Permit rI _ ;: CITY OF TIGARD ELECTRICAL PERMIT
CITY
° PERMIT #: ELC2008 00540
° COMMUNITY DEVELOPMENT DATE ISSUED: 9/19/2008
I TIGARDS 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
11 PARCEL: 2S110DC -02200
SRE ADDRESS: 15660 SW PACIFIC HWY A -5 ZONING: C -G
SUBDIVISION: TIGARD PROMENADE LOT : 011 JURISDICTION: TIG
PROJECT: TIGARD PROMENADE
Project Description: (1) branch circuit for light repair.
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: 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:
TIGARD CENTER HILLSBORO ELECTRIC
9777 WILSHIRE BLVD. 21185 NW EVERGREEN PKWY #110
#609 HILLSBORO, OR 97124
BEVERLY HILLS, CA 90212
Phone: Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -499C
[ELPRMT] ELC Permit 9/19/2008 $46.85 LIC 134481
[TAX] 12% State 9/19/2008 $5.62 SUP 4941S
Total $52.47 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 ore 180 s. ATTENTION: Oregon law requires you to follow rules adopte• • the Oregon Utility Notification Center.
Those r es are set forth in AR 5 - 001 -0010 through OAR 952 -001 -0100. You may obtain c••ies of these rules or direct questions to OUNC at
503.2 .6699 r1.800.3 34 ■
Issu d B ®�`j�'l�d, Permittee S s - % 1 ;
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or r nt.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
l t
SIGNATURE OF SUPR. ELEC'' : _..4!!..
. !_ _��!J 4 / SGW(�` 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.
Sep 19 08 04:02p Joey 503- 601 -3680 p2
` .. E lectrical Permit Application FOR 111FFICE USE ONL,
City of Tigard . Received
g Et Date/B : r �i Permit No.: )03-F-_.CX� �() ig 1312 S W Hall Blvd., Tigard, OR 9 plan Review
: C . Phone: 503.639.4171 Fax: 503.598.1960 D
( 4 ate Other Permit:
11 G �� RD Inspection Line: 503.639.4175 ` � Date Ready /By: mr E See Page 2 for
Internet: www.tigard- or.gov �y Notified/Method: Supplemental Information
TYPE, OI? FY 9 = `; `, • � �ry V 1�1 : . . PLAN REVIEW"
❑ New construction Addition/alter(jb Please check all that apply (submit 2 sets of plans w /items checked below):
E] DemDIitlOnp( her; ❑ Service or feeder400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CA I:16670 Y. OP.4 CON5" RUCTIO1' `- • ' amps at r ❑ Floating buildings.
' exceeds 10 000 ] 50 volts a
less to ground, or exceeds 14,00D ❑ Commercial - use ag
❑ 1 - and 2- family dwelling Commercial/industrial ❑ Accessory building I, amps for all other installations. buildings.
❑ Multifamily ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
.Tde :I Emergency system. larger separately derived system.
SITE ihFOR AND; LOCATION
❑ Addition of new motor load of ❑
✓ J ` .! 100HP or more. occupancy.
Job no.: (,,,q=- Job site addr 1 , .a _ 1k5 [ t 41%.)1.4
T 1 - ❑ Six or more residential rants. ❑ Recreational vehicle parks.
City / State/ZIP: ^ ,tea Q'- i j a i [3 Health-care facilities. ❑ Supply voltage for more than
-^y `f !�� �I ❑ Hazardous locations. 600 volts nominal.
Suite/bidgJapt. no.: 1
Project name: �'� ev�acl� ❑ Service or feeder 600 amps or more.
�21
Cross street/directions to job site: Description ' I Q. l Fee. I . Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,00D sq. ft. or less 145.15 4
Tax map /parcel no
�Ea. add'1500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Y ` 4; s _t..I1LS N :O a " _ `.. t' Y r (with above sq. ft.)
yy� f Limited energy, multi - family 75.00 2
r Zat. DCrn iS i I / i. L /'e q;/' residential (with above sq. ft.)
J Services or feeders installation alteration, and/or relocation
200 amps or less 80.30 2
>t', r ;PIROPERTY , 'i r;.. Y 'i , �4- : o{ t}.:LFENANT :.. , 4 ;. .�• " 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps ' 160.60 2
601 amps to 1,000 amps i 1 240.60 2
Address: Over I,000 amps or volts 454,65 2
City/ State/ZIP: Temporary services or feeders lnstallation,.alteratlon, and/or
relocation
Phone: ( ) I 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 599 amps 133.75 2
Owner signature: Date: ' Branch circuits - new, alteration, or extension, per panel
- A, Fee for branch circuits with
a ,. , 4 (:1 LARPL1CA NT :,. a,: M' t .d 1. i73 k ' D..CONT ftC,,1 + t above service or feeder fee,
each branch circuit 6.65 2
Business name: ' B. Fee for branch circuits
Contact name: wilho service or feeder fe e , J 46 85 1 7 1 4,5 $ 2
first branch circuit /
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not Included)
City /State /ZIP: Each manufactured or modular 90.90 2
Phone: dwelling, service and/or feeder
( ) I Fax: ( } Reconnect only 66.85 . 2
E -mail: Pump or irrigation circle - 53.40 i 2
• , t I . % 'g:l l: , t3 t. eO RAt ; _ .. .i t :: s > &
,' ��� Si or outline lighting 53.40 1 2
Business name: Hillsboro Electric LLC Signal circuits} or limited -
energy panel, alteration, or
Address: 21185 N W Evergreen Parkway #110 extension. Describe: Page 2 2
-
City /State/ZIP: Hillsboro, OR 97124 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 439 -9666 Fax: (503) 601 -3680 Investigation per hour (1 hr min) 62.50 '
CCB Lic.: 134481 Electrical Lic.: 34 -499C Suprv. Lic.: 4941S Industrial plant per hour 73.75
' EL.ECTRLCA PERMIT: PEES
Suprv. Electrician signature, required: ``
,/ �, Subtotal: 4)(p e
j 1 ` - 1 I Plan review (25% of per fee):
Print name: 3oeyVitacco Date: ( D
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: i 5 (� 7
This permit application expires if a permit 6 bt
not oaine within 1811
Print name: Date: days after it has been accepted ne complete.
• Number of inspections allowed per permit.
1: laui lding\Perrnita\ELC- PermhApp.doc 05,27105 44.4615T(11l05JCOYJWEB
CITY OF TIGARD _.
BUILDING DIVISION PERMIT #: ELC2008 U0't0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2008
Phone: (503) 639 -4171 ���FIli;�
Inspection Requests (24 Hrs.): (503) 639 -4175 �' F'..
INSPECTION WORKSHEET FOR DATE: 9/25/2008 TIME: 7:0fIAM PAGE: 36
SITE ADDRESS: 1b660 SW PACIFIC Olt' J1 5 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
TIG ARD PROMENADE 011
DESCRIPTION:
TIGARD PROMENADE (e.--F
(1) branch circuit for light repair.
OWNER: TIGARD CENTER, PHONE #:
CONTRACTOR: HIL.LSBOROO ELECTRIC PHONE #: 603-439.9666
Inspection Request Scheduled For: Date: 9/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 075909-01 971-219-8707 Y R
Corrections /Comments/ Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL _, NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: l - 2- 5 JP Phone #: (503) 718-