Permit fi, i CITY OF TIGA D ELECTRICAL PERMIT
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PERMIT #: E /29/20 00607
::1,, COMMUNITY DEVELOPMENT DATE ISSUED: 10/29/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136AD -04000
SITE ADDRESS: 11525 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: PACIFIC TERRACE LOT : 007 JURISDICTION: TIG
PROJECT: FAST SIGNS
Project Description: Reconnect rooftop unit.
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: SIGNAUPANEL:
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:
SMITH, EDITA M WILLAMETTE HVAC
833 NW 170TH DR 3075 SW 234TH AVE. #206
BEAVERTON, OR 97006 HILLSBORO, OR 97123
Phone: Contact #: PRI 503 - 628 -6841
FAX 503 - 848 -2597
FEES
Description Date Amount Reg #: ELE 34- 346LHR
[ELPRMT] ELC Permit 10/29/2007 $46.85 LIC 56951
[TAX] 12% State Surchar 10/29/2007 $5.62 SUP 4025LEB
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 for
more than 180 da • • NTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 -001 -I 10 through ■A : -001 -11100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / / , 1�/ ! • Permittee Signature: X / 1/
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 Application �!�
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City of Tigard Ell) Received ��
a /
`' �' Date/By: ive / t b Permit No.: e G'. ^ ���Q�7
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r t ° 1 3125 SW Hall Blvd., Tig.'1ii.tl(v„' 22: k �� Plan Review
y M Phone: 503.639.4171 F. v . Date /By: Other Permit:
•,� ^"` Inspection Line: 503.639.4 5 r, Date Ready /By: �)un ® See Page 2 for
TtGARDI p �� /i,: Notified/Method: / `a Supplemental Information
,,, ; - „r Internet: www.tigard-or.gov
p�6/ PLAN REVIEW
, � nnpp Itdr
❑ New construction ®Addrtiort `kv Please check all that apply (submit 2 sets of plans w /items checked below):
''� - ��®�
y �� ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ID Other: gU1t .0. ` 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-use agricultural
❑ 1- and 2- family dwelling ® 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.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: Job site address: 11525 SW Pacific Hwy Six or or more. a
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply yl nominal
voltage for more than
❑ Hazardous locations. 600
Suite /bldg. /apt. no.: Project name: Fast Signs ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 "
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot 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. ft.)
Limited energy, multi-family 75.00 2
Reconnect RTU 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: 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 1 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: _ Date: A. Fee for branch circuits with
❑ APPLICANT '' ❑, CONTACT, PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 -� 2
first branch circuit
Address: Each add] branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40
Signal circuit(s) or ii chedr
Business name: Willamette HVAC
energy panel, alteration, or
Address: 3075 SW 234 Ave Suite 206 extension. Describe: Page 2 2
City /State /ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 628.6841 Fax: (503) 848.2597 Investigation per hour(1 hr min) 62.50
CCB Lic.: 56951 Electrical Lic.: 34346CRE Suprv. c.: 4025LEB Industrial plant per hour 73.75
ELECTRICAL: PERMIT FEES f
Suprv. Electrician signature, required: i� Subtotal: . g 7
Print name: Mike Sicard Date: 10/21/08 Plan review (25% of permit Subtotal:
.
State surcharge (12% of permit fee): 5, CO 2.
Authorized signature: TOTAL PERMIT FEE 52 1 ,
This permit application expires if a permit is not obtained within 180
Print name: Mike Sicard Date: 10/21/08 days after it has been accepted as complete.
* Number of inspectionsallowed per permit.
I'\ Build ing'Permits\ELC- PennitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200l3.00607
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 10/29/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 ' `'! I..
INSPECTION WORKSHEET FOR DATE: 1001009 1 TIME: 7:00AM PAGE: 47
SITE ADDRESS: 11625 SW PACIFIC Ham' CLASS OF WORK:
SUBDIVISION: PACIFIC TERRACE LOT #: 007 TYPE OF USE:
PROJECT NAME: FAST SIGNS
DESCRIPTION: Reconnect rooftop unit.
OWNER: SMITH, IEDITA M PHONE #:
CONTRACTOR: WI I AMETTE HVAC (•• c.\<*") PHONE #: 603- 62I3 -GU41
Inspection Request Scheduled For: Date: 1/20/2009 Pour Time:
Code # Inspection Description i irm # Contact # Message
199 f: lecirical final ■79811 -01 971- 99U -29(J( \ Y
Corrections /Comments /Instructions: Y (\tk
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:, `1123 Date: — 2.0 `M Phone #: (503) 718- le- ►'v