Permit t •. CITY OFT ELECTRICAL PERMIT
�y PERMIT #: ELC2007 -00829
COMMUNITY DEVELOPMENT DATE ISSUED: 12/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AC
SITE ADDRESS: 14775 SW 74TH AVE ZONING: I -P
SUBDIVISION: METRO PART /MLP2002 - 00008 LOT : 001 JURISDICTION: TIG
PROJECT: FANNO CREEK BUS. PARK
Project Description: (1) feeder for sub panel & (1) branch circuit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0.00 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: 1 W /SERVICE OR FEEDER: 1 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:
MJR INVESTMENTS LLC BROADWAY ELECTRIC - COCHRAN INC
12665 SW 69TH AVE. 626 SE MAIN
TIGARDK, OR 97223 PORTLAND, OR 97214
Phone: Contact #: PRI 503 - 234 -6564
FAX 503 - 238 -2098
FEES
Description Date Amount Reg #: ELE 37 -546C
[ELPRMTI ELC Permit 12/10/200" $86.95 LIC 72942
[TAX] 8% State Surcharge 12/10/200" $6.96 SUP 3447S
Total $93.91 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: / `Ii . �� 1 Permittee Signature: e � te e :
L_
OWNER INSTALLATION ONLY
The installation is being made on property 1 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.
7
• . .. ,.....
Electrical Permit ApplicQ EE )r . , - FOR OFFICE USE ON . . ,
1
e l
City of Tigard Date/By: /s / /•U /D 7 .�j Permit1\ /I y�� Q�a
13125 SW Hall Blvd., Tigard, OR 97223 / / � /
GtC Ill i Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 !/y'_ 4p it , `'"t\ Date/By: Other Pei l
Inspection Line: 503.639.4175 rr �/ 6 ■ t11, - , •pate ReadyBy: Juris: a See Page 2 for
In www.ci.tigard.or.us ` .'i:1 .1 v ' '� ' � n otified/Method: Supplemental Information
.- � ".. y � Kti �., -;,�++ t '" � hS` � '�� tea' a ` A � �. ,"�' s r
S t �x tEr l i TA � ARLIA � f � `-t g tii-O �'� DAN�REVIEW .
. , �• v..+� N =;V' ��5�t �,+.. � .�§...�`x ..� , ,.,._�.., .... r�a�amxtw ru,S..a� � as y.- :.ic�,.�,a7�su",E.t.J- .ts,.r� -1 ; =�M ,r ,.... ?.�.? s� a �'�:c- k -a�.�z - .:;k ._ ..
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other ❑Service over 225 amps, comm'1 ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
�k
r EGOR�1 ®COISTR TON x k � y dwellin s 4 or more new residential
.,t� ' ` of 1 -and 2 -fam l g
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one sn
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
z r r v t , ❑Occupant load over 99 persons ❑Manufactured structures or
yt,` t ? l J I AND OC 9 • ' , ❑ /light p RV park
Job no.: 4Itit "I _ Job site address: Ave_, ❑Health -care facility ❑Other:
b �� i �„ S �� CV Submit 2 sets of plans with any of the above.
City /State /ZIP: "'(\ W' N The above are not applicable to temporary construction service.
�A \ R �In t, 1 SCIIED L ``
Suite/bldg. /apt. no.: NA
Project name: i b y dim e,,, "
D escription Qty. Fee. Total
Cross street/directions to job site: , C/0.N /1 o jt4, ( Adew residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no
sr „ , Limited energy, non - residential 75.00 2
s r..r -'Js i DESGRIPTIONto WORK nr.
,....;r�.,, � �� _��� -� �- ,..,�, »�, r : ,�..�,.�..� . � .�, �..�. � 5 � ,.� ,�� Each manufactured or modular
V I ` t. ' V ^ . - \ 9 S fr ( dwelling, service and /or feeder 90.90 2
l.�C�l � � Services or feeders installation, alteration, and /or relocation
C �^ ) 200 amps or less / 80.30 g? yC 2 201 amps to 400 amps 106.85 2
$ d. 7] ,2 0P � ERT ,Y O 4:4E4, , - .n � r T ,, e l\ A ,' tRw 401 amps to 600 amps 160.60 2
Name: ry.4v 434 1 . 1 , 6 ,, 1/1 -4.s LI o..... 601 amps to 1,000 amps 240.60 2
Address: / , t (O 6 sl.[/ ll A, Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: - (A CA_ 91? a 3 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
r "` ° "°' ; 1 f g t A P P LICAIvi Te ^ - � �� . > A. Fee for branch circuits with
� •11� a , a PERSON , , � ,.,_4
service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, VVV
--- - °---- .....--- - --..._ - — 46 — �
each branch circuit — / " —
Address: Each add'1 branch circuit? 6.6 1 (p 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
r` 4 �.. w � § ° } w "' TA '3 s energy panel, alteration, or
���`. �t�...:~ CONTRACTOR;.., s� , "aa��t�a.�. � .�.,..a r..� M ;s:.,�
` extension. Describe: Page 2 2
Business name: ? � < - o ddw . \) C \e. c_-\- 4
�� Each additional inspection over allowable in any of the above
Address: Z S M �
Per inspection 62.50
City /State /ZIP: ?� S - \ S G.� (9.--- 1 - 7 2AL4 Investigation per hour (1 hr min) 62.50
Phone: (5o3) 23(A _c6-- LA Fax: (563) 12 ._7_o `1 s Industrial plant per hour 73.75
i , griAlr IECAT . FP FE,EMPR. ;'r.
CCB Lic.: 7 2c_}2.., Electrical Lic.: 3 T- S`11,r_ Suprv. Lic.: 3,44 -1-5 Subtotal k q.
Suprv. Electrician signature, required: \ ( �� Plan review (25% of permit fee)
Print name: \G ev.v,eSv \t1 _ "` �-��� 0 ""' ��� ��` Date: State surcharge (8% of permit fee)
• TOTAL PERMIT FEE ci. 3 1
Authorized signature: This permit application expires if a permit is not obtained within 180
• days after it has been accepted as complete
Print name: Date: + Fee methodology set by Tri- County Building Industry Service Board
• "" Number of inspections per permit allowed.
i:\Building\Permits\ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/100007
Phone: (503) 639-4171 _111"14111 _.
Inspection Requests (24 Hrs.): (503) 639 -4175 _r .
INSPECTION WORKSHEET FOR DATE: 12/19/2007 TIME: 7 :00AM PAGE: 17
SITE ADDRESS: 14775 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: METRO PAR t' /idfLP2002••00008 LOT #: 001 TYPE OF USE:
PROJECT NAME: FANNO CREEK BUS. PARK
DESCRIPTION: (1) feeder for sub panel & (1) branch circuit.
OWNER: M12 INVESTMENTS LLC, PHONE #:
CONTRACTOR: BROADWAY ELECTRIC - COCHRAN INC y i PHONE #: 503 -234-6564
Inspection Request Scheduled For: Date: 12/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 081850 -01 971 -218 -2121 Y
Corrections /Comments /Instructions:
M
F I N -- (p'601 -
s c iik) s
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY It\i‘&) L- Date: v ! Phone #: (503) 718 -Z V