Permit CITY OF TIGARD ELECTRICAL PERMIT
j O
PERMIT #: ELC2008 -00395
COMMUNITY DEVELOPMENT DATE ISSUED: 7/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 134DC -00600
SITE ADDRESS: 11355 SW TIGARD ST ZONING: R - 4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: VERIZON WIRELESS
Project Description: TI
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: 1 W /SERVICE OR FEEDER: 3 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:
ANDERSON, LARRY R AND OREGON ELECTRIC GROUP
CYNTHIA M 1010 SE 11TH AVE
11355 SW TIGARD ST PORTLAND, OR 97211
TIGARD, OR 97223
Phone: Contact #: FAX 503 - 247 -0108
PRI 503 - 546 -6062
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 7/11/2008 $100.25 LIP 203
[TAX] 12% State Surchar 7/11/2008 $12.03 SUP 4818S
Total $112.28 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: � /i Permittee Signature: _S.S2 "37/e 'TS �M� WNER 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.
( 07/11/2008 12:13 5032470108 OREGON ELECTRIC GRPU PAGE 02
Electrical Permit A licf�, ' E V +
_ I l►k U7'i u I a' \l ()11
City of Tigard Receive t s , 3 k
i iil
13125 SW Hall Hlvtl., Tigard. OR 972 AeteB . 4r"Y WmdtNo t•�?
Phone: 503 679 4171 Fax: 503.598.1 L 1 Z Q P1ee Review _ Wv
Inspection Line, 503.639.41)5
Date /By; fur her jr LI 8-- /
I' I , . ., ,, t, _ Dale Reaey- /9Y, lurk
Internet; wWw.tigard•or, i� I� V r -� i GAR D NottIIed Met had: S See Pape 2 ror `
rpplemaMal information
TYPE Q� ► NIG D VIS ON PLAN REVIEW
0 New construction CO Addition/alterationir0 lncoment Please check ail that
� - y P aDDIY tsubtnit j sate of alerts wawa checked below(
L I Demolition ❑ Other: d3orvtce or feeder 100 amps or more (] gu,lding over there srarira
where Ire available Rol/ current ❑ Manus and boatyard:
_ CATEGORY OF CONSTRUCTION e'teeeds IQ000 amps m tso v or ❑ Floor bwtd:nus.
Q I- and 2- family dwelling taretowound uxceade 14 .0 s
El Multi- ffmll 00 OCommeing rc,el a Ic
$ ®Co bnmercisllindustrial [] Accessory building ow for all ot ira[allerion ❑ Master builder I all ti
❑Other ❑ lira pnmD- p Inaenmton or rs xvA or
JOB SITE IIVF�ORMATION AND LOCATION ❑ 1?meraeney system larger separately derived system
Job no.: 12596 Job site address 11355 SW Tigard St. ❑ Addition of new Motor load of ❑"An. 1 ", 1a
I00HP or mote, oceupancy-
City / State/Z1P: Tigard, OR 97223 17six Or more resldorltial waft:, 0 Recreational vehicle polka
0Henith•cero enmities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg.apt. no.; Project name: P a • • cents ( 11 (Akre UAS ❑ service or Rader 600 soya or more.
Cross Street/directions tojob site: FIRE BCREAULE -
Now wildcatted stogie- or multi- family dwelling unit n -
Inctedeo attached gars.e.
Subdivision:
i Lot no.: 1,000 s4.11. or less MIII NIIII 4
Tax map /parcel no.: Ea. add'( 500 sq ft. or portion 33.40 I
' ' - DESCRIPTION OP WORK Limited energy, residential
wttb above a.. II. 75.00 2
•
Generator / ATS Install; 200 Amp service, 3 Circuits Limited energy, multi family
residential with above ft, 75.00 2
Services or feeder; Installation alteration, and/or relocation
200 amps or less 1 80.30 80 30 2
, -, El ' PROPERTY [SWNER_ . , 1 . • ; • . • p_ I TENANT • -. 201 am • s to 400 cps 106.85 2
Name: Verlaron Wireless 401 amps to 600 amps III 160.60 2
Address: 601 amps l0 1.000 amps 240.60 2
Over 1,000 am.: or volts MI Inaall 2
City /State/ZIP: m - Temporary scrvlee or ederslostullatlon , alteration, and/or —
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85
Owner installation: This installation is being made on ro w t -
p party that I own which is not -' 201 maps to 400 amps t 00.30 2
intended for sale, lease, rant, or exchange, according to ORS 447, 449, 670, tied 70i. 401 Innps 10 599 amps 133.75
2
Owner signature: Date: Branch circuits - sew alteration or extension , er anti _
E `; + ,ti, ; ; ;i;: c '® ' , 1 _ A, Fee for branch circuits with
s`?ti!1.1 V' , .."•': - , . : . • ,. ; ®' • A 'I pg1iSQN =a r; above service or feeder &e, 3
Business name: Oregon ElectricConatruction, Inca
each branch circuit
6.65 2
S. Pee fOr branch circuits
Contact name: Jennifer Devine
wit/ orir service or feeder fee,
first branch circuit 46.85 2
Address: 1010 SE 11 Ave. Each add'( branch circuit 6.65 2
-
City/State/ZIP: Portland, bit 972 T1 - Miscellaneous service or feeder notJoduded
Each manuilictured or modular "`
P062 dwetlin : , service m et/ feeder
Phone: (503) 546-6062 90 - 90 2
Fax : (503) 247.0105 Reconnect only III 66.85 111.111 2
E -mail: .a.devine ®Isg- group.com
I ' ,,, t , ; _ Pump or irrigation circle no 53.40 2
-- • :' , i i' ':. 6R I Sign or oulline lighting 53.40 � 2
Business name: Oregon Electric Construction, Inc. Signet circuit(s) or limited-
energy panel, alteration, or
Address: 1010 SE 11th Ave. extension. Describe: Page 2 2
City/State /ZIP: Portland, OR 97211 J Each addltieoel ins . cation over allowable In an of the above
Phone: (503) 546-6062 Pax: (503) 247.0108 Per inspection 62. $0 Mill
Investigation per hour° lvmin) 62.50
CCl3 Lie.: 203 Electrical Lie., 26 -95C Suprv. Lie.: 4549S Industrial plant pullout —Ma
Suprv. Electrician signature, require. ' ' : ELECTRICAL PERMIT .PEES
1 '�'t , 106, • " Subtotal 100.25
Print name: Richard McEllion Date: ~i 1 I k 108 Plan review (25% Of permit the): 0
F State surcharge (12 %of permit fee)' 1 2.00
Authorized signature: TOTAL PERMIT FEE 112 26
Print name. ._�._ pate' days after Tab permit appttcater I f hos b a Ir a een a ccepte is sot ablei within 1110
ter t hoe b ccepted as complete.
Weber ormrpeclionsallowedperpennp,
tAanndteewerminaLC- rerv,happ 440a6107t1 lrosxroMnvea
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00365
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1112008
Phone: (503) 639 -4171 ( Is
Inspection Requests (24 Hrs.): (503) 639 -4175 A. ° i
INSPECTION WORKSHEET FOR DATE: 8/29/2008 TIME: 7:OOAIvl PAGE: 19
SITE ADDRESS: 11355 SW TIGARD ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERI7_ON WIRELESS
DESCRIPTION: TI
OWNER: ANDERSON, LARRY R AND, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-
Inspection Request Scheduled For: Date: 8/29/2008 Pour Time:
Code # Inspection Description
/Confirm-If Contact # » \sage
199 Electrical final 074856.01 503.913 -7658 'r`
Now
'III..
//J 4 Corrections /Comments /Instructions: \ � oviO>e LA F ti `
pia kfiNie w . OAk g, i it • 311- oo'- 3 • Qi *4. 4. ; LT
® WkahliD1li $k vcrso 55 i 31 '+ 4( fireft. kg 10 •
® b.6c.c)Ak si4 Ig 6 c___ 2a kecY• 2 .36
Q La CAlt b v at. p 7 Z2.5• 32.
vite.6013 A W) 4.1?0,6-
31 ill 0 q G-, NpgL
►I PASS PARTIAL APPROVAL ❑ CANCEL — NO ACCESS
.'( FAIL %CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N Vv Date: t ' .- `. Phone #: (503) 718- i *It
CITY QE TIGARD '
. .
BUILDING DIVISION PERMIT #: ELC2008- 0039.5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/11/2001#
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 - 4175 �
INSPECTION WORKSHEET FOR DATE: 8/28/2008 TIME: 7:00AM PAGE: 38
SITE ADDRESS: 11355 SW TIGARD ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON WIRELESS
DESCRIPTION: TI
OWNER: ANDERSON, LARRY R AND, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 - 546.6062
Inspection Request Scheduled For: Date: 8/28/2008 Pour Time:
Code # Inspection Description K Contact # Message
199 Electrical final 074767 -01 503-546-6062 N
Corrections /Comments /Instructions:
c
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G • Nb8 Le Date: t 14` I Phone #: (503) 718- 7-414