Permit CITY OF TIGARD , I , ELECTRICAL PERMIT
!p q PERMIT #: ELC2007 -00100
COMMUNITY DEVELOPMENT DATE ISSUED: 2/15/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S110AA -00900
SITE ADDRESS: 14050 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: CODA
Project Description: (2) branch circuits for outlets & receptacles.
Job #80.1981.
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:
DAVIES, ROBERT TICE ELECTRIC
c/o PIERCE FAMILY LIMITED PART 5405 N. LAGOON AVE.
BY GEORGE MCELROY + ASSOC INC PORTLAND, OR 97217
DALLAS, TX 75356
Phone: Contact #: FAX 503 - 872 - 8290
PRI 503 - 233 -8801
FEES
Description Date Amount Reg #: ELE 26 - 126C
[ELPRMT] ELC Permit 2/15/2007 $53.50 LIC 166
[TAX] 8% State Surcharge 2/15/2007 $4.28 SUP 2586S
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: Permittee Signature: ,. S-Q 0
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.
r FOR OFFICE USE ONLY
Electrical Permit r
Received
City of Tigard Date,/B . ,? '/ 7 1�� Permit No. C D/I /!Id
13125 SW Hall Blvd., Tigard, OR 223 Plan Review Other permit:
Phone: 503.639 4171 Fax: 503.598 1960 f rr�3 'to ,-.:!..14,' , 3' .4 � '�� ' Date/By;
Inspection Line: 503.639.4175 F �, oo 1 ' 1 1 I � Date Ready/By: leis la See Page 2 for
Internet: www.ci.tigerd.or.us - Notified/Method; Supplemental Information
;l j ! - • • T1[ M PLAN REVIEW
0 New construction . rao'Y. ^t. hr A t ?lttz8 replacement Please •
check all that apply:
❑Service over 225 amps, corur'I ['Hazardous location
D Demolition ❑ other: - . ['Service over 320 amps – rating ['Bulldog over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling XJ Commercial/industrial ❑ Accessory building T ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 snips or more
Multi - family ❑ Master builder ❑ Other: 0 Occupant load over 99 persons ❑Manufachm d structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑health -care facility 0Other:
Job no.: 80.1981 I lob site address: 14050 SW Pacific Hwy Submit." sets of plans with any of the above.
City / State/ZIP: Tigard, OR 9 7 2 2 3 The above are not applicable to temporary construction service.
Coda FEE SCHEDULE
Suite/bldg./apt. tan.: l Project name: Description I Qq. l Fee. I Total I
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
],000 sq. R or less 145.15 4
Subdivision:
Lot no.: Ea. add'l 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
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
new outlets in office and duplex receptacles S erv i ces or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
T 201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER 401 amps to 600 amps 160.60 2
Name: Coda - Tigard Outpatient _ 601 amato 1,000 amps 240.60 2
Address: 14050 SW Pacific Hwy Over 1,000 atwps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Tigard, OR 9 7 2 2 3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( 9 7 ) - 2 21 - 71 61 Pax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which i$ 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 amjss 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. Pee for branch circuits
Contact name: without service or feeder fee, 1 46 85 4 6 . 8 5 •
each branch circuit
Address: Each add'1 brunch circuit 1 6.65 F a i
City/State/ZIP: . Miscellaneous (service or feeder not included)
Pup or irrigation circle 53.40
Phone: ( ) ]Fax:: ( ) Sign or outline lighting 53.40
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 •
Business name: Tice Electric Co. - - - - —
Address: 54 0 5 N Lagoon Avenue Each additional inspection over allowable hi any of the above
Per inspection 62.50
City/ State/ZIP: Portland, Oregon 97217 Investigation per hour (1 ter tele) 62.50 .
Phone: ( 503) 233 -8801 Fax: (503 ) 872 -8290 Industrial plant per hour - - 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 166 Electrical Lic.: 26 -126C Suprv- Inc.: 2586S Subtotal 5 3. 0
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4 . 2 8
Print name: John J. Maloney Date: 2/1 4/07 5 7.7 8 v
TOTAL PERMIT FEE
Authorized signature: This permit application expires it a permit li not obtained within 180
days after it ban been accepted as complete
Print name: Date: " Fee methodology set by 'hi -County Building Industry Service Board
- "• Numher of inspections per permit allowed.
iABuUaa,g‘PatmitAffi.0 PermitApp.QOe raai UO- 46tsrtiomitCOMWW1l9
CITY OF TIGARD
BUILDING DIVISION r v PERMIT #: ELC2007- 00100
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1512007
Phone: (503) 639 -4171 -to 9 4&
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 3/7/2007 TIME: 7:18AM PAGE: 62
SITE ADDRESS: 14050 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CODA
DESCRIPTION: (2) branch circuits for outlets & receptacles.
Job #80.1981.
OWNER: DAVIES, ROBERT, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503233-6801
Inspection Request Scheduled For: Date: 3/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final R 044437 -01 3 *5.033.1470 \ Y
3 31 y -10
Corrections /Comments /Instructions: %)
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �V V L> Date: IP Phone #: (503) 718- 29'1
CITY OF TIGARD t i
BUILDING DIVISION PERMIT #: El .C2007-00100
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21182007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 W
INSPECTION WORKSHEET FOR DATE: 2/23/2007 TIME: 7 :01AM PAGE: 52
SITE ADDRESS: 14050 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CODA
DESCRIPTION: (2) branch circuits for outlets & receptacles.
Job #80.1981.
OWNER: DAVIES, ROBERT, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503.233 -8t301
Inspection Request Scheduled For: Date: 2/23/2007 Pour Time:
Code # Inspection Description .1 irm # Contact # Message
195 Misc. inspection 1.3793-01 503-341 -7337
Corrections/Comments/Instructions:
MU; 00\1\1 1 0 2
\-Age L 'E LRC ci& > P ANa- Rioz NAG 'MA
g IZE tL vAl ALIT., w
bkowe i 13k6 ce 11 • 1
G
NoBLE.
The electrical installation detects noted
on this report shall be corrected end
an Inspection request made within 20
calendar days per OAR 918-27147U 3U
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-- R,6 N 6e L Date: ZI P 6 Phone #: (503) 718- 2144
CITY OF TIGAR -
BUILDING DIVISION PERMIT #: ELC2007 -00100
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1612007
Phone: (503) 639 -4171 �.u.Z'1
Inspection Requests (24 Hrs.): (503) 639 -4175 P_-
INSPECTION WORKSHEET FOR DATE: 2J2212Q07 TIME: . 7 :02AM PAGE: 51
SITE ADDRESS: 140550 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CODA
DESCRIPTION: (2) branch circuits for outlets & receptacles
Job #80 1981.
OWNER: DAVIES, ROBERT, PHONE #:
CONTRACTOR: TICE ELFCI RIC PHONE #: 503-233-8801
Inspection Request Scheduled For: Date: 2/2212007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 043699 -01 503-341 -7337 N
Corrections /Comments /Instructions:
N b Mti� 5 .
1 g,4N icJ po .
•
❑ PASS PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ DDITIONAL FEES ASSESSED
Inspector: ' I des t, Date: 1•Zi2 " tY1 Phone #: (503) 718- 2-44 10