Permit i.
514 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: E -00675
DATE ISSUED: 12/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110DB -00702
SITE ADDRESS: 15410 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: WILLOW BROOK FARM LOT : JURISDICTION: TIG
PROJECT: VALVOLINE
Project Description: (2) branch circuits to hook up new pumps.
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: 1 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, CENTER LP OREGON ELECTRIC GROUP
9777 WILSHIRE BLVD #609 1010 SE 11TH AVE
BEVERLY HILL, CA 90212 PORTLAND, OR 97214
Phone: Contact #: FAX 503 234 - 1001
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 12/16/2001 $53.50 LIC 203
[TAX] 12% State Surchar 12/16/2001 $6.42 SUP 4549S
Total $59.92 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 throu OAR 952 - 001 -0100. You ... : : . "I copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. 40- Issued By: — _�_ Permittee Signature:P � � � /G-gi /a/
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.
AECEIV , I- - / '
Electrical Permit Application FOR OIMrl( h: 1'SE (a\1.1
DEC 1 200 Rc lved
City of Tigard oate/B . j/ 4, _�1/� • .
13125 SW Hall Blvd, Tigard OR 97 CITY OF T I(�A '' LT
' . Phone: 503.639.4171 Fax: 503.595.1 960 c/B . Other Penult:
I
1' t C: n t+. t nppection Line: 503.639.a 173 t; ^� ease rape
Internet: www.tigard•or,gov ULLDING DIVI lethod A �� � Supplemental Information •
TYPE OF WORK PLAN REVIEW
❑ New construction _,In/Additioa /altetation/replacement Pimse check all that apply (submit X sets of plans w/itaas checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Other. where the available froth current ❑ Marinas and boatyards.
• CATEGORY OF CONSTRUCTION • .. • exceeds 10.000 amps at 150 volts or ❑ Floating buildings
less to wound. or exceeds 14,000 ❑ Commercial - use agricultural
❑ 1 - and 2- family dwelling _. Commercial /industrial ❑ Accessory building amp., for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KvA or
JOB SITE INFORMATION AND LOCATION ❑ 161y �t`�' larger separdely system.
• ❑ Addition of new motor load of ❑ "A " °E", "1 -2 ", - 1-3".
L f Job site address: .�. 1� f wy I ix or Dr man ocam�b'.
Job no.:
/ � / �� I 0 btu �� �, �c ❑ Six a< more residential units. • ❑ Recteotiao, l vehicle per.
City /State/ZiP: T % 0 E Gl '7-2 El Health-care facilities. El Supply voltage for more than
❑ Flazardons locations. 600 volts nominal.
Suite/bldg /apt no.: Project name: v c ` 00(4 hln t tt,w,vT 0 6 ❑ Service or feeder 600 amps or mom.
•LEE SCIlEDULE
Cross street/directions to job site: oeaatrnnm I On. I Fee. J Trod i •
New residential single- or multi - family dwelling unit
includes attached garage.
Subdivision: Lot no.: 1,000 sq. It. or less 145.15 __ 4
Ea. add'I 500 se). it. or portion 33A0 1
Tax map/parcel no.: Limited maw, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.) -
Limited energy. multi - family 75.00 2
(`lo c* L3 L - • . — rsidential (with above sq. ft.) -
Services or feeders instaliation and/or relocation
200 amps or less 8030 2
❑ PROPERTY OWNER [ p. TENANT. • • • 201 ampsto amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
•
- - •- 601 snips to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /StatelZiP: 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 I own which is not 20I amps to 400 amps 10030 2
intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. 40I amps to 599 amps - 153.75 2
Branch circuits •- new, alteration, or extension, perpanel
Owner signature: Date: k 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 e46,.55 2
first branch circuit
Address: Each add'I branch circuit _ t 6.65 - to • Io51 2
- Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or fed 90.90 2
eer
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
A,,,,_ Signal circuit(s) or limited -
Business name:
Q r e K ��, energy panel, alteration, or
extension. Describe: Paget 2
Address: 101 p 5 1 NA._ A ve.._ _
Cit /StateizrR `„,„„d 0 t Z . - 7 021 4 Each additional Inspection over allowable in any of the above
Phone: Per inspection 62.50
Ph
o : (, J3 a3 _ e Fax: (SUS ) 535 _ r� : Investigation per hour (I hr min) 62.50
CCB Lie.: { ' " I electrical Lic.:0? _9j5 I Suprv. Lic.: Li 5 > industrial plant per hour 73.75 - -
ELECTRICAL PERMIT FEES .
Suprv. Electrician signature, N� Subtotal: 53 .50
Plan review (25% of permit fee):
Print name: t c L G � � u i 1 oi Date: 1 / 6 - 9 stare surcharge (12% of permit fee): C, .9
Authorized signature: TOTAL PERMIT FEE: 5z .i 2...
Print name: Date: This permit appaendon expires If a permit is not obtained within Sao
days after It has been accepted as complete.
• Number of itaveetions aaerwed ter pennil
OZZ - d Z00 /lOO d 8217 -1 E91ZSESEOS OAS 0181313 80 -4010dd INd9S :110 800Z- 5l -O30
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008.0:1015
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/18/2008
Phone: (503) 639 -4171 ���jI�������A
Inspection Requests (24 Hrs.): (503) 639 -4175 s
INSPECTION WORKSHEET FOR DATE: 1 /Ei/2009 TIME: 7:OOAm PAGE: 15
SITE ADDRESS: 16410 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: TYPE OF USE:
PROJECT NAME: VALVOLINE
DESCRIPTION: (2) branch circuits to hook up new pumps.
OWNER: TIGARD, CENTER LP, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 -234 9900
Inspection Request Scheduled For: Date: 1/6/2009 Pour Time:
Code # Inspection Description C . Contact # Message
199 Electrical final 079409-01 503.969. 3510 N
Corrections /Comments /Instructions:
\ I
A
1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ni C) 0 � Date: Phone #: (503) 718- 7I