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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2009 -00061 COMMUNITY DEVELOPMENT DATE ISSUED: 2/ TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 102 D B - 00200 SITE ADDRESS: 09275 SW HILL ST ZONING: CBD SUBDIVISION: BURNHAM TRACTS LOT : 007 JURISDICTION: TIG PROJECT: VERIZON Project Description: Install (2) 100 amp services. 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: 2 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: BURNHAM BUSINESS & STORAGE LLC ADK ELECTRIC, INC. 9500 SW BARBUR BLVD STE 300 PO BOX 2676 PORTLAND, OR 97219 BATTLE GROUND, WA 98604 Phone: Contact #: PRI 360- 546 -5155 FAX 360 - 576 -6975 FEES Description Date Amount Reg #: ELE 37 -934C [ELPRMT] ELC Permit 2/13/2009 $160.60 LIC 148882 [TAX] 12% State Surchar 2/13/2009 $19.27 SUP 4853S Total $179.87 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: k:P�l� 1 Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Sent By: FARWEST ELECTRIC INC; n;• .•• Feb -13 -09 5:25PM; Page 2/3 ..,„ ,, i a=v; : II:, . Electrical Fermlit Application' 1.(, f , t 11 I ll l ( tie l l•:1..l - FEB 1 3 2009 Re ceived - ± i a iry of Tigard Date D • t • o ci _� ri. 7; � < 3123 sw Hall ales, Tura oR TY OF TIGARD °i pe t: 13( phone: so3.63: 503.639.4175 Sit: 503- 99$ bUI LDING DIVISION , See Page 2tar s flan Line: 503.639.4175 Da te ed/Mc I neerne t www .hgUrd- of -gov Notified/Method: Supplemental fofonnstioa f?E iOIF volt „ . . ltf1.AI4 IkEV>tE',41+ Please cheek all that apply tathin t 1 aetr of plane w /items ch teed below): Nor pol> itNh Additit71t 1a1tGtatiodiCpl9Cemeat 0 Service or feeder 400 awe or more ❑ Building over three stones. ❑ Demolition Outer: Mime the available Leah currant El Marinas and boatyards. �` exceeds 10 000 SO voila Floating baiMinge i l.li �r t '. OF `��1� ' „ ": '., - r ' : lest m gusted, cxceods 14,000 Commercial -aeo ap[icuhw�l ❑ i - and 2 - -1 miiy dwelling W Commercial/industrial n Accessory building Map fora other installations. buildings, 0 Muni- 6101y ■ Master builder ❑ Other. O Fero pump. ❑ installation of 75 KVA or ❑ g W Farms separately derived system, 400 1140, t A'UU011 Axe) 1Ak∎ i'MUN © Addition of now motor lard of ❑ "A ", "8", .1 -2", "1.1 ", p , : l ( 100HP or more. ay- Job t10.: p lr � 1 3t)b site address: q 7 l�v,1 y Y l �' t� _ ❑ six ar more residential units- El Recreational vehicle perks, L S' ❑ i l oars acuities. ❑ Sum* voltage for mmv than Clry/3#ete/ 1�': ! i y b ? ©et®rdous locations. 600 volts novena]. f ❑ ervice or feeder 60o amps or Suitt:/bldg./apt. no.: Project name: 4"t1 " r. • g ester - Cross street /ditulions to job site ) . r .4../ .7 w,,i? fy/ ?�c4-k f { i f± rite na (ots T far, • • r '�r� l .. `- 0 Q _ �� [ New residential single- or mulls- family dwelling unit. I 501 (44 ,11 �/7d k ''/ /tS i' /In n l /- 'iv 47 (‘57- . Includes attached ganigt. Subdivisitm 1 1 Lot no.: 1,000 sq. ft. or le s 145.15 4 _ - Es. add'l 500 so- R a portion 33,40 I Tax trap parcel no.: Limited energy. residential 75.00 2 D� 'OF w C Limited multi ... 'J w above �, l ed gy. 75.00 2 /56 / ,,, /1° i . j. residential (with above r4. ft) , Services or feeders itaarsOation and/or relocation 200 amps or less 2- 80.30 ' os br 2 El] '0 OWN W. < :. 0 TENANT . • ; 201 amps to 400 gulps 1 06:85 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 r 454.65 2 N Temporary services or feeders Instatlarten, alteration, and/or City/S'ta LxP: . - relocation _ - Phone" ( ) J1 Fat: ( ) 200 amps or less 66.85 1 100.30 2 ° Owner instillation: This installation is being made on property that 1 own which is not "01 amps to 499 amps 133.75 2 intended 03i sale. lease, net, a exchange, according to ORS 447, 4491 670. and 701. 4 Z01 tulips to 400 amps 2 Branch circuits - new alteration or eitenaioo, per panel Owner argtl>irttlfe' Date: A. Fee for brunch circuits with • LICAN"� . . . El <70NPTACL: PE . ON above service or feeder fee. 6.65 2 .�APP .. each branch crna+h Business nine :: 4 D x 6 / , - , 4 . 1 1 . z 1 _ 1 i . , , - . - _ - B. without seavfcc or r ihedrr tee, . Contact nacre: j ill first branch circuit 46.65 2 E ach add" blanch circuit 6.65 2 '� 1; ►� t X (+ MiaceBaneooa (aervic_e or feeder not lnduded) City/State/ZIP: 6,i {-� f E f',,e„ _ ,1 A ' / 4 {.' L' Each manufactured to modular 90,x)0 2 _ .dwcllin: service and/or feeder Phone: (1.-1 ij,") Eli 4; : S f s Fax:: ( 3f,• t ) S'' - Reconnect only - 66.85 _ 2 G�YI L Pump or irog no t circle . 53.40 2 • E-mail: .. 53.40 2 . C1. V Si ou ou tline li Siprtisl circuh(s) or limited - Buslitess (tame: • )v . f C L , c . 1, f _ energy panel, alteration, or extension. Describe: ' Page 2 2 Address: 1G F? Z L'1ao f ' Each additional torapcctton over allowable in any of the above l II City/StateP: p }4li (� wtcv rt , V ; S V'; _ - Per rosier fort 62.50 Phone: (A ) i . S 15 5 I Fax:( ? <:, ) c 'j L . - v investigation per boor (l hr mist) 62.30 " Electrical Lie.: Suprv. _ Lic.: L oa 5 Industrial punt Per hwn 93.75 CCBi,ic.: < � �1' 134C- Suprv. Electrician signature, required: ---.411/ . . Subtotal; Q • 6 .T G Plan mview (25% of permit fee): )'riot etmre . I �,/ 17 - �a r. 1. a 'Cr f / U ! . ... State surcharge (12% of permit fro): / 4. 7, Authorized signature: / .1 • r . _ TO1 AL PERMIT FEE: +'� q . . , Mb permit appli:atlea expires if a permit Is cot obeniaed within ISO Date: /3 0 ' ' days after It has bees accepted as complete Print nemq: U 1 l n' K t; lc S • Number of inspections allowed per penult CVO OS/4 440- 4415T(11/05/C MAYBB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELCV 4 1°6004 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171Aititt Inspection Requests (24 Hrs.): (503) 639 -4175 _.. INSPECTION WORKSHEET FOR DATE: 3 •Act -09 TIME: PAGE: SITE ADDRESS: 5215 S WILL S f CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 Act • (y) Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections/Comments/ Instructions: VI PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: "`' Date: - L Phone #: (503) 718- 14415_ CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC7009-00061 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/13;2009 Phone: (503) 639-4171 A - r --- „,i,,,t Inspection Requests (24 Hrs.): (503) 639-4175 .0 INSPECTION WORKSHEET FOR DATE: 2/20/2009 TIME: 7:00AM PAGE: 17 SITE ADDRESS: 09275 SW HILL ST CLASS OF WORK: SUBDIVISION: BURNHAM TRACTS LOT #: 007 TYPE OF USE: PROJECT NAME: vFR17.014 DESCRIPTION: hid all (2) 100 amp services. OWNER: E3URNHANI BUSINESS & STORAGE LLC, PHONE #: CONTRACTOR: ADK ELECTRIC, INC. PHONE #: 360 Inspection Request Scheduled For: Date: 2/20/2009 Pour Time: 1:16 c f:Zo Code # Inspection Description Confirm # Contact # Message 105 tinciergroundtslab cover 000656-01 360.54(3-5165 Y . Corrections/Comments/Instructions: S\ b c: FAi PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: G- N6eL. Date: 2 - 243 '1 Phone #: (503) 718- 3_14k)______ CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELC2008.00061 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2113i20e9 Phone: (503) 639 -4171 L I/ t ra Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' 'I.L INSPECTION WORKSHEET FOR DATE: 2/20/2009 TIME: 7 :00AM PAGE: 16 SITE ADDRESS: 09275 SW HILL ST CLASS OF WORK: SUBDIVISION: BURNHAM TRACTS LOT #: 007 TYPE OF USE: PROJECT NAME: VERIZON DESCRIPTION: lnsiall (2) 100 amp services: OWNER: BURNHAM BUSINESS & STORAGE LLC, PHONE #: CONTRACTOR: ADK ELECTRIC, INC. PHONE #: 360- 546 -5155 Inspection Request Scheduled For: Date: 2/20/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 Temporary electrical service 000656.02 360-546-5155 N Corrections /Comments /Instructions: gam/, PASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 3m 1 s NS LT Date: 2-3 ' 1 Phone #: (503) 718 - 1. 7`0