Permit =' 1 CITY OF TIGARD ELECTRICAL PERMIT
� ° PERMIT #: ELC2008 -00273
COMMUNITY DEVELOPMENT DATE ISSUED: 5/13/2008
TIGAO' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102BA -00304
SITE ADDRESS: 09826 SW TIGARD ST ZONING: I -
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. LOT : 021 JURISDICTION: TIG
PROJECT: FRYE ELECTRONICS
Project Description: Installing (1) branch circuit.
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: 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 INDUSTRIAL LLC R C COSTELLO ELECTRICAL CONTRACTING
11336 SW BULL MOUNTAIN RD #103 PO BOX 336 •
TIGARD, OR 97224 AURORA, OR 97202
Phone: Contact #: PRI 503 - 982 -7400
FAX 503 - 982 -7401
FEES
Description Date Amount Reg #: ELE 3 -344C
[TAX] 12% State Surchar 5/13/2008 $5.62 LIC 87402
[ELPRMT] ELC Permit 5/13/2008 $46.85 SUP 3934S
Total $52.47 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. •u may o• ain • • - of these rules or direct questions to OUNC at 503.246.6699 or 1.800 332.2344.
Issued B Permittee Signature: /��
4
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.
y
Electrical Permit Application FOR OFFICE USE ONLY
— 7 ., - City of Tigard Received �f � = /� .v �J6 p. (Jd—�
U 1 .1
� �L�� R Re e i � _ ermit No.:
114
v 13 125 SW Hall Blvd., Tigard, OR 973.'`' t Ian Review
Il Phone: 503.639.4171 Fax: 503.598.1960 - - y; Other Permit:
T IG A RD Inspection Line: 503.639.4175 ,,` . ,ap eady/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov „ . At. �'Notified/Method: Supplemental Information
E OF WORK L.' PLAN REVIEW
❑ New construction Addition /alteration/i2�l� cement Please check all that apply (submit 2 sets of plans w /items 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 amps at 150 volts or ❑ Floating buildings.
f less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
U ,
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: G] g 2.6 S W • j i q c r S >< 100HP or more. occupancy.
J ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: t-r i e EIec tr n iC j ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family
g A',1 �l , upGin t La o r1 / o J residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ 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 2
City/State /ZIP: 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 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 extension, per panel
Owner signature: Date: A. 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, ]
first branch circuit / 46.85 e 2
Address: Each add'l branch circuit 6.65 --
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
c S � /� / / � ,AI� Signal panel, or alteration, limited-
Business name:
/� GO �P f i/a a C.�1 C energy panel, alteration, or
Address: p ), --1- k 33 extension. Describe: Page 2 2
City/State /ZIP: A..,,--D re, . , 'C 0 U..DZ Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (5 3) q j,?- Fax: (5 q �-(u j Investigation per hour (1 hr min) 62.50
CCB Lic.: 9 f 7 Ci Z Electrical Lic.: 3 - 3 Lf zf ( Suprv. Lic.: 3g 3 y S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: L f (p ,gs
/ C ate: J� l Plan review (25% of permit fee):
Print name:
C C tl S/ /V State surcharge (12% of permit fee): ��---.. G
Authorized signature: TOTAL PERMIT FEE: s . 1I
This permit application expires if a permit is not obtain l within 180
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
I: \ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
I; COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00273
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/13/2008
Phone: (503) 639 -4171 ,, 11�'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 .J F__..
INSPECTION WORKSHEET FOR DATE: W27/2008 TIME: 7 :00AM PAGE: 16
SITE ADDRESS: 09826 SW TIGARD ST CLASS OF WORK:
SUBDIVISION: NO.TI GARDVI LLE ADDITION AMEND. LOT #: 021 TYPE OF USE:
PROJECT NAME: FRYE ELECTRONICS
DESCRIPTION: Installing (1) branch circuit.
OWNER: TIGARD INDUSTRIAL LLC, r� PHONE #:
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING a � � PHONE #: 603-982-7400
Inspection Request Scheduled For: Date: B/27/2008 Pour Time:
Code # Inspection Description -' onfirm • Contact # Message
145 NC or heating unit circuit 074716.01 503-504-6757 'F
Corrections /Comments /Instructions: `M
VHF N4N5 VI 14 , I s y : , �.
J es b 14 CO ,i C VN t
tZA 01 6 0 .
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COCti2 r oA ".: Fix $ lr CO w i` ► akil t
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C,Ikerk 0")
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
X FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6-- 6 (% Date: 1 -.1 • 4 % Phone #: (503) 718- L
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: r
ELC2008- 002.73
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5113/2008
Phone: (503) 639 -4171 rlilll
Inspection Requests (24 Hrs.): (503) 639 -4175 °:_..
INSPECTION WORKSHEET FOR DATE: 8/8/2008 TIME: 7:00AM PAGE: 20
SITE ADDRESS: (19926 SW TIGARD ST CLASS OF WORK:
SUBDIVISION: NO 11GARDVILLE ADDITION AMEND. LOT #: 021 TYPE OF USE:
PROJECT NAME: FRYE ELECTRONICS
DESCRIPTION: Installing (1) branch circuit.
OWNER: TIGARD INDUSTRIAL LLC, PHONE #:
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 503 -982 -7400
Inspection Request Scheduled For: Date 8028 Pour Time:
Code # Inspection Description Confirm-.# Contact # Message
\
199 Electrical final 073962 -04 503.422 -1991 Y
Corrections /Comments /Instructions: ►M 1
t 5o Q'P � 5-.cum '� NE ►M
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The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918- 271 -0030
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION \ �1c :,
Inspector: 3\ Noe Lg Date: l'i'1 Phone #: (503) 718- 11441
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