s...-' p,\nsc 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 639 - 4175 by 7:00pm for an inspection the next business day From:HILLSBORO ELECTRIC LLC. 5036013680 08/30/2004 16:33 #826 P.002 Electrical Permit Appli .a • FOR OFFICE i1Cr ()N IS' T- City of TigTigard e•.JBv:. - - / . L oot._ Permit NO.: �LC,,cOD d0sr', 13123 5w Hall Blvd., Tigard, OR 973. `b Ph Ravi= �,..': Phone: 503.639.4171 FaX 503,598,1960 0 � s l �l Date/8 . Other Permit: 0 • Inspection Line; 503.639.4175 �� 67 Date Ready /By: el see Pape; for Internet: wWw.Ci.tigard.or.US A ` Notified/Method; Supplcatental information , . . TYYii :. • .. PLAN REVIEW • � .. ❑ New construction + Addition/alteration/rcplacement Please check all that apply: ❑Service over 2 25 amps. comm'I ❑Hazardous location ❑ Demolition ` ❑ Other: - ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., • CATEGORY OF CONSTRUCTION • • ' • • • . •. • ' , of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling 'immercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ['Building over three sinries ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or . " .. JOB SITE INFORMATION AND LOCATION : • .. ' •• ❑Egress/Iighting plan RV park Job no.: - 3c5L j Job site address: \\r)Z5 ��y CI� ❑Healthcare facility ❑Other. Submit 2,, sets of plans with any of the above. City/ State/ZIP: `\ , OZ C\7 Z7--1 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: Ar.T..S.�o� FEEa SCHEDULE.:: Degerlptltm I Qrr. I Fe• I Total I -' 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! 500 sq. ft. or portion 33A0 1 Limited energy, residential 75.00 2 ' Tax map /parcel no.: . . . . Limited energy, non - residential 75.00 2 • ,.. , .. : , - : : : "' :. , DESCRIPTION OF WORK • _4: : ..- : :ki• :,:::;. 2 . :°• �• ::' %• : ? : : :; .:. :; ;:l " Each manufactured or modular dwelling. service and/or feeder 90.90 2 •Li , �� • Services or feeders installation. alteration. and/or relocation .. 200 amps or less 80.30 2 TENANT';'' :..: ' `: ; s ii e ... 301 amps to 400 amps 106.85 2 • : :.• : ❑ PRl)PERTY OWNER' " :`: :, : 401 amps to 601) amps 160.60 2 Na me :_A`C e-A 601 amps to 1,000 amps 240.60 . 2 Addres \ 57 - t f Over 1.000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: `v S 4Jr 1 OT_l �� Temporary services or feeders installation. alteration, and/o J relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 . 1 Owner installation: This installation is being made on property that 1 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 ; :., :. :. :;•;; :..• ❑ APPLIC ANT. : :. : .. :;' :;.• : :' : ... ,�." �:❑ C ONTA CT PERSON=' .... f with r A. Fee for branch circuits wi �.`. service or feeder fee, each 6.65 2 Business name: branch circuit - B. Fee for branch circuits • Contact name: without service or feeder fee, si each branch circuit 46.83 $ 2 Address: Each add9 branch circuit " I 6.65 V 2 City / State/ZIP: Miscellaneous (service or feeder not Included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2 e-mail: Signal circuit(s) or limited- 1.: .'. ' ....:•:;!..:.,-/ ••:::: :. , .:.. • ' .: CONTRACTOR .::: n, or : .: extension. Describe: Page 2 2 • •�• • •••• energy panel. alteration, Business name: Hi11Sboro Electric L.L.C. -- Address: 21185 NW Everc7reert PKWY Ste #110 Each additional inspection over allowable in any of the above Per inspection 62.50 City / State/ZIP: Hillsboro, OR. 97124 Investigation per hour (I hr min) 1 62.50 Phone: (5 0 3) 439-9666 I Fes: (503 )6 01 - 3 6 8 0. Industrial plant per hour 73,75 .. - • ELECTRICAL PERMIT FEES" • . CCB Lic.:1 3 4 4 81 1 Electrical Lic.:3 4 4 9 9C I Suprv. Lie.: 49 41 S Subtotal ( 1 0 Suprv. Electrician signature, required: i ee Print name: Joey Vitacc0 i Date: ',... 7:C) State surcharge (8% of permit fee) 5 .34 � v TOTAL PERMIT PEE '' 2_� Authorized signature: / T h)a perm application expires if a permit is not Obtained within 1 p 0 - -O - days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building industry Service Board - - •• Number of inspections per permit allowed. l: 3iiiidins \Prnniu‘at.c.ramiIApp4oe 12111 4411- I6I5711t1/02/COMiW® • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested —/ AM PM BUP Location 1 / 5135 fr Suite MEC Contact Person l {a Ph ( ) �j� 3 � 1 `9�� PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELCabb 4 /- 6O55 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT / Post & Beam SLIM Ext Shear Anchors ea th /Sh Ext Sheath/Shear Int Sheath/Shear Framing Insulation p, 5 n ,4 ' l' �,q1 Drywall Nailing / Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling t Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm PASS PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection RE: • Unable to inspect — no access Fire Supply Line ADA Cr Approach/Sidewalk Date © C l Inspector v M . / 1 , / y Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL