Permit 7:1*- i CITY OF TIGARD ELECTRICAL PERMIT
�� PERMIT #: ELC2006 00694
. ,a COMMUNITY DEVELOPMENT DATE ISSUED: 12/6/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
*rl g PARCEL: 1S134AA
SITE ADDRESS: 10105 SW NIMBUS AVE ZONING: MUE - 2
SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT : 001 JURISDICTION: TIG
Project Description: BURGER KING. (3) branch circuits.
Job # 71995.
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: 2 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/CONSTANCE A L H MORRIS ELECTRIC INC
ROBINSON, LYNN + BELL, KAY ET 7051 SW SANDBURG ST, #100
BY ELLIOTT ASSOC TIGARD, OR 97223
PORTLAND, OR 97204
Phone: Contact #: PRI 503 639 - 2334
FAX 503 - 620 -7405
FEES
Description Date Amount Reg #: ELE 20 -39C
[ELPRMT] ELC Permit 12/6/2006 $60.15 LIC 1838
[TAX] 8% State Surcharge 12/6/2006 $4.81 SUP 30065
Total $64.96 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: �-y A .� Permittee 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. 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.
�, 11 615
Electrical Permit Appl i : L t FOR OFFICE USE ONLY
1 , Received
Date/By: �O 2 `- i;1 )/ / �lJ Z Permit No. � a6� �/3 6 .9G/
13125 SW Hall Blvd., Tigard, OR 97223 EC Plan Review t vti
K 11 '
City of Tigard A Date/By: Other Permit
Phone: 503.639.4171 Fax: 503.598.1960 � .
Inspection Line: 503.639.4175 „ t r . 1 . 0 1 Date Ready /By: Juris El See Page 2 for
Internet: www.ci.tigard.or.us �� of 1 • II T 4 � Notified/Method: Supplemental Information
4143NWR-M! PLAN REVIEW
m
❑ New construction ❑ Addition /alteration /replaceeent Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ID Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi family D Master builder I=1 Other:
['Occupant load over 99 persons EManufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: Job sit ad dress: h i\1 ❑ Health -care facility ❑Other:
1 V� S S\1,1 1 � $ ; C Submit 2 sets of plans with any of the above.
City /State /ZIP: The above are not applicable to temporary construction service. FEE* SCHEDULE
Suite/bldg. /apt. no.: - 1 - 15 pal
name: Fj lJ`J V tY ■1 Description Qty. l 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'I 500 sq. 0. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Fie nd (3) 20 Goa c iYC!vk i -F dwelling, service and /or feeder 90.90 2
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
401 amps to 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
relocation
Phone: ( ) Fax: ( )
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
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: L.H. MORRIS ELECTRIC INC branch circuit
B. Fee for branch circuits
Contact name: 5 t j t Car Or) without service or feeder fee, I 46.85 ti(p.$S 2
Address: 05\ Sw bu each branch circuit •
S�l OD Ea ch add'1 branch circuit 2 6.65 IS.30 2
City /State /ZIP: �1 Aru olz N44111 Z �3 Miscellaneous (service or feeder not included)
Phone: (503) 639 -2334 Fax: : (503) 620 -7405 Pump or irrigation circle 53.40 2
//��
Sign or outline lighting 53.40 2
E - mail: S co r \Sb' O. \h Vw If I . CCrrx Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: L.H. MORRIS ELECTRIC INC
Address: 7051 SW SANDBURG ST #100 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: TIGARD OR 97223 Investigation per hour (1 hr nun) 62.50
Phone: (503) 639 - 2334 Fax: (503) 620 - 7405 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 1838 Electrical Lic.: 0 -39C Suprv. Lic.: 3006S Subtotal (DD. 15
Suprv. Electrician signature, require . Plan review (25% of permit fee)
/ , j�� ` Date: State surcharge (8% of permit fee) y, 8 I eS L Print name:
`�C �'U— 2 I I u� TOTAL PERMIT FEE ( , 9(
Authorized signature: 1 # 4 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: v. , ` � e n vk(urS Date: , i4 ( 0 * Fee methodology set by Tri- County Building Industry Service Board
�► + �Y�I •* Number of inspections per permit allowed.
is \ Building \ Permits \ELC- PermitApp.doc 12/03 440- 46t5T(10/02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION #: EI.C2Od;1O.O05g4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: rn6p006
Phone: (503) 639 -4171 � 1�,�
- !i
Inspection Requests (24 Hrs.): (503) 639 -4175 1
INSPECTION WORKSHEET FOR DATE: 12)12/2006 TIME: 7:01AM PAGE: 49
SITE ADDRESS: 10105 SW NIMBUS AVE CLASS OF WORK:
SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT #: 001 TYPE OF USE:
PROJECT NAME: BURGER KING
DESCRIPTION: BURGER KING. (3) branch circuits
Job # 71995.
OWNER: ROBINSON, WILLIAM R /CONSTANCE A, PHONE #:
CONTRACTOR: L H MORRIS ELECTRIC INC 1 ,(,n PHONE #: 503-639-2334
Inspection Request Scheduled For: Date: 12/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 1 040933-01 503 - 830 -1599 Y
Corrections /Comments /Instructions:
Z .pLA c_c h (- L
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1 \'(-)
►j PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
1 1 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V1._.
Inspector: • \16v L Date: 1 1 10 Phone #: (503) 718