Permit r * CITY OF TIGARD- ELECTRICAL PERMIT
PERMIT #: ELC2008 -00656
COMMUNITY DEVELOPMENT DATE I SSUED : 12/1/2008
T I G A it D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112AA -00300
SITE ADDRESS: 14200 SW 72ND AVE ZONING: I -H
SUBDIVISION: NELSON BUSINESS CENTER LOT : JURISDICTION: TIG
PROJECT: GERBER
Project Description: TI.
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/ SVCI 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: 7 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:
GERBER LEGENDARY BLADES OREGON ELECTRIC GROUP
14200SW72NDAVE 1010 SE 11TH AVE
PORTLAND, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 234 -1001
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 - 95C
[ELPRMT] ELC Permit 12/1/2008 $93.40 LIC 203
[TAX] 12% State Surchar 12/1/2008 $11.21 SUP 4549S
Total $104.61 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: ,2iL,1.2 >yt'
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNERS 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.
Electrical Permit Application O
O FOR OFFICE E USE ONI,1'
City of Tigard �` / permit No.: _ r► Ar
Ilii • 13125 SW Hall Blvd, Tigard, OR 9
Phone: 503.639.4171 Fax 503.59 .19 • 0 • !r 1 otherPernait.
or
T 1 C; A P, t: inspection Lirth> S03.639.4175 \ •
'� �`t , , 1 , : l „ s 5ce rae 2 t ofarmanon
Internet www.tiprd or.gvv � : � _
- TYPE OF WOW(' 'f I A \ : • PLAN REVIEW
t Pkase check all that apply (submit 1 sets of plans w/items checked below):
❑ New construction G Addition /altelatio !
❑ Demolition ❑ Other. �r- ❑ Service o r feeder 400 am>n or more O Building over three stories.
• where the available Omlt eurtent ❑ Marina and boatyards.
CATEGORY OF CONSTRUCTION \ + acct 10.000 nips at 150 700th or ❑ Floating buildings.
�� t - ' b less a grwnd or tx kxeds 14.000 p commercial aye alp icuhhual
❑ 1- and 2- family dwelling,Commcrcialipdustrial ❑ Accessory,� , L'• ■ g amps for all other installations. buildings.
In Multi - family ❑ Master builder ❑ Other ` ❑ FQe pump- ❑ installation of 75 KV A or
❑ Emergency system. larger separately derived system,
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor Toad of ❑ "A ", "E", "1.2 - • "1 -3 ",
I tramp or more, occupancy.
Job no.: 19Q ! 1 Job sitc address: 2-( n SL) � 11t 4, c- [] Six or more residential units. ❑ Reae,dional vehicle PW1C .
.
ore
❑ Health-care facilities ❑ Supply voltage for mom than
City /State/ZIP: -1 5 ca. Q ❑ ; u fivatr omlp or m 600 volts nominal.
Suite/bldg./apt no.: LProject name:
FEE more
LE
Cross street/directions to job site: lam- "ttoa K'IilwrIm
New residential single- or multi - family dwelling unit.
Includes attached garage.
— I Lot no.: 1,000 sq. 11 or toss 145.15 4
Subdivision: Ea. addl 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited malty. residential 75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
Limited angry. multi - family 75.00 2
L ��
0
�� residential (with above an,. n)
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
Q PROPERTY OWNER J 0. TENANT 201 amps to 400 amps 106,85
401 temps to 600 amps 160.60
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
— Temporary services or feeders installation, alteration, and/or
City/State/ZIP: _ relocation
Fax: ( ) 200 amps or less 66.85 1
Phone: ( ) 10030 2
201 limps to 400 amps
Owner installation: This installation is being made on property that I own which is not 401 amps 599 133.75 2
amps intended for sale, ]case, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, zor panel
Owner signature: Date: k Fee for branch circuits with
0 APPLICANT • 1 ❑ CONTACT PERSON above service or feeder fee. 6.65 2
each branch circuit
Business name: B- Fee for branch circuits
without service or fader fee, ( 46 2
Contact name: first branch circuit _
- — — Each addl branch circuit 7 6.65 1 16.. 2
Address: _ Miscellaneous (service or feeder not included'
Ci //ZIP: Each maufactur•od or modular 90,90 2
— ty State n
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
_ _ _ 1 S ignal ct rouit(s) or limited -
Business name: C. re yzAik, `_G�Ni'1 TY3c.1 ener panel. alteration or 2
extension- Ucscribc: Page 2
Address: 1 p g, g F 114-1A, -1Le -
Ci
ty ' D 9. - ci - 7at Each additional inspection over allowable in any o the above /StateJZIP: Per inspection - 62 -50 .
Phone: ( c-,p) a 3c-(, - q' 1O Fax: (5D3) 5 -- g - 763 investigtion per hour (1 hr min) 62.50
Pt? hour 73.75
i
CCB Lic.: Electrical Lic.: c 94' —y Sup1v. Lic.: 4 industrial plant 5 ELECTRICAL PERMIT FEES -
C. Subtotal: Ci' -Si K�
Suppv. Electrician signature, require trqu Plan review (25°% ofpermit fee):
Print name: 121. G uY\ IPA C Et k ..0-ti- Date: ) 2 ^ I-00 State surcharge (12% of permit fee): C7 11104
TOTAL PERMIT FEE: / 0 . td, '4' ,6
Authorized signature:
This permtt application expires it a permit Is not obtained within 180
Duke: days after It Wm been accepted hn complete.
Print name! — . ......I......e a,a..•. - +iema Aimed oar centlit.
9S1 -d Z00 /100'd 111 -1 £9129£9£09 OAS OId10313 dO- V'iOdd Wd9q :10 8002 -10 -330
C
CITY OF TIGARD _ Alb
BUILDING DIVISION PERMIT #: ELC2008- 00656
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1/2008
Phone: (503) 639 -4171 `Atiilt
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1218/2008 TIME: 7 : 00AM PAGE: 30
SITE ADDRESS: 14200 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: GERBER
DESCRIPTION: `fl.
OWNER: GERBER LEGENDARY BLADES. PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: J03 -234 -9900
Inspection Request Scheduled For: - - Date: 12/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Eloct.rical final 03-519-6196 Y
Corrections /Comments /Instructions:
b'ee W- _ � P s o� '� ;ysa
X03 -Q6�( � I q
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • IV W Date: it-11 Phone #: (503) 718- 1-44'