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11476 SW TWIN PARK PLACE 11476 SW Twin Park Mace L J TY Or TIGARD I G`,A R D ELECTRICAL PERMIT I PERMIT#: ELC2003-00215 DEVELOPMENT SERVICES DATE ISSUED: 4/16/03 13125 SW HP!' Blvd., Ticlard, OR 97223 (503) 639-4171 PARCEL: 1S134DC-00500 SITE ADDRESS: 11476 SW TWIN PARK PL SUBDIVISION: TIGARD PARK 'ZONING: R-4.5 BLOCK: LOT : JURISDICTION: TIG Project Description: Install 200amp service and 12 branch circuits. RESIDENTIAL UNIT 'TEMP SRVC/FEEDERS _ __ MISCELLANEOUS 1000 SF OR LESS: _ 0 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUr.S ADD'L INSPELTIONS 0 200 amp: 1 W/SERVICE OR FEEDER: I:' PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FUR: 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/FOR 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DEAN BUSSCHAU OWNFR 11476 SW TWIN PARK, PL TIGARD.OR 97223 Phone: 503-209-7093 Phone. Reg #. FEES__ D scrlption Date Amount �I I 1 ItM1'� IiLc'Permit Ir. (11 -- --- $160.161 Required Inspections 1 R"s state'rax .a /r u t $12.30 Rough-in Flect'I Service Total $172.90 Elect'/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. d Issued By: `�� k�'�, 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. ELF.C'N: �r>i< ` — �. _ DATE:___ LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application — Date receivedt (� Permit no,:L City of Tigard PtojecVappl.no.: Expire date: Citi,u/Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: yy:17Receipt nn: Phone: (503) 639-4171 Fax: (503) 595-1960 ('axe lite no.: Payment type: Land use approve;: _ �} 1 &2 family dwelling or accessory JCommercial/industrial J Multi-I'arnily J Tenant improvement J New construction J Add ition/alteration/rcplu.;(!meni J Other: J Partial Job address. 11,476 ( win BI Jg. no.: Suite no.: JTRX map/tax lot/account no.: Lot: I Block: Subdivision: _ Project nam:•rr;la j ficu l A act, etc Description and lo_c stion of work on premises: /V Srdt qq fret q "Estimated date ol'com Iction/ins cction: Q- — ankmolaiLmalli� Emma Job no: Foe Max Business name: — —v---- betcrlptbn I-) 1'dd rar.irrap ------• Ne"reelAer■ful %ingleornraNl WW4per Address: _ dwelNrrRrdt.Inc Indy.a nacMA garage. City: State /IP ffervicelnrlsaird: Phone: — Fax: — E-mai I: 1000,V4 It mImo" 4 ---- Each additional 5491. it or onion thereof CCB no.: — Mee.bus,lie.no: — Limited energy. ngidential 2 City/metro tic.no.: _ Limited enet$y, non-reaidemial 2 Each manufactured home or modular dwelling S nature of supervising electrician IresLircdl - - I)at Service and'or f-reder 2 Sup elect twine(print): t.wo se no 8ervlceaorrretlera-InatdlUloN, ■k■nthrrwreloc■Non: unimaimmki 200 amps or Icas 2 1`lame(print): BU cJ. _ 201 amp%to 4491 ams 2 401 amp%to MR)amps - _ M- og address:)J,17L Sal/ t+✓t f n�- _ (tfi amps m IINNI amps 2 City. �` S(atco ZIP:Y1 Z.L�— Over 14X9)amp%or volts 2 Phone:,rp. . c Fax: C-mail:•Fe4�S Q (ru? Reconnect and I Owner installation: The installation is bring made on property I own Irraptrart terrlrr,orretrter+ which is not intended I'or sale,lease,rent,or exchange according to inga n!or ievt lon,orrrlrnatlrrn ORS 447,455,479,670, 701 NNI amp%car 4M 2 �1 2111 amps to 4(NI amps 2 (hurter s si?nature: %&,Wil �---- Date: 4/2-503 401 In MR)amLys, 2 Nranchcbrrafts toe".ahentlnn. or txtt ardor per panel: Name A 1-m lot branch circuil%with purchax of 12 Andreas: service or fiectl-r I'ee,each branch circuit 2 (it Slate: ZIP: 11 Fee for branch cirruffs without purchase y - of service to le t-det fee.first branch circuit: 2 Phone Fax: C-?nail I,sch addhinnal branch eircaii: Mint.(service or feeder not lncldtd): J icc mer 225 amps.inimtrcial J Health care tacility Each pump of irrigation ctlrle J Service m-a 320 amps-rating of I&2 J Harardoms b aNat 1'.wb signor saline lighting lemily dwellings J lluihting over loom)aquae Ceti four or Signal carcuiN%f or a Ihniltd etregty panel. .!System over NON)rnit%ricaninal more residential unh%in nne structure alteration, or extension• _ J l)uikiiq mer three sbries J Faders,400 amps or more •r)nerition J(krupant bad over 99 persons J Manufactured stnicuatw or RV park Fachadditional Itweir ion over the■Ibw■bleInsay orthe■bove: J Fgre-Migh ing plan J Other' ----_--- -.--_--___-�- Per nispcx'tum F - Subink_.- sets or plans with any of the above. Imasco anon ke The,above art nm applicable to temporary comailr actlon service. Other Permit fee ...................... bolev --- Voo all iuntdirtrus accept credit cards.plutc call itaisdiclum lin nnre inbnnatitin Notice: This permit application J Vii J MitinCK'ant expires if a permit is not obtainal flan review(at , %) S -------- Credit card nnmtocr ! / within IRO days after it has been State surcharge(8%).....S rx 'rc. r» accepted as ccxnplete. TOTAL.........................$ 7Z,Ya___ Nauta of cardluldrr a..1■.w n.m?odic card S Canlho ldrt .ignatury Aaaanu 4404615((iM.'11M CITY OF TIGARD _ ELECTRICAL PERMIT PERMIT#: ELC2003-00595 DEVELOPMENT SERVICES DATE ISSUED: 9/23/03 13125 SW Hall Blvd.. Tivard. OR 97223 (503) 639-4171 PARCEL: 1S134DC-00500 SITE ADDRESS: 11476 SW TWIN PARK PL ZONING: R-4.5 SUBDIVISION, TIGARD PARK BLOCK: LOT: JURISDICTION. TIG Project Description: Installation of 200 amp service&feeder and(12)branch circuits. RESIDENTIAL UNITTEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS:W _ 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 _—A ADD'L INSPECTIONS 0 200 amp: 7 W/SERVICE OR FEEDER: 1l PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'I_. BRNCH CIRC: IN PLANT: 601 - 1000 arnp: _� _PLAN REVIEW SECTION 1000+ amp/volt: 4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: _ SVC/FDR —225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DEAN BUSSCHAU OK BROTHERS ELECTRICAL 11476 SW TWIN PARK PL CONSTRUCTION TIGARD,OR 97223 PO BOX 231133 TIGARD,OR 97281 Phone: 503-209-7093 Phone: 697-4873 Reg #: I It 49562 --- ,i 1, 43345 _ FEES _ 1 34-451 C Description Date Amount) Required Inspections 11 I.PRM'I-I ELC Permit 9/21 i t $240.40 X f�"„titatc"lar 9121 $19.24 Elect'I Service Elect'i Final Total $259.64 This Permit Is Issued subject to the regulations contained in the Tigard Munidpal Co(te,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 H.work is suspended for more than 1t30..days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center, ose rules are set forth in t0 952-001.11010 through OAR 952-001-0100. you may obtain copies of these rules or direct questions to OUNC at(50 )246.6699 or 1-80032-2344. 7 It3su By: 'W ` , -!Y Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: _-- DATE:— NTRACTOR Jl1illlS 'ALLATIUN ONLY -_--__ - SIGNATURE OF SUPR. ELEC'N: k; �� ^� _---_- DA-.E:-- LICENSE A.E:_LICENSE NO: �- _ _ ---- ---- - - Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit A licatio>n� - - — Received Electrical a �� Date/By: 191 - Permit No.: �� GYJ C©a City of Tigard Planning Appr a Sign 13125 SW Hall Blvd. Date/By! PermitNo: Itr1ew Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Ilse Internet: www.ci.tigard.or.us .—Date/By: Case No: Contact J See Page 2 for 24-hour Inspection Request: 503-639-4175 N—/Method: `� Su lernental Information. ---- - — j4Addition/alteration/rcpla onstruction _ Demolition Service over 225 amps Health-care facrhiy cementOther: commercial ❑Hazardous location Service over 320 amps-rating of ❑Building over 10,000 square feet, 1&2 family dwellings four or more residential units in -Family dwelling, C'ommercial/Industrial ❑System over 600 volts nominal one structure Accessory Buildin Multi-Family ❑Building over three stories ❑Feeders,400 amps or more -- ----- —_ _ ❑Occupant load over 99 persons ❑Manufactured structures or RV park `.1 . Irr Lluilder Othcr: ❑F.gressllightingplan ❑Other:_ d6ll: iE_ IYIfID1l�MAt1 NndQ ��d s Submit_sets of plans with any of the above. I he abuse are notapplicable to tem orar construction service. 1 1 U -1' _ Inl r,i',c address: �1N 11Art P/ A� Suite#: I Bldg./Apt.#: Number of Ins ectlons per permlt allowed Pr!�ect Name: - Descrl tion QtyFee(ea.) 'Total Cross street/Directions to Job Site: — New residential-single or multi-family per dwelling unit.Includes attached garage. Service Included: !000 s .ft.or less 145.15 4 Each additional 500 sq,ft.err portion thereof 33 40 1 Subdivision: Lot#: Limited ener residential 75.00 — 2 ----- Limited energy,non residential 75.00 2 Tar ma l arceH: �r Each manufactured home or modular dwelling UF,bC:Rli°PION 01'NN OR K service andior feeder 9090 2 Services or feeders-Installation, alteration or relocation: 200 amps or lessQC _ A0.30 2 -_ — ----- 201 amps to 400 amps _ 106.85 2 401 ams to 600 ams 160.60 2 601 ams to 1000 ams 240.60 2 - _- -""- — - Over 1000 as or volts 454,65 2 Name: m Reconnect only 6685 2 Address: 1 y tG- Mr,21 N i,L Temporary services or feeders-installation, Cit /State/Zi : alteration,or relocation: 200 amps or less 66.85 1 Pho Fax. 201 ams to 400 amps -_� 100.30 2 h 401 to 600 ams 133.75 2 Branch circuits-new,alteration,or Name: C I>4"7E L C,, extension per panel: Address: �Io A.Fee for branch circuits with purchase of gp service or feeder fee,each branch circuit i 2_ 6.65 ' 2 Cit /State/Zl : rt'1. �► Z r C �L 9-12 r' 1 B.Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.85 _ 2 Pyrone: r r FEach additional branch circuit 6.65 2 E-mail: s(4, Misc.(Service or feeder not included): Each pump or irrutation circle 53.40 2 Each sign or outline lightina 53.40 2 Job No: C 3`j Signal circuits)or a limited energy panel. Business Name: C_1 3 U aMZ alteration,at extension Pee 2 2 Address: Description: E'U �� Z -�1�-��a� Cit /State/Zl 1 1 c ) Each additional Inspection over the allowable in an•of the above: ---p_ 1 �i7"= �� 1Z- 1�� Per ina coon r hou4Review(25% �- �(i2 50 —i Phone: - - f)WJE Fax: '7 )--7- lnvesti tion fee: CCB Lic. #: `3 C. Lic. #: _ y-'-t 5 ► other: Supervising electrician signature required: I Subtotal S� Planf Permit Fee S Print Name: L Lic. #: 3t, State Surcharge SS°o of PerYtut Fee $ TOTAL PERMIT FEE S Authorized Notice: This permit application expires if a permit Is not o twined within Signature: _ _—` Date:— 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms\ElcPermitApp.doc 01103 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: _ Fee for ALI systems............................................................ $75.00 Check Type of Work Involved: Audio and Stereo Systems* Ourglar Alarm EJGarage Door„pener* LJ Heating,Ventilation and Air Conditioning System* DVacuum Systcros* ❑ Other COMMERCIAL WORK ONLY: Fee for each system.......................................................... $75.00 (SEP.OAR 918-260-260) Check Type of Work Involved: Audio and Stereo Systems Boiler Controls ❑ Clock Systems Data Telecommunication Installation Fire Alarm Installation HVAC instrumentation F-1 intercom and Paging Systems 0 Landscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* Protective Signaling Other_ —-- -- - --Number of Systems * No licenses are required. Licenses are required for all tether installations ODstsTermit Forms\E1cPermitAppPg2.doc 01/03 CITY OF TIGARD 24-Hour BUILDING Inspection L!ne. ;503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received Date Requested Z--Z---AM---___ PM BLIP — Location �f �g Tk In Suite_ MEC Contact Person �.L-------- Ph(—) PLM -— ---- Contractor— ___—_ Ph( —) SWR BUILDING Ten int' wrier 3 3.5� ELC 3 ` 0 O I�S^ Footing 1� Foundation ELC Access: Ftg Draind.cl-�s�- � � ELR — Crawl Drain Slab Inspection Notes: SIT Post&Beam _ Shear Anchors - -- Ext Sheath/Shear - Int Sheath/Shoar Framing - -- - - Insulation Drywall Nailing -- Firewdii I- ',Li , 1 I � 1� �� C , V 1,• 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 Iran 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 larm 1 Fj Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 33 PART FAIL g Please call for r inspection E:-----_ _ Unable to inspect-no access Fire Supply Line Approach/Sidewalk Date: ate Q i Inspector w1' _ / Ext Other: Final DO NOT REMOVE this hispection record from the Job site. PASS PART FAIL