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Permit f CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2009 -00017 COMMUNITY DEVELOPMENT DATE ISSUED: 1/13/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102DA -00200 SITE ADDRESS: 08720 SW BURNHAM ST ZONING: CBD SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: CITY OF TIGARD Project Description: (5) branch circuits for data room. Job No. 80016 -102 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: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 4 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: CITY OF TIGARD OREGON ELECTRIC CONSTRUCTION INC 13125 SW HALL 1010 SE 11TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 639 -4171 Contact #: FAX 503 - 234 -1001 PRI 503 - 234 -9900 FEES Description Date Amount Reg #: ELE 26 -95C [ELPRMT] ELC Permit 1/13/2009 $73.45 LIC 203 ITAX] 12% State Surchar 1/13/2009 $8.81 SUP 4549S Total $82.26 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- rough 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 B • _ , �ILr � IP P Si gnature: ��; .' .4 . / / , ,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: ry 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. t � =1 - Electrical Permit Apjicatiola D ECEIVE I ' FOR OFFIC •t: CSC ONIS ' , ' ' City of Tigard JAN 1 2 20[1'A Received DetcB . lily Permit No.: E / / g.. 000/ 2 a 13125 SW Hall Blvd., Tigard, OR 97223 plan Review m Phone, 503.639,4171 Fax: 503.598.I9t ,ITY OF TIGAR i. Date /B . Other permit: ' 1, 1 �; A ,�� D tnspcction Line: 5 03 . 639 . 4175 ��$$��to Rcady�ay to ;fee raga 2 fur lntcrnet: www,tigird- or.gov BUILDiNG DiVISI c 4vbtifitd/Method: Supplemental laformrHon TYPE OF WORK PLAIN REVIEW • • 0 New construction , .Addition /alteration/replacement Please check u1l that apply (submit 1 sets of pions willems checked below): ❑ Service Of feeder 400 amps or more ❑ Building over three stories. Demolition ❑ Other: where the available fault current ['Marinas and bontynrds. CATEGORY OF CONSTRUCTION • exceeds 10.000 amps at 150 volts or ['Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -usc agricultural Q 1 - and 2- family dwelling •Commercial/industriai ❑ Accessory building ;nap, fur all other installations, buildings. ❑ Multi- family ❑ Master builder [] Other: ❑ Fire pump. 1:1 installation of 75 KVA ar ❑ Emergency system. larger separately derived system. • JOB SITE INFORMATION AND LOCATION • , • ❑ Addition anew motor load of 1=1"A". " E". "1 -2", "1 -3", yil — 1001 -IP or more. occupancy- )Olt no.: poi 6 _to? Job site address: ea o w „ _, ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: ( ❑ Health -care facilities. ❑ Supply voltage for m1)t than `�v-G\ �� ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /Apt- no.: I Project name: t Q , ( A \ El Service ar feeder 600 amps or snore. `� FEE SCHEDULE Cross street/directions to job site: Demn-l.uun it . Fe Total 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'! 500 sq. ft. or portion 33,40 1 Tax map/parcel no.: Limited energy, residential • DESCRIPTION OF WORK _ above sq. ft.) 75,00 2 Limited energy. multi - family. 75.00 2 C. c. ? v ' ' � � - "`5 � ( \g -- residential (with above sq. IL) Services or feeders Installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER Q 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 installat alteration, and/or _ relocation _ Phone: ( ) I 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, lent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extCllSlon. perpanel Owner signature: _ . Date' A. Fcc for blanch circuits with ❑ APPLICANT • © CONTACT PERSON ` above service or feeder fcc, 6.65 2 each branch circuit - , Business name: B. Fee for branch circuits n� without service or feeder fcc, I 46.85 Lit, es 2 Contact name: first branch circuit �� .,I - _ Address: Each add'l branch circuit 1-1 6.65 D°. 2 Miscellaneous Ccervice or feeder not included) City / State/ZIP: Each manut etured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E-mail! Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 5ignal' eircuit(s) or limited - Business name: Or e p V`- L. \. c., , tom \ G energy panel, alteration, or Address: t (' l O l I-„.- Au extension Describe: Paget 2 City / State/ZIP: r �t L]( Cr 14 ditional lnotcctio over all owable in any of the above _ Per inspection 62,50 Phone: E [ 3) ,93a•) -9 4'00 Fax: (3),535 - ( 976_3 Investigation per hour (1 hr min) 62.50 _ CCB Lin.: ao Electrical Lic „�� Suprv. Lie.: �� I ndustrial plant per hour 73.75 PERMIT FEES Suprv. Electrician signature, requ i' ' r �� , ``� _ Subtotals ? 3. 1 l b Plan review (25% of permit fcc): Print name: ' \c _\, Ett,, 0 -1} Date: /- f - rj b State surcharge (12% of neural fee): g , 8 1 Authorized signature• TOTAL PERMIT FEE: '02 . ( This permit application expires if a permit is not obtained within 180 Print n- Date: i - i 2 — 0 ` rte] days after It has been accepted to complete. • ti,,.,, t,,- ,nflnanerrinns,dlowcd 9017-d 200/100'd 5£9 -1 £9129£9609 OAS 0I2110313 dO -MOd Md617:£0 600Z Zl -NVr CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2009- 00017 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/13/2.009 Phone:' (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/15/2009 TIME: 7:01AIv1 PAGE: 16 SITE ADDRESS: (18720 SW BURNHAM ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CI OF TIGARD t) DESCRIPTION: (5) branch circuits, for data room. Job No. 80016.102 OWNER: CITY OF TIGARD, PHONE #: 603- 6394171 CONTRACTOR: OREGON ELECTRIC CONSTRUCTION INC PHONE #: 603-234-9900 Inspection Request Scheduled For: Date: 1/16/2009 Pour Time: Code # Inspection Description Cry irm Contact # Message 199 Electrical final 079784.01 601635-2660 Y Corrections /Comments /Instructions: " 321 -5 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 I N FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1, 1S1 Se L Date: 1 l7 / Phone #: (503) 718- 1-4 410