Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00397
•
!tilt DATE SERVICES DATE ISSUED: 7/21/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134BC -00600
SITE ADDRESS: 12390 SW SCHOLLS FERRY RD ZONING: C -
SUBDIVISION: PP1993 - 057 LOT : 002 JURISDICTION: TIG
Project Description: 200 amp service to cell site.
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: 1 W /SERVICE OR FEEDER: 2 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
THOMPSON; DENNIS C AND ADK ELCTRIC, INC.
DAVIDSON, WILLIAM G PO BOX 2676
12475 SW MAIN ST BATTLE GROUND, WA 98604
TIGARD, OR 97223
Phone: Contact #: PRI 360 - 608 -0665
FEES
Description Date Amount Reg #: ELE 37 - 934C
[ELPRMT] ELC Permit 7/21/2006 $93.60 LIC 148882
[TAX] 8% State Surcharge 7/21/2006 $7.49 SUP 4853S
Total $101.09 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: � ,' r 2 7 Permittee Signature: C;;NR,
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.
Alan f ngas 13606766975 07/20/06 11:04A P.002
Electrical Permit Ao o iJ El .r r(i, o r F R c F. l'-4... O\ i.
e� - PvmitN.. a(' a ?
City Of'Itigsrd Data/R 7 � �'- +�`�U•"� 9
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review Other lsbone: 503.639.4171 Faic 501.598.1960 1uL 4 O 201 ,A an
;J I � DerclBtr P`ni 1.
inspection lac 503.639.4175 -' �. ma. Raadtrliiy: huh' el ace Page 2 for
• Interact: www.citignrd.or.us iir it� - `1'•`‘' - K° �
tOaihu -.� I (r Suppiem tettnro.m.tlon
. I n.I79 N . • . ' . ' • >rlr;N :RIIvI>�w t.
CI New Please check all than apply
❑ Demolition .rOthcr. C in ['Service over 225 amps. cannel ❑ fiaitudous location
1y` 0 Siervice over 320 amps - rating C Htuildng over 10,000 sq. 0
' ' CATEC4)I(Y 'OF: CONIO'RUCfIiON • ' . of 1- and 2- family dwellings 4 er more now residential
0 I- and 2 -fermi ly dwelling El Commacial/indttstl'iol ❑ Accessory building
over 600 wells nominal units to one structure
oBoakiing over throe stoics E3 sedan, 400 amps err more
0 Mu2ti- fancily 0 Master builder .........Other Cp 000t load over 99 persons O MamifactumdJ'tructurne or
• •: JOB . SITE :1NFOktMATION AND LOCATION ' ' . , ' • ❑Egreas4iglnung Plan RV Wt
Job no.: Jab site address: 123'tO SC i liS vo 2a . CI Heahh-eae facility ❑Other:
Y- " � Submit 2 acts orphan with any ofthe above.
City/StaterLlP: c t ^ V The above am nut applicable to temporary construction service.
: )
,f,. �J I I • h1C REDtJIJa
Suite/bldg./apt. no.: Project flame: &65116 2UA - 1 Ln -c
�t� ' Qd. I rem J rain I .*
Cross street/directions to job site: ;fin 2 I, \ jo jj 5 New reeldential for mniti -fnn� dwelling unit.
Iodides stenches{ 9,4 . 1 0 1(r w `tQ * * 1� C .- .....T 1,000a R cokes 145.15 • 4
Stibdi on: I Lot no.: Fa adds 500 sq. R or puetion 33.40 , 1 W
�-- - ^ Looted energy, rosidentiat 75.00 2
Tax map/parcel ^
l,inbted energy, non-residential 75.00 2
' DESCRIPTION OF 'WORK Each mannfacturod or modular
VD 0019 y dwelling. service feeder and/or eder 90.90 2
LiG �i� l Service' or feeders ober/dion and/or aelotsation
200 amps or less t 1 80.30 UD 313_2
• . • . ❑• PROPE1 Y .OWNER • . .J Q TENANT • 201 amps to 400 amps 106.85 - 2
401 snips to 600 amps 160.60 2
Name Got amps to 1,000 amps , 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Roconnoct only 66.85 2
City /State/ZIP. Temporary sewkes or feeders Insuattation, alteration. and/or
Phone ( ) I Fax; ( )
relocation
Owner installation: This installation is matte on that I own whi ch is not 200 to or late 400 66.55 ' 1
:
�$ property - 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 signalize: Date: Branch durst - sew, alteration, or estendon. per panel
"
. • '' • ' ❑ • APPLICANT • • . •1' . • • . 0• oorrraCr P16RSoN A. Fee for btancb circuits with •
Rusin s name branch a !Ceder A each Z 6.65 3. 31 2 circuit
Contact rook B: Fee for bowels circuits
.... • _. -'
without service or feeder fee, 4685 2
Address: fest branch circuit - —
k
Each add, branch circuit 6,65 2
City/Slat ZIP: riMiseellencoso (sen4cr or r eader not Included
_ Pranp cc ihrighrtien circle 53.40 2
Phone. ( ) I Fax: : ( )
Sign or outline lighting 53.40 2
E-mail: Signal circuit(u) or limited-
CONTRACTOR energy paned alteration, or
extension. Describe: Page 2 2
Business name: h t e Alt er_ tytt.
Address: 1 l - up Each additional Ins pedtaaa ove allowable in any of tbo above
rat h .. . e ` Per impaction 6250
City/Stater/AP: y� r � II I !t 0 tea tnvesti grdion per hour (t hr min) 62.50 .-
—
Phy (fit 5- 153 Fax: ( • ,D) 6'_ 6 p 1 S
on Industrial plant per hour - 73.75
p F1.ECTR1CAL P M1T PKNS;Pi'•'''' •,•
CCB Lic.: 14 0 Z 1 Eh-rani Lek:. :'31(� -C n Suprv. tic.: y � t'�?•)S � Subtotal 1 3 gp._._
Suprv. Electrician siignature, tequila oil Plan review (25% of permit foe)
Print name: Akan D / /, a (q, I Date- 1201(A State aurcbwge (8% of permit fee) 7 - 4
t TOTAL PERMIT FEE l b 1 .
Authorized signature: Thb ■p
permit plic tioh expires If a peen* Is not obtained within 180
"
days aeef It bits s bare mended as ew ey Se
• Print thane: • ti r Data l a : t ao noeahodolo set by rricoatay Building [Dewey Service floa,rt
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200G -00397
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 r _
INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7:01AM PAGE: 58
SITE ADDRESS: 12390 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: PP1993 LOT #: 002 TYPE OF USE:
PROJECT NAME: MONOPOLE
DESCRIPTION: 200 amp service to cell site.
OWNER: THOMPSON, DENNIS C AND, PHONE #:
CONTRACTOR: ADK ELCTRIC, INC. PHONE #: ?,60-608 - 0665
Inspection Request Scheduled For: Date: 7/28/2006 Pour Time:
Code # Inspection Description Confirm # ... . • Message
115 Electrical service 033938 -01 360 - 606 -06• N
Corrections /Comments /Instructions:
Y.JSI ► t t,�R.vi cg. ASA) Nee Ito v4Z4
NM. kMs Z
❑ PASS ❑ PARTIAL APPROVAL XCANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: NI L Date: / 1 IT D( Phone #: (503) 718- .2„fik___
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL( 2000 00397
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2006
Phone: (503) 639 -4171 �.«Q A
Inspection Requests (24 Hrs.): (503) 639 -4175 _,' I —
INSPECTION WORKSHEET FOR DATE: 7/2812406 TIME: 7 PAGE: 57
SITE ADDRESS: 12390 SW SCHOLL.S FERRY RD CLASS OF WORK:
SUBDIVISION: pp1993-Q57 LOT #: 002 TYPE OF USE:
PROJECT NAME: MONOPOLE
DESCRIPTION: 200 amp service to cell site.
OWNER: THOMPSON, DENNIS C AND, PHONE #:
CONTRACTOR: Ant ELCTRIC, INC. PHONE #: 360.608-0665
Inspection Request Scheduled For: Date: 7/28/2006 Pour Time:
Code # Inspection Description Confirm # . . Message
199 Electrical final 033938-02 360 -600 -0665 N
Corrections /Comments /Instructions:
EX j S7 i n £rvaN Ci' ANgfs t itt\A,
rr o AOSwL.
V-AsT i , r n o ' I Th f; 1 ' - 1 j
aoS FCC, 2006- Z02-4 i .
‘
❑ PASS ❑ PARTIAL APPROVAL ACANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t 6 6 lA Date:1 610 Phone #: (503) 718- 27`?b