Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00041
i l l n DEVELOPMENT SERVICES DATE ISSUED: 1/28/04
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171 PARCEL: 1S134BC - 00800
SITE ADDRESS: 12398 SW SCHOLLS FERRY RD
SUBDIVISION: PP1993 -058 ZONING: C -P
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Job No. 78235
Lighting retrofit, T12 to T8, replace lighting
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: •
THOMPSON /DAVIDSON LEA SE OREGON ELECTRIC CONST /GROUP
PROPERTY VENTURE, THE 1010 SE 11TH AVE
PO BOX 398 PORTLAND, OR 97214
PORTLAND, OR 97207
Phone: Phone: 503 - 234 -9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/28/04 $53.50
[TAX] 8% State Surcharge 1/28/04 $4 Ceiling Cover
Wall Cover
Total $57.78 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
JAN - 27 - 0 02:06PM FROM - Oregon Electric Estimating 5032313587 T -988 P.001 /002 F -873
Electrical Permit Application OFFICE USE ONLY
City of Tigard I
I Date received: Permit no.LLC a Doi- OOo��_
Pro�ect/aPPl. no.: Expire date:
13125 SW Hall Blvd
. l lI a Phone: (503) 639 -4171, FAX: (503) 598 -1960: Date issued: By: !Receipt n0.:
no.: Payment type: file no
Internet address: www.ci.tigard.or.us Case ,
24 -Hour Inspection Request 503-639-.175 u MultifamlY ❑Tenant improvement
U 1 &2 family dwelling. or accessory l 1 Commercial/Industrial ❑ Other. ❑ Te rtial
0 Newodnstruction. • ' 0 additionlalteratlorilre •lacement
JOB SITE INFORMATION
Bldg. No.: Tax mapftax lot/account no.:
Job Address: 12398 SW Scholls Fe Rd Subdivision I ,
Lot Block: lighting retrofit, T1z to T8, replace lighting
Descri tion and location of work on premises: 9 9
Project Name: Oil Can Honly's i?
Estimated Date of completioMnspaction: ❑ I No ❑ P t Contact Shawn Heinf • e 5112 b36 2671 Phone
Will oar call for ins•ection within 24 hours? Yes FEE SCHEDULE' . , o
CONTRACTOR APPLICATION T o1Hl pip
description oty Fee lea,
Job No.: 78235 • ew rem; en eng• • -
� multdemlty per dwamn0
Business name: Oregon Electric Groff . , - uit. Includes attached
garage. Service included: $ - 5.
415
Address: 1010 SE 11th Ave. 1000 ...1t, or tess S 1 4 $ 4
Car PortlandiState: OR Zip: 97214 , Ea Addl Sot, SF or Portion S S 75.00 S -
wiled Enmity. l a 2 Family PhoneJ501294-g900 Fax (503) 2941001 LE -mail: 75.00 5 _ 2
CCB no.; 209 Elec. bus, lie no.: 26 y lu
timltoo Energy. 5
C• / , • • . N.,: 1 ' - 5 Each manufactured home or
modular dwelling. Service S 90,90 $ • 2
' . �/ 1I » ^ _ 1/27/200 I Service Feeders
_ License no:4460S Servi leoon,eeder tlonor
Su.. Elea Nam ��� Relocation:
� Y
P •'G 7. rY • r •-- 200 am* orleas S man S ?
—,
2
20-lame - 400ampa $ 106.85 $
Name (print): i 5 ,6o.eo 5 - 2
p01amaa - 600amps
Mailinn Address: 2
m p , $ 240.60. $
■
City 'Zip: eolaa- 1000ampa
Phone:
Fax: 1E-mail Over 1000A or Volts - 5 454.65 $ 2
I ReronnoaCaly S 66.85 $ - h
Owner Installation: The installation is being made on property i own which Is T emporary Services or
not intended for sale. lease, rent, or exchange according to ORS 447, 455, Feeders - Installation,
479, 670, 701. Alteration or Relocation: I $ S z
Owner's & nature: Date: 200 a a or lea
201amps -400ampa , S 100.30 . 5 2
I
Over 401amps- 600ampa $ 133.75 $ - 2
Name: Branch circuits • New,
Address: I Alterodon or Extension Per
Penal: A. Foe forbraneh
CI % : State: 21 • ; , circuits with purchase of service
Phone:
or feeder fee, each branch 6.65 $ - 2
Fax: E-mail: circuit -
B. Fee for branch circuits
WIOut Purchase of Service or 46.85 2
Feeder. 1st Branch C.Id 1 $ 46.85 S
PLAN REVIEW
Eac additional branch circuit 1 $ 6.65 $ 6.65_
•
0 Service over 225 amps -comm ❑Health -cat>a facility •
of 0 Hazardous location ' Miscellaneous - (service or
0 Service over 320 amps i feeder not Included)
162 family dwellings 0 Building over 10,000 square feet four or Each t11P or i Oros lion Oe S 53.40 $ 2
2
0 System over 600 volts nominal more residential units in one structure Each Spa or Oulli^e IJg"°"o 5 53.40 $
0 Building over three stories 1:1 Feeders, 400 amps 01' more Panel Signal Alm Alteration of �ensi Energy
0 Occupant load over 99 persons 0 Manufactured structu or RV park -
o • S Ts.o $ 2
0 Egress/lighting plan O Other. -oo erlptlon:
Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. e a o ver
tha Allowable in A bove. per Ins
Nonce: i11is Pit application $ 62.50 1 $ •
orrplres Mil pemrn Is not rnve.tl�6on fee:
RECEIVED has 00000100 as saRerlt L
has fined d italn 1 553.50
con1Ple� Permit Fee
•
Plan review 25% 50.00 A
JAN 2'7 2004 state Surcharge 8% �' 28 P
Total $57.78
CITY OF TIGARD `:
BUILDING DIVISION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIV4SIO4 Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 60 3- AM PM BUP
Location a 3 ite MEC
Contact Person Ph ( ) 9- , PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner � 1_ k . d4 L . ELC -ZOO 7 c4 — ° O 4 7 4 /
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation r P. I (� I n r�
Drywall Nailing '�," / v ���5
Firewall d�1 ` t'1 f (,�--� X r Q �
Fire Sprinkler Il lJ
Fire Alarm slskiCLS
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
Fire Alarm
ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
('PASS PART FAIL
S Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date L O - I 22 If Inspector en Ng Ext
Other:
Final DO NOT REMOVE this inspectio re rd from the job site.
PASS PART FAIL