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Permit A • a CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00089 41/ 11(11' DEVELOPMENT SERVICES DATE ISSUED: 2/15/2005 r �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 110 D B -01300 SITE ADDRESS: 15298 SW ROYALTY PKWY LEGACY SUBDIVISION: PP1996 -010 ZONING: C -G BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Reinstall plug & sign after wall damage. Job # 3554. 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: 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: PARR - FRANKLIN LLC HILLSBORO ELECTRIC 330 SW LINCOLN 21185 NW EVERGREEN PARKWAY PORTLAND, OR 97201 HILLSBORO, OR 97124 Phone: Phone: 503 - 439 - 9666 FEES Reg #: ELE 34 -4399C Description Date Amount LIP 194451 SUP 4941S [ELPRMT] ELC Permit 2/15/2005 $46.85 [TAX] 8% State Surcharge 2/15/2005 $3.75 REQUIRED ITEMS AND REPORTS Total $50.60 • This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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: / / �1�'��� Permit Signature: le „to c5c \p. 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 02/14/2005 15:09 #924 P.001 0, p . Electrical Permit Aap Jig E w E FOR ()FFIr :F. 111S1 ONi.l• City of Tigard Received ;� / — i # 1 Permit NO.'' _ /OSY/IJO s 13125 SW Hall Blvd., Tigard, OR 97223 F EB 14 200 Plan Review - h..i,, ._y �;• y: Other Permit: . • Phone: 503.639.4171 Fax: 503.598.1960 I ( DwdB Inspection Line: 503.639.4175 CITY pF T IG _ , 1 . �. ` 1 •, Date Ready/By: see Page 2 for Internet: www.ei.tigard.or.us BkItLDING DI • ` Notified/Method: Supplemental Information TYPE, OF WORK : N REVIE ❑ New construction ❑ Addition/alteration/replacement . Please check all that apply: ❑Service over 225 amps, comm Hazardous location . ❑ Demolition T.� Other over 330 amps — rating Buildng over 10.000 sq. ft ['Service a ng , • • '.CATEGORY OF CONSTRUCTION. : ; - :!. l `' of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2- family dwelling ig Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi-family ©Master builder ❑Other ['Building over three stories . ['Feeders, 400 amps or more ['Occupant load over 99 persons ❑Manufactured structures Or • JOB SITE JNFORMATION,ANDD LOCATION.. :, . „ . , .. . D . . ': . ❑Eg ess/li plan RV park ; a Ll Job site address: IS' a l Q R ..r J PPK y ❑He-care facilit Q�her: Job no.: � � l p Q Submit alth Z sets of plan with any of t above. City/State/ZIP: • S 4{ a dg , q '7 2 . y The above are not applicable to temporary construction service. 1dgJapt no.: ' . c Project name: `': 7• F scHgliDL & :..: :•: / '� � Suite/b " .• I..e v' � •' .... lic , :. ; 1 `' ?. I Qt,. 1 p.c. •• Toed , . 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'I 500 sq. A or portion 33.40 1 • Limited energy. residential 75.00 2 Tax map/parcel no,. • "..i.;. - >:. :1DE RIPTiON OF .'WO _ �: ,.; ,. a, ..., Limited energy, non - residential 75.00 2 • .. ; ,,, ... ... , , . , ' !: SC RrC4; . _ .... . . ; ', ;:�, ::T•!: "�';:= Each manufactured or modular • / I dwelling, service and/or feeder 90.90 2 g tr * AG4 I1 i3It15 Rh � _i c n CL i 1, ai 't• S.C. Services or feeders installation, alteration, and/or relocation J 200 amps or less . 80.30 2 .. ... ... ... am to 400 amps ....... .Qp . 120PE1IT1r'OWNIi � - � °J ;...., ;... r . = . 401 amps to 600 amps 160.60 2 — Name: 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/ZI P: • Temporary services or feeders installation, alteration, and /or Phone: ( ) • I Fax ( ) r0p 200 0 a a mm 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 - • ' 'Q::APPI:ICA')<TT•`A i; ";- "':4 . ;.7 ., .. :'CONTACT PERtSOPf ^i :' `'..' A, Fee for branch circuits with service or feeder fee, each 6,65 • 2 Business name :. branch circuit . . B. Fee for branch circuits • Contact name: with/no service or feeder fee. • • each branch circuit • l • 46.85 ` .0 2 Address: .Ba ad d'l branch circuit 6.65 2 City/Stale/ZIP: Miscellaneous (service or feeder not included) • Pump or irrigation circle 53.40 2 Phone. ( ) Fox.. ) Sign or outline lighting 53.40 , 2 E-mail: Signal circuit(s) or limited. C NT • •,r,::.: energy panel, alteration, ' O RACTOR . .:r> ...... • . or be ....' . :•: :� � extension. Describe: Page 2 • Businessname:Hillsboro Electric L.L.C. - _h._ - Address: Each additional inspection over allowable in any of the above 211 85 NW Evergreen 'RWY Ste. #11 0 Per inspection 62.50 City/State/ZIP: Hillsboro, OR. 97124 Investigation per hour (thrmin) 62.30 Phone:(503) 439 -9666 Fax: (503 )601 -3680 •.:: >,:::':••: Industrial plant per hour 73,75 :::: . :PERMIT FEES! CCB Lic.:1 3 4 4 81 Electrical Lic, :3 4 4 9 9 C I Suprv. Lic.: 49415 Subtotal i( F6-- Suprv. Electrician signature, required: �.../..e.t...C.•e) Plan review (25% of permit fee) t State surcharge (8% of permit fee) .3_,�s Print name: Joey Vi.tacco Date: .2 t 7 ..OS ^ TOTAL PERMIT FEE 5•p, by Authorized Signature: This permit application expires if a permit is not obtained within 180 . days after It has been accepted so complete Print name: . Date: s Fee meghodoloi set by Tri County 8uildinj Indusay Service Board •" Number of inspections per permit allowed :\ Building \Pamhs\EI.C- PenniLAPpp.doc I2/03 440.46 sT(IINa2/COM/WEB • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/15/2005 Phone: (503) 639 -4171 4,4111 Inspection Requests (24 Hrs.): (503) 639 -4175 L. INSPECTION WORKSHEET FOR DATE: 3/11/2005 TIME: 7:27AM PAGE: 79 SITE ADDRESS: 15298 SW ROYALTY PKWY LEGACY CLASS OF WORK: SUBDIVISION: PP1996 -010 LOT #: 002 TYPE OF USE: PROJECT NAME: OSHU CLINIC DESCRIPTION: Reinstall plug & sign after wall damage. Job # 3554. OWNER: PHONE #: CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503439 -9666 Inspection Request Scheduled For: Date: 3/11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 001297 -01 503439-9666 N Corrections /Comments /Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: J Date:" - 11 �� Phone #: (503) 718 -