Permit Ill
CITY OF TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC2008-00271
COMMUNITY DEVELOPMENT DATE ISSUED: 5/13/2008
.TI G ,AR D , 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102CC 00500
SITE ADDRESS: 13600 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: TIGARD MARKETPLACE LOT : JURISDICTION: TIG
PROJECT: RICE PUFF
Project Description: TI - (8) branch circuits. Job No. 439248 - 17720
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 7 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:
13500 PACIFIC CORP BROADWAY ELECTRIC - COCHRAN INC
BY CAP ADVISORS 626 SE MAIN ST
38345 W TEN MILE RD, STE 170 PORTLAND, OR 97214
FARMINGTON HILLS, MI 48335
Phone: Contact #: PRI 503 - 234 -6564
FAX 503 - 238 -2098
FEES
Description Date Amount Reg #: ELE 37 -546C
[ELPRMT] ELC Permit 5/13/2008 $93.40 LIC 72942
[TAX] 12% State 5/13/2008 $11.21 SUP 3447S
Total $104.61 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 se ' 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 0 .800.332.
Issued By: (ILO/U/-4 ` Permittee Signature: !e- (/d-Z
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: 1 p -t P,Vii9 -1-•- 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.
- ��ROM COCHRAN- BROADWAY (FRI ) MAY 8 2008 14: 52 /ST. 14: 51 /N,. 7500000100 P 2
0 •
Electrical Permit Application REC EIVED FOR OFFICE USE ONLY
City of Tigard owe B : kg �j � Permit No.: ' /I t --V27
III 13125 SW Hall Blvd., Tigard, OR 97223 AAA p Plan Review
Phone: 503.639.4171 Fax: 503.598.196MAY 0 9 2008 Date/By: Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: /nr r B See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: e rb Supplemental Information
I TYPE OF PLAN REVIEW. • ,
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -Ise agricultural
CI 1- and 2- family dwelling .4(Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
[� +
08 SITE INFORMATION AND LOCATION ❑ Addition of new motor toad of
43 2- �{-� 100HP or more. occupancy -
Job no.: -7 7z J ob site addres `? ( j 51.E � 0.C1''f I L
l 0 Six or more residential amts. ❑ Recreational vehicle parks.
City/State /ZIP: ( v !� g i � r ❑ Health -care facilities. 0 Supply voltage for more than
t ❑ Hazardous locarimts. G00 volts nominal.
Suite/bldg. /apt. no.: Project name: ?` 7 s u Ae, (65 ❑ Service or feeder 600 amps or more.
U FEE SCHEDULE
Cross street/directions to job site: Description 1 Q I Fee I TOW 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: LLot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: _ Limited energy, residential
• 75.00 2
DESCRIPTION OF WORK• . - .. (with above sq. fl.)
Limited energy, multi - family 75.00 2
- a t 1 �Q-! '\ C. �'c1� residential (with above sq. ft.)
�' Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY .OWNER . • ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or -volts 454.65 2
City/State/ZIP: /State /ZIP: Temporary services or feeders installation, alteration, and/or
ty relocation
Phone: ( ) Fax: ( ) 200 amps 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 _ 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 401 amps to 599 amps _ 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT. ". - 1 CONTACT PERSON:' .. ` . above service or feeder fee: 6 65 2
each branch circuit
Business name: B. Fee for branch circuits O
C 1 �� 5� rd2�v�n� fist
without service or feeder fee, } 46.85 14. p5 2
C'nntact name: b!-r .^.. ^c!: dr.:tat
Address: Each add'I branch circuit 7 6.65 q( 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
90.90 ( 2
dwelling, service and /or feeder
Phone: (503) L' 2 - '13 (pct Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
• CONTRACTOR . Sign or outline lighting 53.40 2
1?. �` r1C J r' Signal panel, alor teration, li ,
Business name: or
` � �� (,� (,L�, � �e i� nergy panel, alteration, or
Address: Z - ``\�� bt ` extension. Describe: Page 2 2
n
City/State /ZIP: r \iA - 1 614, L A 01E-- ' ! 7 2-(4 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( i 4 ) Z So -(,pe (.9LL Fax: ( S0.) 2 _ 3y - 2.O / D Investigation per hour (1 hr min) 62.50
CCBLic.: c11t Electrical Lic.:. - {( p C, Suprv.Lic.: (A� ... Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES -
Suprv. Electrician signature, required: Subtotal: 93: 40
\ Plan review (25% of permit fee):
Print name: F �/ D 5� c Sta te surcharge (12% of permit fee): (j f 1
Authorized signature: TOTAL PERMIT FEE: tOf I , (p /
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete
' Number of inspections allowed per permit.
1\ building \Permits&F.LC- PerrnitApp doc D5/23/06 440-46157(11 /OS /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Wes • Gen
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 el I
INSPECTION WORKSHEET FOR DATE: L . a 0b TIME: PAGE:
SITE ADDRESS: 13 b0® S µ} F++ C$ CLASS OF WORK:
SUBDIVISION: JLOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: (o .5:- i3 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
•
fl i o
TV \
211 PASS ❑ PARTIAL APPROVAL ❑ CANCEL l NO ACCESS
n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e Me) ) Date6�' ��O Phone #: (503) 718- 9-1i