Permit 4 I , CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00766
,.i DEVELOPMENT SERVICES DATE ISSUED: 10/10/2005
sr 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1S136DA - 02600
SITE ADDRESS: 11140 SW 68TH PKWY ZONING: C -G
SUBDIVISION: MLP1999 -00011 LOT : 002 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: SIGNALJPANEL:
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:
WEBSTAR VI, LLC BEAR ELECTRIC
610 GLATT CIRCLE P.O. BOX 389
WOODBURN, OR 97071 DONALD, OR 97020
Phone: 503 - 981 -0155 Phone: 503 - 678 -1355
FEES Reg #: LIC 20919
ELE 24 -107C
• Description Date Amount SUP 4902S
[ELPRMT] ELC Permit 10/10/200: $66.85
[TAX] 8% State Surcharge 10/10/200: $5.35 REQUIRED ITEMS AND REPORTS
Total $72.20
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 1-800-3 -2.144. `
Issued B l Perm Signature: % r
Y�
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.
10. 2005 12:56PM BEAR ELECTRIC No.4842 P. 2
. t. ctrieai Per - mit . iicaticl� - ::r . ?:.',:iYOB m_ sE -ori —E � t : eC .
Received °'` :.
l'd�i o E lectrica ICE 1VED i
[)a ,; 70.5, � �> Permit No ��Q .pp
City of Tigard Plarm sign
Datc/Bv_ Permit Nu.;
13125 SW Hall Blvd. Plan Review Other • —
Tigard, Oregon 97223 OCT 10 0 1 Date/8 : Permit No.: •
Phone: 503 - 6394171 Fax: 503 -59 SI Y ° O� � . - , - 6 Post- Review Land Use •
C1 ;1 i+ D atc/B ;� .
Internet: www- ci.tigard.or.us �� t Case No.:
_..04- :.`i i I ' Contact 's.• tl See Page 2 for
24 -hour Inspection Request 503 MI w • T Name/Method: A Su. pimento! Information. • " • � : ' =' .�;;r� Pease ti :;:ec -•� :-':- • ....-;-':,...••
New construction I J J DernoIition. ❑ Service over 225 amps- ❑ Health-care facility
Q Additiozl /alteratipa7/xeplacement ❑Other: ❑ Service over 320 amps -rating of ❑ Building `ommctcial ❑ Hazardous location
d y: over 10 square
. ,.:w a .:...": 1 ,T G 0 2•' "Y ` d �,r�:Y : t .enti ua feet
1 & 2 family dwellings four or more residential units in
JD 1 & 2- Family dwelling Commercial/Industrial ❑ System over 600 volts nominal one structure •
_ Aeccsso BUildiri Multi - Family CI Building over three stories [l Feeders, 400 amps or more
❑
Occupant load over 99 persons
0 Manufactured structures or RV park
• Master Builder ,Other: - 4 . 1 4 4 2 1 p .< ❑ Egress/fighting plan ❑ Other,
w
.:.• * + .. .51 ` fQRF (1S•AniriEbt IRAS •'.•;<:'.' 1 ` Submit sets of plans with any of the above.
lob site address: U (, f X The above are not applicable to temporary construction Service.
Suite site
• 131d�. /Apt -#: ::. V`.i IMAVIZ l IMIMS I ;Mv 'd `° '� ..- ""`-••, ..a.'
Number of inspections ter permit allowed
Project Name: a , f __ f , � Q _ Description _ Qty Fee (ea.) Total
Cross street/Directions to job site: New residential-single or multi-family per y
dwelling unit - Includes attached garage.
Service Included:
•
1000 sq. ft_ or less • 145.15 4
Each additional 500 s9. ft. or portion thereof 33 . - 1 '
•
Subdivisi I Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map/parcel #.: Each manufactured home or modular dwelling
... 4 " ^` %�ti ° ...,..` CINwk y R it � leand/orfeeder 90.90 2
Servlets or feeders - installation,
,� ( w ]'-C � � — • . alteration or relocation: .
200 amps or less 80.30 2
201 a • to 400 ern. • 106.85 2
401 am, to 600 am 160.G0 2
rir 7 —M`�J ..W..••7 a .. I r *5' 't' ,a. s.. ; 4- 601 amps to 1000 amps • 240.60 2
Name: Over 1000 amps or volts 454.65 2
Reconnect only 66.85 y
Address: Temporary services or feeders - Installation.
City/State/Zip: alteration, or relocation: �
200 amps or less J 66.85 • 6 pJ 1
Phone: Fax 201 am )>s 400 amps - 100.30 2
r ►, < r • 401 to 600 am 133.71
Branco circuits - new, alteration, or
Name: extension per panel:
Address: A. Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 f 2 • City /State/Zip: B. Fee for branch circuits without purchase of
service or feeder fee, fuss branch circuit 46.85
Phone: Fax: 2
Each additional branch! circuit
• • E , r 1 1 a l 1 , ' ' - •... • • • ' • •• •• • • ••• • • • .: .- •-Misc:(Service•or f e e d e r not included): • ...-- -._. -_ -._ .1r... _ : _ _
... ti re : ' "� „may , _ " ;r � ach rainy or irri�Ration cle irc - 53.40 2 , _
Eac eign
( or outline lightini; S3,40 2
Job No: C 364, Signal circuit(s) m a limited energy panel.
Business Name: t? r alteration, or extension Pa. e2 2
ti]t'_ 4 CLec -1Q � 4 ru-C _ Description:
Address: Pd 44ox 3641 •
C ddre tate/Zl�: � � nn Oft q d Each additional Inspection over the allowable in anvof the above:
�'S ( 0 Per inspection pet hour (min I hour) • 62.50
Phone: S 3- 67g - /3sS- Fax:. 3 - 6 ?8 -• / /t)$ 1 ?:tier fee:
CCB Lic. #: c. p 9/ Lic• #: 02 V -1(77 C.-- Other v -
• Supervisirig el C;fizwt n a , to .-. �,A - • -=,; ---' _ _
ectrician A stilitofal ► S �. �
Si atu re re aire rf.
^ ' P •
Review (25% of Permit Fee) S
Print Name: .0T Qii&4i .S Lic. #: tj State Surcharge (8% of Permit Fee) S _____s . S^
TOTAL PERMIT FEE S .
Authorized Notice: This permit application expires if a permit is not obtainc within
Signature' Date: 180 days after it has been accepted as complete.
"Fee methodology set by Tri- County Building industry Service Board.
(Please print name) V
t- tr..,.N D.—a. G...... -\ C,..».._... -- -- - AA, An,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00766
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/10/2005
Phone: (503) 639 -4171 • *d I h
Inspection Requests (24 Hrs.): (503) 639 - 4175 , p IL.
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 37
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999.00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Temporary service.
1)
OWNER: WEBSTAR VI, LLC, PHONE #: 503 -981 -0155
CONTRACTOR: BEAR ELECTRIC PHONE #: 603 678
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 018839 -01 503- 678-1355 N
Corrections /Comments/ Instructions:
( ,
1
1 i
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
\
Inspector: o�
Date: / -a 4 ---' Phone #: (503) 718-