Permit ' 1
CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00611
° COMMUNITY DEVELOPMENT DATE ISSUED: 10/31/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113A D -01700
SITE ADDRESS: 16800 SW 72ND AVE ZONING: C -G
SUBDIVISION: ROSEWOOD ACRE TRACTS LOT : 030 JURISDICTION: TIG
PROJECT: BED BATH & BEYOND
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/ 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: 24 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:
BRIDGEPORT LAND LLC ELECTRICAL CONTRACTORS & DESIG
3939 NW ST HELENS RD 150 NE VICTORY SUITE A
PORTLAND, OR 97210 GRESHAM, OR 97070
Phone: Contact #: PRI 503 - 666 - 9358
FAX 503 - 667 -7965
FEES
Description Date Amount Reg #: ELE 26 -466C
[ELPRMT] ELC Permit 10/31/2001 $206.45 LIC 47712
[TAX] 12% State Surchar 10/31/2001 $24.77 SUP 5354S
Total $231.22 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 throu • h 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: %L , Permittee Signature: % n'��
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.
Oct 31 2008 8:04AM Electrical Contractors 8• 503 - 667 -7965 p.2
Electrical Permit Application FOR OFFICE 1_:S1 ONLY
Ci Ti R.cived FermitNa.:
hr of g and DatetBy: 3 0 Y R 77 r�C 28�x)(24T / 13125 SW Hall Blvd., Tigard, OR 9722
% nn 8 Plan Review Other Permit:
N,. Phone: 503.639.4171 Fax: 503.598.1960 1 6�i Date/By:
11 n li fa Inspection Line: 503.639.4175 ®V n ' Date Ready/By: 3 : El See Page 2 for
Internet: www.tigard- or.gov P► ;' led/Method: �/ . Supplemental Information • = ryl - ih . 1111 d•c• t :, 1 -
$ c s _
a�:r•
y � , L,- -.. ' t 1• _.- ' �, c-ni" •L - - �81' 11�
❑ New construction ®Addition/alteratio t . _ ; : :. : � iw a} .±� c k.
. t\
1 - Please cheek all that apply (submit a sets of plans wlitenrs checked below):
„ t
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
ry Erse =• j ... ,. • _ --- te '! f j { r.:� - - atceeds 10,000 amps al 150 votes or ❑ Floating buildings.
1'8 - r •i i , 'I [t t A' tt 0 r _ • __ - - 1 "q' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial'industrial ❑ Accessory building amps far all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
;1 u I 77 .11 s7 e_ . u q ' 1 . ,,, :ii. , . --Ill! , ; ❑ Emergency "'gem' "'gem' larger separately derived system.
{fir..
cY: 1-r... � 1 �a T ti _ s N 3 4i , , 1p. - _ 1: ❑ Addition of motor load of ❑ "A
.,13 °I - 2" ••1 - 3 °,
" F„�..era +T. :»Ain'�i'a4rxr.�tt � 'fiiir'
Job no.: 9816 Job site address: 16800 SW 72nd 100HP or more. occupancy.
CI six or more residential units. ❑ Recreational vehicle parka.
City/State /ZIP: Tigard, OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: BBB - Tigard / ' n Service or feeder 600 amps or more ■
S ri ' 17 -n; _ 4:: I . - � a
Cross street/directions to job site: Lower Boones Ferry DeseApttoo ( =.`:
ry. I tee. 1 .r ai.l 1
New residential single• or multi - family dwelling unit.
Includes attached garage.
Subdivision: i Lot no.: _ 1,000 sq. ft. or less 145.15 4
Ea. add' 1500 sq. ft. or portion 33.40 1
Tax reap /parcel no.: Limited energy, residential
; , p 75.00 2
% 7��p ;._ � r` k%.. Ap r ';,: ,a�,it Y + . :, Ili ..f. `-`t (with above sq. H.) ,
Limited energy, multi family 75.00 2
Remodel of existing facility. Relocate light fixtures. Install new track Lights residential (with above sq. ft)
Services or feeders installation alteration, and/or relocation
Circuits fur cash registers. Circuits
display. 200 amps or less 80.30 2
° 9;, A „ t(I r < f lit - rf. . i.. - v ,'„,..:;;,_!_-: , - ; t - 'ilillll�� - w - '. 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 /StateiZIP: Temporary porary services or feeders Installation, alteration, and/o
I
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, 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, r panel
Owner signature: Date: A. Fee for branch circuits with
_ W{)' "' -- J r' tit . t "° j l 1 a7*- above service or feeder fat,
?C`r.:� 7a ' -= - ah'I't'i -_ T =. }4. I ,�.�5'7t' 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 46.85 2
first branch circuit
Address: Each add'l branch circuit 24 6.65 159.60 2
Miscellaneous (service or feeder not Included)
City /State/ZIP: Each manufactured or modular ' 2
dwelling, service and/or feeder
Phone: ( ) I Fax:: ( ) Reconnect only 66.85 2
E Pump or irrigation circle 53.40 2
-A6 - 3 - t t -e^� = t;- - - = - -- : 1 _ ;` "`"l Si or outline li huin 53.40 2
M-a� � {6 ;,, . . _ 7.-__=a i:s'": 1�,�. =- �:t ; � ,l`i�I ��sallltl�y, � !; 8
Business name:
e: Electrical Contractors & Design, Inc. Signal a or limited
energy panel, alteration, or
Address: 150 NE Victory, Suite A extension. Describe: Page 2 2
City /State!ZIP: Gresham, OR 97030 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 666-9358 I Fax: (503) 667 -7965 Investigation per hour (1 hr min) 62.50
CCB Lic.: 47712 Electrical Lic.: 26 -466C Suprv. Lic.: 5354S Industrial plant per hour 73.75
; r„`c ij;!1t 'Lt 1l '' 3'!i:;,." s a: 7 lr1►,`.' -,-'Ij1 .E
Suprv. Electrician signature, required: _ Subtotal: 206.45
Print name: Ernest Wagaman Date: 10/30/2008 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 24.77
Authorized signature: TOTAL PERMIT FEE: i 231.22
Date: This permit application expires If a permit is not obtained within 180
Print name: days after It has been accepted as complete.
• Number of inspections allowed per pernut.
1;\ Building \Pmrae\ELC -PcrmitApp.doe 0503/06 440 -4615T(11 /0S'CDM/WEB
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B -00611
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/31/2008
Phone: (503) 639 -4171 „Vie
Inspection Requests (24 Hrs.): (503) 639 -4175 - ` __..
INSPECTION WORKSHEET FOR DATE: 11/6/2008 TIME: 7:00Am PAGE: Q6
SITE ADDRESS: 16800 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: ROSEWOOD ACRE TRACTS LOT #: 030 TYPE OF USE:
PROJECT NAME: BED BATH & BEYOND
DESCRIPTION: -jl
•
OWNER: BRIDGEPORT LAND LLC, PHONE #:
CONTRACTOR: ELECTRICAL CONTRACTORS & DESIG PHONE #: 503 - 666 -9358
Inspection Request Scheduled For: Date: 11/6/2008 Pour Time:
Code # Inspection Description -# Contact # Message
199 Electrical final 077712 -01 503 - 6669358 Y
Corrections /Comments /Instructions: 1/2 1
IN G ' 311 -3625
J P R-gt.(%b t C0 wv0 N 16 e lit asib LC 11 FlUt
ALL apt v v.) L , _ W gotr & c c 15-
iNczi I I. T
(^
(- V
vv \_
\L ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G— N 66 Date: IV' b r Ca Phone #: (503) 718- 1446
1