Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00574
a. DEVELOPMENT SERVICES DATE ISSUED: 8/10/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1S134AA-01900
SITE ADDRESS: 10105 SW NIMBUS AVE ZONING: C -G
SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT : 001 JURISDICTION: TIG
Project Description: 8 br. circuits.
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: 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:
ROBINSON, WILLIAM R/CONSTANCEA FIVE STAR ELECTRIC, INC.
ROBINSON, LYNN + BELL, KAY ET PO BOX 555
BY ELLIOTT ASSOC BANKS, OR 97106
PORTLAND, OR 97204
Phone: Phone: 503 - 324 -0948
FEES Reg #: ELE 34 -665C
LIC 158231
Description Date Amount SUP 46225
[ELPRMT] ELC Permit 8/10/2005 $93.40
[TAX] 8% State Surcharge 8/10/2005 $7.48 REQUIRED ITEMS AND REPORTS
Total $100.88
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- 00 -332 -2 4.
Issued By: Permittee Signature: d)-) a/42.42,1 < <r ZZ r J
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.
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.-
Electrical Permit Apgli FOR OFFICE USE ONLY
—,,- .
Permit No.: ANINENIM
City
13125 SW Hall Blvd., Tigard,'9147223 006
Pl
A, DgeB:
an Review
, \ .t Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 . ''--, ,, - -oillAi' Date/B :
Inspection Line: 503.639.4175 -\.,, . _.. ,.., ,,,,,, \\ 4 . &J. A i
Date Ready/By: Juris: El See Page 2 for
Internet: www.ci.tigard.or.us ,-,,, ' , ,- At.s Notified/Method: Supplemental Information
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0 New construction lakddition/alteration/replacement Please check all that apply:
13Service over 225 amps, comm'l ['Hazardous location
0 Demolition D Other: . ElService over 320 amps - rating El Buildng over 10,000 sq. ft.,
11 ligiligilleltrifii:ERVII )1 111MiladA r 40 - 0gOiaitdifltreikig 77 ! .. ... 'Aiiiii;fingl
;::: . :. ..... 2.2 . ,2,..r2 22,13222,222i2: 222:iitt.itigin't,2!,.■,.itli.itli,:22,:t.,22■12,22 2,22122,, .2 . , .1421 - `,'",':';',:'''''''"'''',INHIM:; of 1- and 2-family dwellings 4 or more new residential
structure
I:1 1- and 2-family dwelling El Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one
['Building over three stories OFeeders, 400 amps or more
D Multi-family 0 Master builder 0 Other: , .. ['Occupant load over 99 persons 0Manufactured structures or
1111,L -ss/lighting plan RV park
.,,. INT.0%. -care facility (="Other:
Job no.: FS307 I Job site address: 10105 SW Nimbus
s-. ., IIMI 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 _ ' are not applicable to temporary construction service.
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Suite/bldg./apt. no.: Project name: Burger King
Description I Qty. I Fee. Total I .•
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: Lot no.: Ea. add'l 500 sq. fl. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
, „, „,, „,, „ ,. Limited energy, non-residential 75.00 2
:111Iii'lliiIIIIIIiiiiiiiligi,Ei;EE '''''''''''''''''''''''''''''''''''''''''' Each manufactured or modular
'
Tenant Improvement - Electrical
dwelling, service ancVor feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 1 2
WijaTeaMi n ililiirgilini 201 amPs to 400 amps 106.85 2
i-iliiii ''' .: ' .1:1::1.42.: ,,, i ,,, tr ailiiii ,,,,, !IT::::lijiiilAii; ,,, iii„ 41; , .i,,,;: , „,,;;.,;„; , ; , ; , :i,:::pgff..,3 401 amps 10 600 amps
160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 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
liMiYI!!!Irnitiglijill#0136,1011t;;;:iiiiggiltiii;I:iiii; A Fee for branch circuits with
.i -. . . ...1..!a::::;;:mal . IHnibf,1■N;F:::: . :',f:::!Ilii1;;PM — ' • '■iii,: _.,.., .... .!:11!!!!i:Uirh:iiligi:i
service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: _
each branch circuit 1 46.85 (MA i35 2
lti •
Each add'l branch circuit 1 6.65 (1(0.5 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
Th.-,:!!!!i:i4i:i2:F;!0;sai;:::.:,:i,i;I:■,.„.„„,m1,;;,,,,i,6, 1, ,..„..,,,,.. ,.. ., .. ,..L., ...,.. i „
:. rN.IM-'lwaireP.R ergy panel, alteration, of
Business narne: Five Star Electric, Inc. extension. Describe: Page 2 2
Address: PO Box 555 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Banks, OR 97106 Investigation per hour (1 hr rnin) 62.50
Phone: (503) 324-0948 Fax: (503) 324-0973 Industrial plant per hour 73.75
- laig
CCB Lic.: 158231 Electrical Lic.: 34-665C uprv. Lic.: 4622A
Subtotal 613.410 __
Suprv. Electrician signature, required: Plan review (25% of permit fee) —
Print name: R c), 0 s Date: 8/8/05 State surcharge (8% of permit fee) - 7, 41b
TOTAL PERMIT FEE Fi0f) ele,
Authorized signature:
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 Tri-County Building Industry Service Board
" Number of inspections per permit allowed.
TO/TO'd OIHIOSIE HVIS HAId VO:fiT 900Z -OI -onv