Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00665
DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113BA-00400
SITE ADDRESS: 07632 SW DURHAM RD 120
SUBDIVISION: SW CENTER SDR1999 -00020 ZONING: I P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Relocate (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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 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:
HAMBACH, MICHAEL V + CAPITOL ELECTRIC CO INC
SATTLER, SANDRA E + 11401 NE MARX ST
BROWN, LORENE PORTLAND, OR 97220 -1041
TIGARD, OR 97224
•
Phone: Phone: 255 -9488
Reg ##: LIC 048748
SUP 3132S
FEES ELE 26 -496C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/3/03 $73.45
(TAX] 8% State Surcharge 11/3/03 $5 Wall Cover
Rough -in
Total $79.33 Elect'I Final
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: Permit 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 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit An OFFICE USE ONLY
PI I E D Date received: /(MII Permit n :, _ ii rMC
■,. il ` Project/appl. no.. Expire date:
.64:-.11(1. City of Tigard , Date issued: By;, Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, ,t-'1,' RR7223 - ' Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960
Land use approval: CITY OF TIGARD ICI
BUIU ISIOI`!
TYPE OF LDIN PERDIVMIT
❑ 1 & 2 family dewlling or accessory ;0. Commercial /industrial ❑ Multi- family ❑ Tenant improvement .
o New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: 7630 SW DURHAM RD City: TIGARD Bldg. No.: Suite no: Tax map /tax lot/account no.:
Lot: (Block: N/A (Subdivision:
Project name ALL STATE (Description and location of work on premises: SUITE 120 CHANGE AROUND CIRCUITS
Estimated date of completion/inspection: 11/10/03 r C-tA C< -t.:r- -
CONfRACfOR APPLICATION FEE SCHEDULE
Job no: 23 -1406 Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. insp
Address: 11401 NE Marx New residential - single or multi - family per
City: Portland State: OR ZIP: 97220 -1041 dwelling unit. Includes attached garage.
Phone: 503 - 255 -9488 'Fax: 257 -7121 IE-mail: darrell@cepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.no: 26 -496C 1000 sq, ft, or less $ 145.15 4
City /metro lic.no.: N/ Each additional 500 sq. ft. or portion thereof 5 33.40
10/30/03 Limited energy residential $ 75.00 2
Signature of supervising e ectrician (required) Date Limited energy, non - residential $ 45.00 2
Sup. elect. name (print): Kt ek&,r€( ay 4. License no.: -5 Each manufactured home or modular dwelling
Service and/or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: f State: IZIP: 200 amps or less $ 80.30 2
Phone: (Fax: IE - mail: 201 amps to 400 amps $ 106.85 2
Owner installation: The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps 5 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts S 454.65 2
Owner's signature: Date: Reconnect only 5 66.85 1
ENGINEER Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less $ 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E - mail: 401 amps to 600 amps $ 133.75 2
l'LAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health - care facility or extension per panel:
❑ Service over 320 amps rating of I &2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: 1 $ 46.85 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: 4 $ 6.65 26.60
❑ Egress/lighting piau ❑ Omet Misc. (Service or feeder not Included):
Submit sets of plans with any of the above. Each pump or irrigation circle 5 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting 5 53.40 2
Signal circuit(s) or a limited energy panel,
alteration, or extension* S 75.00 2
'Description:
Each additional inspectionover th allowable in any of the above:
Per inspection I I S 62.50 I I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 73.45
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained Statc Surchargc 8% ) $ 5.88
Name of cardholder as shown on credit card withing 180 days after it has been
$ TOTAL $ 79.33
Cardholder signature Amount accepted as complete.
CITYy'OITIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Requested //' `a AM / BUP
Location 7 Co 3 dZ Suite I a 0 MEC
Contact Person Ph (_17L) SDi' — 74 T PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ( g ELC 3 - Od 6 ('S
Footin
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing C�p�.
Fire wall E1405"/ re g* G � Fire Sprinkler �
Fire Alarm
Susp'd Ceiling
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
larm
S 4;= PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line Date NOV / '
Other: P , 2 ct C �? Ext
Approach/Sidewalk Inspector Q om /
�f
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL