Permit 1 �3. CITY OF TIGARD ELECTRICAL PERMIT
1 14 ° PERMIT #: ELC2009 -00055
COMMUNITY DEVELOPMENT DATE ISSUED: 2/9/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112AD -00900
SITE ADDRESS: 14800 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: HOME DEPOT
Project Description: Install (3) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT 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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 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:
HD DEVELOPMENT OF MARYLAND, INC LIN R ROGERS ELECTRICAL CONTRACTORS
POBOX 105842 2050 MARCONI DR SUITE 200
ATLANTA, GA 30348 ALPHARETTA, GA 30005
Phone: Contact #: PRI 770- 772 -3400
FAX 866- 220 -4646
FEES
Description Date Amount Reg #: ELE 37 -727C
[ELPRMT] ELC Permit 2/9/2009 $60.15 L'C 118038
[TAX] 12% State Surchar 2/9/2009 $7.22 SUP 5100S
Total $67.37 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: rat'ti aSZ. , 1/4 ; (n n_ n Permittee Signature: Su Ap 1 (Oa4%
VW�" 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.
N r ITY OF ELECTRICAL PERMIT
q
PERMIT #: ELC2009 -00055
° COMMUNITY DEVELOPMENT DATE ISSUED: 2/9/2009
T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112AD - 00900
SITE ADDRESS: 14800 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: HOME DEPOT •
Project Description: Install (3) branch circuits. 2/19/09, adding (1) service.
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: 1 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: 2 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: •
HD DEVELOPMENT OF MARYLAND, INC LIN R ROGERS ELECTRICAL CONTRACTORS
POBOX 105842 2050 MARCONI DR SUITE 200
ATLANTA, GA 30348 ALPHARETTA, GA 30005
Phone: Contact #: PRI 770 - 772 -3400
FAX 866- 220 -4646
FEES
Description Date Amount Reg #: ELE 37 -727C
[ELPRMT] ELC Permit 2/9/2009 $60.15 LIC 118038
[TAX] 12% State 2/9/2009 $7:22 SUP 5100S
[TAX] 12% State 2/19/2009 $4.81
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $112.28
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 - . h in OAR -952- 001 -0010 through OAR 952 -001 -0100. You may obtain copies oft -se rules or direct gyestions to OUNC at
503.246.669 • or 1.800. 12. .
Issued B -1 . / . & 4 __ Permittee Signet - - 44i
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:
COL r • CTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: A-4. �Uf` -�� 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.
•
Electrical Permit Application FOR I )FFl PeUSE ONL1
ll A cliam
City of Tigard �J o ey. rmirNo.:
o
• 13125 SW Hall Blvd, Tigtur�ig113 PGu, Rcv,cw • O9 Adler ['erotic •
. Phone: 503.639.4171 Fax: 503_598.1960 9 1 Date/By; •
T iGAr D Inspection Linc: 503.639.4175 Gv Dare Ready/lily: hnt; El So Page 2 for
Internet: www.tigard -or.gov G . o� Nodli,�/MCrhod: ' 1 �+, Supplemental information
•,' .,•. ' . ,. 11 Y .. ."4 y 4, ' ... - ,.. ' 1 ''- P1$4 114
,., . 1 t „10, +1
''
7i'i'., �'� , '.d ' ; i,�.
El New construction ® Additio i, acement Please check all That apply (submit 2 sets of plans w/i tems • I cal bcr }'
B i ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other where the available fault =M U 0 Marinas and boatyards
"P j ap , ,•;:. ' .4.t e. {'.; y s; ...' ,. • r exceeds 10.000 amps at 150 volts or C) Floating buildings.
. r � U F- ,COST •'• . less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
(] 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory buil amps for all other installarions. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fin pump. ❑ Installation of 75 KVA or .
C - ❑ Emergency rystem. larger separately derived system.
!,... • ':A, : ...„,,,,,,,,,,,,m ' . , A .,1 }, , , ,f R ,.. ,;, t ^ _ 4 -, - •r . i' D Addition of new roo4tr load o Q A . - El , b? . k 3 .
• . 4002 address:
mow IP or more.' occupancy.
❑ Six or more residential ,nits. 0 Recreational .,chicle parks.
City/State/ZIP: Tigard, OR • ❑ Healthcare facilities. 0 Supply voltage for more than
❑ Hazardous locations, 600 volts nominal
Suite/bldgJapt. no.: Project name: Floor Polisher 0 Service or feeder 600 amps or More.
oVh' p „ e
Cross street/directions to job site: :natit4 Qty- 1 Fay l rorw_
• • New residential single or multi -famlly dwelling unit.
Includes attached garage.
Subdivision: • I Lot no.: 1,000 sq. ft. or less 145.15 I 4
Ea. add IV0 sq. R or portion 33.40 1
Tax map /parcel no.: en L residential
�Iy� ��y. +
' Limited vgy, 75.00 2
0 "; - - I''..''r'•� r' ..:+r' 4YfA4:. �, Ol.' ON OE _w'SFV'; ' t4' ... •” r ^ . { ';",e ;Ail:. (with above sq. IL)
Add 3 new outlets Limited energy, multi- fatnify 75.00 ?
residential (with above s R )
Services or feeders installation, alteration, and/or relocation
•
200 amps or less • 60.30 'J 2
+ I ' r "' "" ,
x I ,:P�ROP ;;�: �' f ' �r, � ' �' , r :F, "'a dJ . • 201 amps to 400 amps 106.85 2
Name: Home Depot 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: po box 105573 Over 1.000 ;traps or volts 454.65 2
City /Statc/ZiP: atlantn ga 30348 Temporary aery es or feeders installation, alteration, and/or
relocation
Phone: (770)30348 I Fax: (. ) 200 amps or less _ 66.85 - 1
• . . . Owner installation: This installation is made on property that T 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 snips to 599 amps 133.75 2
Owner si attue Date: Branch circuits stew, alteration, or extension, per panel
!�^ A. Fec f or branch circuits w
E it tY. l'I ''y ' d' m. o Gerr RI 9 c, .:.. :. above service or feeder (cc,
ajEllI "� + "'.A • "" .i � ' each branch circuit 6.65 2 •
B. Fee for branch circuits
., without service or feeder fee, 1 R5 46.85 2
Contact name: first branch circuit
• Address: Each add ltranch.circuit 3 6.65 13.30 2
Miscellaneous (service or feeder not included)
Lash manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone; Reconnect only 66.85 2
E-mail; Pump or irrigation circle 53.40 2
t/lirJn": .r : "Sa ; a n'T• 7' 01!: • r1.3 M•Ii'.: w:', Sign or outline lighting 53.40 2
Business name: Lin R Rogers Electric
Signal panel, or Limited- •
g energy panel, alteration. or
Address: 2050 Marcomi Dr #200 extension. Desenbe: Page 2 2
City /State /ZiP: Alpharetta, GA 30005 •• • — Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (770) 7723400 Fax: (866) 2204646 Investigation per hour (I hr mini 62.50
CCB Lic.: 11803: _'i,`in Suprv. Lic.: 5100s Industrial plant per hour 73.75
'•, :r,. :,,i RICNB'P ERIVII'T,INE-Wi►, :TA!l!..:•"• -
Suprv. Electrician signature, required: Subtotal: 60.15
i
Date' Plan review (25% of permit fee):
/ . 2,9o State surcharge (12% of penult fee): 7,22
Authorized signature: TOTAL PERMIT FEE: 67.37
Print name: paw. This permit applcanon expires if a permit is not obtained within tai
days eler II has been accepted as complete.
' Number of inspections allowed per permit.
I:l tt nlding\PermialBLC- PermitApp,JOa maims 440.4615T(11/05 /COM/WEB
Z 00I j ZV - 0 impala S ,113D02i 68CL9TBCZ9 DU LT : TT 600Z /60 /Z0
��N ��N��������
��n ��r~"�vo TIGARD
BUILDING DIVISION PERMIT #: ELC2009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2y9/2009
Phone: (503) 639-4171
Inspection Requests (24Hxo.):(5O3)G3Q'4175 ,,-20.4,
INSPECTION WORKSHEET FOR DATE: 2232009 TIME: 7:00AK4 PAGE: 17
SITE ADDRESS: 14BOO SEQUOIA WM' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOME DEPOT
DESCRIPTION: Install / 3\ branch cjruu(0. 2Y19/09. adding (1) uevicm.
OWNER: HD DEVELOPMENT OF MARYLAND, INC, PHONE #:
CONTRACTOR: LIN R ROGERS ELECTRICAL CONTRACTORS PHONE #: 770-772-3400
Inspection Request Scheduled For: Pour Time:
Code # Inspection Description Contact # Message
199 E|md|ix;si|fina| 406'270-9752 N
Corrections/Comments/Instructions:
`
.
��� �� PARTIAL �� CANCEL -- NO ACCESS
�"�`...�� �� �� -_
ri FAIL 11 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G lAJl LE_ Date: o Phone #: (503) 718- IA
``
CI F TIGARD 4
BUILDING DIVISION PERMIT #: FLU2009.000 f3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/9/2009
Phone: (503) 639 - 4171 „ 1 . ,, ; , k � l l ,,
Inspection Requests (24 Hrs.): (503) 639 -4175 ... M '"L
INSPECTION WORKSHEET FOR DATE: 2/19/2009 TIME: . 1:01AM PAGE: '3.3
SITE ADDRESS: 141100 SIN SEQUOIA PKW( CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: F1OME DEPOT
DESCRIPTION: Insiail (3) branch circuit^,
OWNER: HD DEVELOPMENT OF MARYLAND, INC, PHONE #:
CONTRACTOR: LIN R ROGERS ELECTRICAL CONTRACTORS F , „, PHONE #: 770-772-3400 Inspection Request Scheduled For: Date: ?119/200E t Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electiical final 0t30636 -01 406.270.9752 '`'. Y
Corrections /Comments /Instructions: C
a es 5
-? 91.0N i p c s 5 r---to‘.. ■ (J sir -- .
L tjj-• 1 t.) scantt .
- pI;�N;D Fo .v 1 c _ Pio, - 2.004,- cL Lt-
‘■■1 virtVt■"110■ ".-- "Aii__■__ A
n PASS El PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
A FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G ' N6€ 1,- Date: 2-” VI, e l Phone #: (503) 718 - Ili 14