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Permit ..CITY OF TIGARD ELECTRICAL PERMI . PERMIT #: ELC2004 -00665 - DEVELOPMENT SERVICES D ATE ISSUED: 10/18/2004 . --II' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 112AD -00900 SITE ADDRESS: 14800 SW SEQUOIA PKWY SUBDIVISION: _ ZONING: I -P • BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of (5) branch circuits for seasonal power. Job No. 243702 - 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: . HOME DEPOT USA INC IDEAL SERVICES INC ' BY MARSHALL + STEVENS INC 3525 S ALDER ' ATTN: MELISSA SHAPIRO • TACOMA, OR 98409 PHILADELPHIA, PA 19103 . Phone: Phone: 253- 671 -2160 • , Reg #: LIC 154353 . • ELE 37 -988C FEES .. • SUP 1551S Description Date Amount Required Inspections • [ELPRMT] ELC Permit 10/18/200' - $73.45 - [TAX] 8% State Surcharge 10/18/200' $5.88 Rough - , Elect'I Final Total $79.33 - 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 AR 952-001-0 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at,(503) , 246-0 or 1 -800 -332- . Iss d By: I CikaiP�' Permit Signature: '( l� - 1 , . , • • 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: • �CONTRACTO - I •+ ON ONLY SIGNATURE OF SUPR. ELEC'N: ! /�i. i/ �� DATE: /d �/ • LICENSE NO: . /55/ 5 ' • Call 639 - 4175 by 7:00pm for an inspection the next business day • Electrical, Permit Application FOR OFFICE USE ONLY City of K i gard D Received /B . /o ig o WPM Pemti : EGG �� (4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 - ^ \ Date/8 : Other Permit: Inspection Line: 503.639.4175 - ■ {,l if a pl''� Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: / Supplemental Information Y �-.. T r Y .a — .y* i r v -r�..: - s LTS. �. F -7.7 484E:17•4; SL' ti`_ a f . .., w r,.,.,,,, ' _ s ^t a+ t''�, 7;r. ti*g y _�.] `7 ,J �t' � x i. t� '4 .q: _ r � : ' '' �:' �5 +.YS.F .;_r lc� _ �.., .1'._�- ���� _a :_.� 5- + ��+.�t''� •°�i i� 1 -•_ •,gar,, .. ❑ New construction X Addition/alteration /replacement Please check all that apply: ❑ Demolition ❑Other ❑Service over 225 amps, comm'1 ['Hazardous location tx ,., `' - , ,- r 1 --, t t •� . ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., 4 r w_ , 1 ' 4 'I � '^"``"'"L 'r »' r - ' 1 n of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2 family dwelling 123 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 ❑Occ ant load over 99 persons OManufactured structures or _�s f l� , =y ^u [3M r s4, n''"' i ❑Egress/lighting p RV park Via, r s "mss � sa .�,.0 --- , Job no.: 2.431 y Job address: ,v,,,,, rs�s vatr•� ,i,,,,,7 ❑Health -care facility plan 2 sets of plans with any of the above. City/ State/ZIP: / r �,g. O "L__ q7�z 3 / The above are not applicable to temporary construction service. Suite/bldg. /apt no.: I Project name: ? h9 te '' - ' ' r�'. y m � ? s F ' , [ t... ,' ~ , Description Qty. Fee Total •. 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'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no Limited energy, residential 75.00 2 7r� a � .� ` �. YFt y � � f4t � u „ 5 r . U q 4 Limited energy, non - residential 75.00 2 y.! w : . ?. -I ice.,.: ,- r . N . .. . :._ ,, -. s0 _s, _ t. ' �- s4l, Each manufactured or modular r :----• / dwelling, service and/or feeder 90.90 2 /4- s ” C»�ti S P" � , - - ew j{� Services or feeders installation, alteration, and/or relocation V 200 amps or less 80.30 2 i�F'. i'Y A'r 4 S "l h - L. a r 7'1 � ' . , . `%' x a� :vi4L..'_ Fi'`'' ru , pmt 201 amps to 400 amps 1 5 2 401 amps to 600 amps .160.60 2 Name: i 1 _Air... 601 amps to 1,000 amps 240.60 2 Address: /9 kaa ) t; ,9 /)�� Over 1,000 amps or volts 454.65 2 City/ State/ZIP: f _ (J Reconnect only 66.85 2 J / �E! / 6,,_ 17z - z-3 Temporary services or feeders installation, alteration, and/or relocation Phone: ) 6 4 l_ 3 . , © Q I Fax: ( ) 200 amps or less I 66.85 i 1 Owner installation: This installation is being made on property that I 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 �' 7 s e. �.t � � Err .2 . w -7ry ' ° �� ' r : v. 0:i,, ' ? .' A A. Fee for branch circuits with ,. . a. s. �� : {t° '.� . - � _F ._ a,. y 2 --- service or feeder fee, each Business name: branch circuit 6.65 2 Contact name: B. Fee for branch circuits 0 without service or feeder fee, / 46.85 (p'd 6 2 Address: each branch circuit Each add'l branch circuit 6.65 - 6,0_ 2 City/State/ZIP: Miscellaneous (service or feeder not induded) Phone: ( ) I F ( ) Pum or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - �yf'' _i�i �"�y .. ,? ak .� ^.N ( - /S r ,: G b z y _ 4; -i t- gy p s ener panel alteration, or " #"` " ` " �`�'` l ` extension. Describe: Page 2 2 Business name :�cle�✓ / .*.....5.. .. 2" ._ Address: �.� Sa , Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: 47-16740r - , a. altg- 47 gy 0, Investigation per hour (t hr min) 62.50 jj)i,7 /' O I Fax:�7, ) 67�_ 7O Industrial 7375 Phone: E " CCB L i c . : / 6 j /. , I Electrical Lic.:3 _ _ I Su.rv. Lic.: / % s Subtotal '76 • , i6 j Suprv. Electrician signature, required: _ / • 'e/ 6 Plan review (25% of permit fee) — L .• i A. / d Print name: / 1 f • ` r te ri f G 41 State surcharge (8% of permit fee) . 6 : 8$ G �f �/�{ B/ TOTAL PERMIT FEE 79. 33 Authorized signature: [l This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tti -County Building industry Service Board / •• Number of inspections per permit allowed. is BuildingtPemtitalELC- Permitppp.doc 12103 7� /Q aa04 M/ 6157(10 /02/COVVE.B CITY OF TIGARD 24 -Hour BUILDING Inspection Line: '(50;3) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received / ,1 Date Requested /6 — �° AM PM BUP Location J 7 g ©v Suite MEC ����� _ a Contact Person Ph ( ) � S3 -� 7l /(o o PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC ,RZ 7 " �d / o5 Footing ELC Foundation . Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors ' , 1 Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall -- rkq , 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 Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 4 PART FAIL SIT ❑ Please call for reinspection RE: Ei Unable to inspect — no access Fire Supply Line ADA te Approach/Sidewalk Date /� - Q Inspect / _ Ext Other: Final DO NO REMOVE this inspection recor rom the b site. PASS PART FAIL