Permit 4 �
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00130
DEVELOPMENT SERVICES DATE ISSUED: 2/15 /2006
'=--' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S 10X8 -01802
SITE ADDRESS: 13405 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 5 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: 4 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:
BARUCH, ISAAC TRUSTEE LEAR ELECTRIC
BY PACIFIC PIZZA CO • PO BOX 573
1905 NW 169TH PL STE 201 GRESHAM, OR 97030
BEAVERTON, OR 97006
Phone: Contact #: PRI 503 - 665 - 9840
FAX 503 - 661 -6389
FEES
Description Date Amount Reg #: LIC 00052278
[ELPRMT] ELC Permit 2/15/2006 $73.45 SUP 37865
[TAX] 8% State Surcharge 2/15/2006 $5.88 ELE 26 -411C
Total $79.33 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= 332 -2
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.
02/13/2006 16:19 5036616389 LEAR ELECTRIC CO INC PAGE 02
. % - Electrical Permit Applica w ' i s t - ()i l Si ., ()NI V -
City of Tigard V c r Receiv -,
��� Dal O b jj 6 Permit No ,�bb D D 130
13125 SW hall Blvd, Tigard. OR 97213 • plan R y e
Phone: 503.639.4171 Fax. 503.598.1960 %` +s ' , , , ::r ` ' Other Permit:
inspection Line: 503.639.4175 �.1' ,, I E LI. Dote/
FEB 13 L i.;-,F.,- - Date 12redy/By: Jw; ! ® See Page 2 for
Internet: www.ci.tigard.or.uS Nolified/Mcdt �j�t/Y Supplemental rnforroatton
z^` . L C`.._ 'SY� rr {.'";i i;',t -F ... _ ., _ -
4, , -1i y:.r%: ,- 'n:{ f ! `t ..r.. r4iii, - i+:'•'2:�: , l•4L: . ; ,
. �;,; `(� x .�f:' - ?� Fri. �?. -' .r :C "i'.
ro
,y
❑ New construction 1.1 A. In :.v,i .• �ii) Please check all that apply
El Demolition M .,' : � ' ❑Service over 225 amps, comtn'1 ['Hazardous location
i;�;z:as��;. �: a`r�, �, ?:''•�i- � ,`,� `�' �f; . ,-._ �, - : '- >; . Service over 320 amps - rating Buildng over 10.000 R.,
i.: `' � -; =� `:�:` ��;,' �= .;:: :;:':: ' -i:. of 1 -and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
El Multi - family ❑ Master builder
❑ Other:
�- - ._. 4r
:.Y'
'I.1•4'`'' a�,,:, 5 , yn �,, Vy �.ys,,;� - .�_.,,� �:. - - ; : T ' <, � ;'. , ... ,t : . .: ❑Occupant load over 99 persons ❑Manufncntred structures or
- s, �!=' _ ..,. $:�5 #h ,ii; 44# .. ,,...' ['Egress/lighting plan RV park
Job no.: /55 1 Job site address: ❑Health -care facility ['Other: 7 3 y0 5 S u/ P4 /r ad FJ e- . Submit 2 sets of plans with any of the above.
City /State /ZIP: -R,e LAS / OA - / _ 97Z� The
,U /y oabovearenotto temporary construction service.
t
Suite/bldg./apt. no.: Project name: ; -r ^` ��` r..:- �` `' T+�.
ProjeC AZ . / / `: 9, 1: a 6y:_:;:'' } °� : "�c;a�_
( � U s e ( - �. . ,
Deteriptba I- Qty. i Pee. I Total I
Cross street/directions to job site: New residential single- or multifamily dwelling unit.
Includes attached garage
1,000 sq. $. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map/parcel no.: Limited energy, residential 75.00 2
� :•:i;'= t :;ate :° �> Limited energy. non- residential 75.00 2
. , _. _ ,....._.. . _.�_...,. : c:. � , _ , a , . �•-;� -. ; �;.`'` : � _. ...:. ' • .. , ..:` Each manufactured or modular
/JQ n � A /1 J ACE dwelling, service and/or feeder 90.90 2
u L Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
i "'K,Wi l'g n::: :-, .Ypin�r_�_f�rl, ., , ..� , : # :l' Ys , i :. . wz;y � �: ;: .:, 201 amps to 400 amps 106.85 2
a - ... " �`i. , .:�" "fa��..f... A -.r.:, ., K,.. c %t'ea` >:'a' -- „ .. _., .. � *io! ,"1•''c "< . _.. ?F
Name:
401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City / State/ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 2
intended for sale, lease, rent, or e>tchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: C
Date: Branch
.,.• _ _ _ - � circuits - new, alteration, or extension, per panel
;. - - 6:4-'<? j:. A.Feef
-.. 'er •G::b }��.` tsi�- �:�: yy�i�pp Or branch circuits with
.
'
�'� "- �" �'�,' service or feeder fee. each J
Business name: branch circuit 7 6.65 �O , log 2
B. Fee for branch circuits
Contact without service or feeder fee.
Address:
first branch circuit / 46.85)/6 • s- 2
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) l:ax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail:
Signal circuit(s) ts) or limited -
iF. 2�jr i; Y.;+�� d- - .i' - r- , �:,;' r_`.'J'p' -'"v' y . - �:':
.,: ;': .,�3.;i; .-•:;; ., .;$!k'.�w�'G,;r.a;icI fir'C6 gi ±,'�t. ,'�`"_:i.;:.,.!,... _ -"9.`• enClgypanel,alteration,or
extension Describe: Page 2 2
Business name: Z /Z CL� ' / C
r ddress: - "Po 3 t7 X s 7 3 Each additional Inspection over allowable in any of the above
Per inspection 62.50
IP City /State /ZIP: G R t1,C/,/ie} 1.V 9'7D.3 a Investigation per hour (I hr min) 62.50
1 Phone: (503 ) (o ( -9g Y 9 Fax: (5 >A4 / - 6387 Industrial plant per hour 73.75
I r itc:i ,, - - t. •
7,6 Electrical Lic.: ( yf .e Suprv. Lic_ 3 / i� p .13 •�S
y loS Subtotal
Suprv. Electrician signatur quired: 1 . / // Plan review (25% of permit fe fee)
a� - �
Print name: t e : �C State surcharge (8% of permit fee) y /'7
'.aliS/ 4,41;1,71,/y--,15,4 ` /� ... e.' < :::, TOTAL. PERMIT PEE . o \ 'l • 35
Anthoriz e: , /i!�� This permit application expires If a permit is not obtained within 180
7
days after it has been accepted as complete
Prin name:
Date :G - /3 Q.6 • Fee methodology act by Tri-Counry Building Industry Service Board
" Number of inspections per permit allowed.
i:\ BuildneartnitmELC- PermitApp.doc 120 4404615Ti10/02 /COM/wEa
CITY OF TIGARD - ELL,
BUILDING DIVISION PERMIT #: c: 00 (0 — CO /30
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 At
Inspection Requests (24 Hrs.): (503) 639- 4175 ill
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
r • r
SITE ADDRESS: 1 q O S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 Is (.P Pour Time:
Code # Inspection c
9 D ription Confirm # Contact # Message
g� j. DQ d
1 - $f
Corrections /Comments/ Instructions:
• '(
)4PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-Al E"' `E Date: 04 Phone #: (503) 718- 2 o .