Permit 311 CITY OF TIGARD ELECTRICAL PERMIT
•
PERMIT #: ELC2009 -00044
COMMUNITY DEVELOPMENT DATE ISSUED: 1/29/2009
TIGARH 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102DA -00401
SITE ADDRESS: 13125 SW HALL BLVD COURT ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: COURT
Project Description: (4) branch circuits.
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: 4 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, CITY OF OREGON ELECTRIC CONSTRUCTION INC
13125 SW HALL 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 234 - 1001
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMTJ ELC Permit 1/29/2009 $66.80 LIC 203
[TAX] 12% State Surchar 1/29/2009 $8.02 SUP 4549S
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Total $74.82 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: . ) �' j / .� , r ] Pe rmittee Signature: t (
� � I ^ ems n o
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.
• RECEIVED
. ..
Electrical Permit Application JAN 2 9 2009 ' oll cw :ic .: us' ()NIA' . .
; Iii . • City of Tigard R eived O 9 �, Permit No.: t OO
q 13125 SW Hall Blvd.. Tigard, OR 97223 CITY OF TIGAR I 'Ian Review
m .. Pho ne 503.639.4171 Fax: 503,598.196( BUIL DIVISI ��� . e /n . Other Permit:
Inspection Line: 503.039A 175 Date Ready /By rut see P9 o z rpr
Intcmct www.tigard- or.gov Notified/M 1' 1 ty Supplemental information
TYPE OF WORK 'PLAN REVIEW
•
p New construction „Addition /alteration /replacement Please check all that apply (submit? sell Of {AXIS w /hems Checked below);
❑ Service or feeder 400 amps or more ❑ Building over three stories,
Demolition ❑ Other:
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION' • exceeds 10.000 turps at ISO volts or ❑ Floating buildings.
❑ 1- and 2 - family dwelling Commercial/industrial El Accessory building less to ground or exceeds 14.000 ❑ Commercial-use atgtiCUltunl
ry g buildin
amps for all other ingrillations. g.
❑ Multi - family ❑ Master builder ❑ Other: ['Fire pump. ❑ installation of 75 KVA or
JOE SITE INFORMATION AND LOCATION ❑ Emergency eyeless. larger separately derived system.
❑ Addition of new motor load of ❑ .•A °L", "l -2 "1 -3
Job no.: SOC( Job site address: l3 l 2.5 S 1 � 100 or more ne Recreational i !� � i <' ❑ Six or more rgidentia] units. El Racrcationat vehicle parks.
City/State/ZIP: q 7 2 , ❑ Health -care facilities. ❑ Supply voltage for atone than
d 1 �' ❑ Hazardous locations. 600 volts nominal,
Suite/bldg, /apt. no.: 1''roject name: ❑ Service or lbcdcr 600 amps or more.
FEE SCHEDULE - .. - •
Cross street/directions to job site: Dneriptinn I qty, I. Fen. I Total 1 -
_.._. _.. . New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. IL or less 145.15 4
Ea. add'I 500 sq. f_ or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK • - (with above sq. ft.)
��
rIA C _ Limited energy, multi - family 75.00 2
0 U s LA, I; 4 s Gti.ti�? t ip V off) V residential (with above sq. R)
11 �� Services or feeders instnlIntloti alteratlon, and/or relocation
e I A JD 7o r tU 1 v■ (t 00 V' - '•tt)U tv■_ 200 amps or less 50.30 2
❑ PROPERTY OWNER 0 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 t 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 am sp or ic 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
_ Branch circuits - new, alteration, or cxtensoon, pe panel
Owner signature: Date: A. Fcc for branch circuits with
❑ APPLICANT I Ca CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name:
B. Fee for branch circuits
without service or feeder fee.
Contact name: first branch circuit 46,85 ufj, 2
Address: Each add'] branch circuit, 3 6.65 l dj.y } 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 2
dweltin ,z, service and/or feeder
Phone:
( ) I Fax: : ( ) Reconnect only 66,85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR . Sign or outline lighting 53.40 2
Business name: '-� Signal circuit(s) or limitcd-
l� V" 6 y1 __L, ••4, C v L C_ energy panel, alteration, or
extension Describe: Page 2 2
Address: i C7 Z C] � i 1, I � A_ •�.a w! g
City /State/ZIP: 1'c v.- %\4.+.1., Q 1 7 a J N Each additional Inspection over allowable in any of the above
Phone: ( 23) a3� - Cop � ) Per inspection 62,50
Fax; ( �J �� investigation per h our (1 hr min) 62.50
CCB Lic.: * 0 3 Electrical Lie.' - -5,5 Suprv. Lic.: g5 � Industrial plant per hour 73.75
Suprv. Electrician si atur ELECTRICAL PERMIT FEES
Su
p gn t ' ei 1116,:. * ,y \� % ` 1 Subtotal: 66- 0U
Print name: l c_S ..,ci_v_„A /l e a l . ;( -N- I Date: `- �j - p Plan r (25% of permit - the):
Y ` S tate su rchar ge (12% of permit fee): 6. tea
Author, � �. I . 5t
TOTAL P ERMIT FEE: � aC
Print name: Date: This permit appneatlon expires If a permit Is not obtained within leo
days after It has been accepted as complete.
• Number of inspections allowed oer permit.
619 —d Z00/100 'd 819 -1 £919£9£09 OAS OId10313 d0—WOdd 1NdO'1 :90 600Z -6Z -WP
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLC2009- 00044
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29.0009
Phone: (503) 639 -4171 . h
Inspection Requests (24 Hrs.): (503) 639 - 4175
INSPECTION WORKSHEET FOR DATE: 25/2009 TIME: 7 :00AM PAGE: 31
SITE ADDRESS: 13125 SW HALL BLVD COURT CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: COURT
DESCRIPTION: (4) branch circuits,
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: OREGON ELECTRIC CONSTRUCTION INC PHONE #: 503 - 234 -9900
Inspection Request Scheduled For: Date: 2/5/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 01028:3 01 503.535-2660 N
Corrections /Comments / Instructions:
f■ PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
n F IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: d\loe L Date: 776'49 Phone #: (503) 718- Wilt