Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00482
�Ifc'- DEVELOPMENT SERVICES DATE ISSUED: 8/28/2006
'' -- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1 S136DD -04100
SITE ADDRESS: 11850 SW 67TH AVE ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT : 007 JURISDICTION: TIG
Project Description: Temporary service
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
PACIFIC NW PROPERTIES CAPITOL ELECTRIC CO INC
ATTN: PAUL GRAM 11401 NE MARX ST
P.O. BOX 2206 PORTLAND, OR 97220 -1041
BEAVERTON, OR 97075
Phone: 503 - 626 -3500 Contact #: PRI 503 - 255 -9488
FAX 503 - 257 -7121
FEES
Description Date Amount Reg #: ELE 26 -496C
[ELPRMT] ELC Permit 8/28/2006 $66.85 LIC 48748
[TAX] 8% State Surcharge 8/28/2006 $5.35 SUP 3132S
Total $72,20 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: & Permittee Signature: a Ca
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 FOR OFFICE USE ONLY
Eteetric 'al Permit Application Received
2
1006 Date /By: # �
City of Tigard AUG y Permit no.:� A ur p , „ yeg,✓L
�a Y ' Plan Review /` W 30
r ► Other Permit:
13125 SW HALL BLVD., TIGARD, OR 97223 CITY OF TIC�A to nl ,� Date /By:
Phone: (503) 639 -4171 Fax (503) 598- 196 UILDING DIVISMst TIGARD Date Ready /By: Juris: L I See Page for
Inspection Line: 503 - 639 -4175 Notified/Method: t Supplemental Information
Internet: www.ci.tigard.or.us
TYPE OF WORK PLAN REVIEW
131 New construction ❑ Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'I ❑ Hazardous location
CATEGORY OF CONSTRUCTION ❑ Service over 320 amps - rating ❑ Building over 10,000 sq.ft.
L i 1- and 2- family dwelling ILI Commercial /industrial U Accessory building of 1- and 2- family dwellings 4 or more new residential
❑ Multi- family ❑ Master Builder ❑ Other ❑ System over 600 volts nominal units in one structure
JOB SITE INFORMATION AND LOCATION ❑ Building over three stories ❑ Feeders, 400 amps or more
Job no.: 261350 Job site address: 11850 SW 67th Ave ❑ Occupant load over 99 persons ❑ Manufactured structures or
❑ Egress /lighting plan RV park
City/State/ZIP: Tigard, OR ❑ Health -care facility ❑ Other:
Submit 2 sets of plans with any of the above.
Suiuhitlg_!apt. ,to.: Project name: Tigard Triangle Commons The above are not applicable to temporary construction service.
FEE SCHEDULE
Cross Street/Directions to job site: Description I Qty. 1 Fee. I Total I "
New residential - single or multi - family dweiiittg unit.
Subdivision: Lot no.: Includes attached garage.
1000 sq. ft. or less $ 145.15 4
Tax map /parcel no.: Ea. Add'l 500 sq. ft or portion $ 33.40 1
DESCRIPTION OF WORK Limited energy residential $ 75.00 2
Temporary construction service Limited energy, non - residential $ 75.00 2
Each manufactured home or modular
L I PROPERTY OWNER I Li TENANT dwelling, Service and/or feeder $ 90.90 2
Service or feeders installation, alteration, and/or relocation
Name: -
Pacific NW Properties 200 amps or less $ 80.30 2
Address: 6600 SW 105th Ave 201 amps to 400 amps $ 106.85 2
401 amps to 600 amps $ 160.60 2
City /State /ZIP: Beaverton, OR 97008 601 amps to 1000 amps $ 240.60 2
Over 1000 amps or volts $ 454.65 2
Reconnect only $ 66.85 -
2
Phone: Fax: -
Temporary services or feeders installation, alteration, and/or
Owner installation: This installation is being made on property that 1 own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less 1 $ 66.85 66.85 1
Owner signature: Date: 201 amps to 400 amps $ 100.30 2
401 amps to 600 amps _ $ 133.75 _ 2
11 APPLICANT I U CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Business Name:
service or feeder fee, each
branch circuit $ 6.65 2
Contact name:
B. Fee for branch circuits
without service or feeder fee,
Addi ess:
each branch circuit I $ 46.85 I 2
City /State /ZIP: Each additional branch circuit: $ 6.65 2
Miscellaneous (service or feeder not included)
Phone: Fax: Pump or irrigation circle $ 53.40 2
Sign or outline lighting $ 53.40 2
E -mail: Signal circuits(s) or limited -
CONTRACTOR energy panel, alteration, or
Business Name: CAPITOL ELECTRIC CO., INC. extension. Describe: Page 2 2
Contact name: Each additional inspection over allowable in any of the above
Per inspection $ 62.50
Address: 11401 NE MARX ST. Investigation per hour (1 hr min) $ 62.50
Industrial plant per hour $ 73.75 ,
City /State /ZIP: PORTLAND, OR 9 722 0 -1 041 ELECTRICAL PERMIT FEES*
Subtotal 66.85
Phone: 503- 255 -9488 Fax: 503- 257 -7121 Plan review (25% of permit fee)
State surcharge ( 8% of permit fee) 5.35
CCB Lic.: 48748 (Electrical Lic.: 26 -496C ISuprv. Lic.: 3132 -S TOTAL PERMIT FEE 72.20
This permit application expires if a permit is not obtained within 180
Suprv. Electrician signature, required:
days after it has been accepted as complete
Print Name: DARRELL MCNEEL Date: 0 24/ * Fee methodology set by Tri- County Building Industry Service Board
Authorized signature: * *Number of inspections per permit allowed.
Print Name: DA RELL MCNEEL
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200 &00482
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/28/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _41, I
INSPECTION WORKSHEET FOR DATE: 8/31/2006 TIME: 7:0OAM PAGE: 31
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Temporary service
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503,626..3500
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 - 251,91188
Inspection Request Scheduled For: Date: 8/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 t -4 %.„„,! lectrical service 035875 -02 87'1 - 506 -0383 N
r /Co men 6gtr ; tions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6e bsr Date: i t 3I k) Phone #: (503) 718 - A4t