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Permit
CITY OF TIGARD T ELECTRICAL PERMIT f V PERMIT #: ELC2005 -00342 DEVELOPMENT SERVICES DATE ISSUED: 5/20/2005 ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S113AD-01900 SITE ADDRESS: 16600 SW 72ND AVE B10 ZONING: I - SUBDIVISION: OREGON BUSINESS PARK I LOT : 00g JURISDICTION: TIG Project Description: Relocate (1) power pole, add: (1) 30 amp circuit for hood 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: SIGNAL /PANEL: MANF HM/ SVCI 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: 1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PACIFIC REALTY ASSOCIATES OREGON ELECTRIC CONST /GROUP 15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE PORTLAND, OR 97224 PORTLAND, OR 97214 Phone: Phone: 503 - 535 -2652 FEES Reg #: LIC 203 4460S Description Date Amount SUP 26 ELE 26 -95C [ELPRMT] ELC Permit 5/20/2005 $53.50 [TAX] 8% State Surcharge 5/20/2005 $4.28 REQUIRED ITEMS AND REPORTS Total $57.78 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: � Permittee Signature: A 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. MAY -20 -2005 10:21AM FROM-OR ELECTRIC $F, VIO 5035352763 T -087 P.002 /002 F -624 • M\L•L \■ L .SSA A .10 " \Aar L A \abt{F'b � ' My, _l. .- , Spew f 1 # City of Tigard Received - i I>dte.B1' I I t� r,� Permit No O ', 13125 SW Hall Blvd., Tigard, 0 23 e — �� Plan Review Phone: 503.639.4171 Fax 503.598.196 ,1 cl Q 100 ,.! 3I '' Date:By. Omer Permit. Inspection Linn: 503.639.4175 V\ PA ` A A:) ,0 ' � { Date Ready/By hua. Tel See Pace 2 far Internet: www,citigard.or.us ^��`, o � 1' qi , 0 . 1 Notified/method: i Supplemental Tnformatioo p V r '' PLAN � REVIEW ❑ Ncw construction 0 Addition/alteration/replacement Please check all that apply: Service over 225 amps, comm'1 Hazardous location 0 Demolition ❑ Ot her: ❑ p ❑ . - ['Service over 320 amps - rating ❑Buling over 10,0000 0 sq. ft., CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential ❑ 1 - and 2 -fi miry dwelling CO Conunercial/indusgrial ❑ Accessory building ['System over 600 vole nominal 'units in one structure ❑ Multi- family Master builder ❑Other; ❑Building over three stories ❑Feeders, 400 amps or more ['Occupant load over 99 persons © Manu facture d strucwres or JOB SITE INl?ORI LOTION AND LOCATION ❑Egress/lighting plan RV park Job no_: 86053 Job site address: 16600 SW 72ND []Health - care facility °Other. Submit 2 sets of plans with any of the above. City/State/ZIP TIGARD, OR The above are not applicable to temporary construction service. - Suite/bldg. /apt. no.; BLDG 10 Project name:[ LIGHT DYNAMICS . PEE* SCHEDULE cs Doi 1 Qty. 1 Fw. 1 Total I •• Cross street/directions to job site: New residential single- or multi -family dwelling nnit. Includes attached garage. 1,000 sq. ft. or iota 145.15 4 Subdivision: Lot no.: Ea. add'1500 sq_R or portion 33.40 1 Tax ma Limited energy, residential 75.00 2 p/paivcl no.: -- Limited energy. non - residential 75.00 2 DESCRIPTION OF WORE Each manufactured or modular RELOCATE (1) POWER POLL ADD (1) 30 AMP CIRCUIT FOR HOOD UNIT_ dwelling. service and/or feeder_ 90.90 , 2 Services or feeders installation, alteration, and /or rulut sttlun 200 amps or less 80.30 2 ❑ PROPERTY OWNER , ❑ T 201 amps to 400 turps _ 106.85 2 - 401 amps to 600 amps 160_60 2 Name: ROCKWELL COLLINS/FLIGHTDYNAMICS 601 amps to 1,000 amps 240.60 2 Address: 16600 SW 72N1) Over 1,000 amps or volts 454.65 2 Reconnect only _ 66.85 2 City /StateJZIP: TIGARD, OR Temporary services or feeders Jnstatlatlon, alteration, and/or Phone ( ) Fax: ( ) rclotattion 200 amps or less 66.85 1 Owner installations This installation is being made on property that I own 'Whi'1t is not 201 amps to 400 a mps 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 Foe for branch circuits birth - - service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or fonder fee, i 46,85 2 Address: each brunch circuit Each add'I branch circuit 1 6.65 2 City /State/ZIP: Miscellaneous (service or feeder nut lddu Phone: ( ) FAX :: ( ) Pump or irrigation circle 53.40 2 - Sign or outline lighting 53.40 2 - E - mail: Signal circuits) or limited- CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: Oregon Electric Group Address: 1010 SE 11th Ave Each additional Inspection over allowable in any of the above Per inspection 62.50 City /Staic/ZIP; Portland, OR 97214 Investigation per hour (1 hr min) _ 62.50 Phone: (503) 234-9900 f Fax: (503) 5352763 Industrial plant par hour 73.75 ELECTRICAL PERMIT FEES" _ CCB Lic.: 203 Electrical i . . -9 C •• .e prv. Lic.; 4460S Subtotal 5 3 �JO Suprv. Electrician signature, regttired J ' � - Plan review (25 %ofpetmit fee) ^ Print name: M ark 1/43-.. K ,,, .e. 0 Dateaa' 1 . , - _ state surcharge (S% ofponttit foe) . a $ TOTAL„ PERMIT FEE 5 j 1 $ Authorized signature: This permit application expires ir a permit is pen. obtained within 180 - - days ellcr 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,