Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00716
DEVELOPMENT SERVICES DATE ISSUED: 12/11/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AC
SITE ADDRESS: 07360 SW BONITA RD 130
SUBDIVISION: EMPIRE BATTERIES MLP2000 -00002 ZONING. I -L
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: (2) 200 amp or less services and (2) branch circuits. Job No. C 515 - 94
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: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: 2 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:
EMPIRE BATTERY ABC ELECTRIC CORPORATION
7320 SW BONITA RD 135 NE 9TH
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 503 - 639 -5515 Phone: 233 -7551
Reg #: LIC 288
SUP 1241S
FEES ELE 26 -2C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/11/03 $173.90
[TAX] 8% State Surcharge 12/11/03 $13.92 Elect'I Service
Rough -in
Total $187.82 Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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.
i
,519
Issued By: �� af -, Permit Signature: j �L �X °/�
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: "a ``i S
Call 639 -4175 by 7:00pm for an inspection the next business day
Electr ca1..,PermitApp11cation . FOR OFFICE. USE ONLY . ,,, , ";.'
Received i 1 �! Permit N o.: . x 6601 r
tBy: � D Permi No.: �T
' Date/By:
City f Tigard Planning Approval Sign
Y g an Date /By: Permit No.:
13125 SW Hall Blvd. Plan Revi Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503- 598 -1960 Post- Review Land Use
Internet: www.ci.tigard.or.us gi l Contact Case No.:
Juris.: ® See Page .. W Contact e 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: , Supplemental Information.
.,; m .. i .. r
❑ New construction ❑ .
"._. , . , �:� :. ,;..m � °': °TYPE'sQF,WQRK�, ; ?`��r�� " ,,, �:'n.� ' "�� °�:�� �= '`�.'PL�AN' REVIEW .Please'check ,...;:
� - - PP Y)� t�
D Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous
El Addition/alteration/replacement 111 Other: on
❑ Service over 320 amps - rating of ❑Building Building over 10 10,000 square feet,
t;`''. ?. . , " : �`I'Y'2
_ _. I & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling ' Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
E] Accessory Building El Multi- Family
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
r 'V`- ° "- : ::,4OB SITE IN' FOR -,` , "''' "; ' Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: `7_51 ,, 1 Y " `FEE *SSCHED ._ .:..
Suite #: , 5 0 Bld . /Apt. #: Number of inspections per permit allowed
Project Name: `Ir kr ■ \ Description Qty Fee (ea.) Total
Cross street/Directions to b site: New residential- single or multi - family per 1
7 �
} dwelling unit. Includes attached garage.
�] Service /� n C ' ' Q ni�a., 1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 l
Subdivision: Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
` .,_ . " -, /DESCRIPTIO .,O ; WORK :; ;1,;' service and/or feeder 90.90 2
Services or feeders - installation,
alteration or relocation:
200 amps or less 80.30 W.V.) 2
201 amps to 400 amps 106.85 2
■
1. 401 amps to 600 amps 160.60 2
WA'R PERTY' WNE ' " .r i" _ "''15 -V''i ° ' ^` 601 amps to 1000 amps 240.60 2
q Over 1000 amps or volts 454.65 2
. e: E l ` , _ i Reconnect only 66.85 2
Address: 7 U 5},u 6 � z t
! ` Temporary services or feeders - installation,
City/ State/Zip: // alteration, or relocation:
Y p I ! 4 C-r(,! , 0 Il . 200 amps or less 66.85 1
Phone: (93C _5S 1 Fax: ( 2 y _ Q ,)_9 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
:EjfAPPLICANT.'` ' ., ' i' : `, :.ligTONTACT:PERSON` 47: ;, _ Branch circuits - new, alteration, or
Name: extension per panel:
Address: A Fee for branch circuits with purchase of !�
service or feeder fee, each branch circuit pt 6.65 13.3 C 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
`` .' «'
"; P_ .; ., . ;`;•_' <: ` ='..0 " ONTRACTOR :: ::V „ -;e < * `-�� Each pump or irrigation circle 53.40 2
_ Each sign or outline lighting 53.40 2
Job No: 0 ..., I5 I _ -q Signal circuit(s) or a limited energy panel,
Business Name: (� �� alteration. or'extensron Page 2 2
�� Description:
Address: \ 7 M (7-7 C.�-j- \_)42-Al
(3-1::\ \�� 1 ( t > 12 (`l` -� Each additional inspection over the allowable in any of the above:
City /State /Zip: 1 J
4 \ / Q,3 Per inspection per hour (min. I hour) 62.50
Phone: 7 , .2,, _) 5 Z \ Fax: a 3 7 S ,„2 Investigation fee:
CCB Lic. #: , A! ic. #: Other:
• 1 �! : : x`' ;. ^: - "3 1 - 3 EUeiftiCal'PCPlllit1: §"triMt- �. „' k:* r , e
Supervising electricia Subtotal $ 1 ` 3 , 90
si. ature re • uired: � } //!�.r�i.Y/ , � Plan Review (25% of Permit Fee) $
Print Name: / � t�G� q
State Surcharge (8% of Permit Fee) S 1 3 ,
_'�
TOTAL PERMIT FEE $ i ? 7, g
Authorized , Notice: This permit application expires if a permit is not obtained 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)
is \Dsts \Permit Forms \ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information •
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
Audio and Stereo Systems
El Burglar Alarm
I Garage Door Opener
n Heating, Ventilation and Air Conditioning System
n Vacuum Systems
Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
I T Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control
Ej Medical
n Nurse Calls
n Outdoor Landscape Lighting
EI Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171
MST
/ p.�, BUP
Received 12- 11 l Z V 03 �a Requested 7 2 - / 0 M PM BUP
Location 0 7 3 „ Suite / J MEC
1
Contact Person Ph ( ) PLM
Contractor � Ph ( 503) 235— 7557 — 755 SWR
BUILDING Tenant/Owner C z (A-t!' t J -1-eA,La� Co 3 0071,
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
' Fire Sprinkler
Fire Alarm U'IN) 0 �,'�� �� C( ) 1
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING � G \" - , ' \ O
Post & Beam
Under Slab
Rough -In S / 9 �, '6_v ' G )Tor
Water Service \� `
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Ft Ff ICAL
(Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
in Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS ART FAIL
SITE LI Please call for reinsp-ction RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA / Approach/Sidewalk Date — Inspecto ” Ext
Other:
Final DO NOT REMOVE this inspection record rom the job site.
PASS PART FAIL