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Permit CITY OF TIGARD ELECTRICAL PERMIT P ERMIT #: ELC2009 -00036 COMMUNITY DEVELOPMENT DATE ISSUED 1/26/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102DA - 00200 SITE ADDRESS: 08720 SW BURNHAM ST ZONING: CBD SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: CITY OF TIGARD NICHE Project Description: (1) branch circuit for a /c. 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: 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: 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: CITY OF TIGARD OREGON ELECTRIC CONSTRUCTION INC 13125 SW HALL 1010 SE 11TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 639 -4171 Contact #: FAX 503 - 234 - 1001 PRI 503 - 234 -9900 FEES Description Date Amount Reg #: ELE 26 -95C [ELPRMT] ELC Permit 1/26/2009 $46.85 LIC 203 [TAX] 12% State Surchar 1/26/2009 $5.62 SUP 4549S Total $52.47 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: I f1 t ki t ,• Permittee Signature: < Q , p p 1 '� (� b A • 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. i* RECEIVE S - Electrical Permit Application -.- - 1 (iii (-)hr.it R. tit 3 O.l �, f City of Tigard JAN 2 6 2009 O Receiv v ed Pemtit No.: Frc 2Uoc. o - a 13125 SW Hall Blvd, Tigard, OR 97223 plan Review 10 ' Phone: 503.639.4171 Fax: 503.598.146oCITY O T IGARD oatc /B , Other Permit; Inspection Line: 503.639.4175 Date Ready /By Sec [age 2 fur :; �- i BUILDING DIVISIO Notified/Method; Supplemental information In ternet; www.tigard-or.gov TYPE OF WORK FLAN REVIEW ' • ❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): 0 5c or feeder 400 amps or mom El Building over duce stories. ❑ Demolition 0 Other: where the available fault cvnent El Marinas and boatyards. • CATEGORY OF CONSTRUCTION. • exceeds 10.000 amps at 150 volts or CI Floating buildings. lee to ground, or exceeds 14,000 El Commercinl - use agricultural 0 1- and 2- family dwelling ® Commercialindustrial El Accessory building amps for n11 othnr installations, buildings. ❑ Multi - family 0 Master builder El Other: ! ©Pirc pump. 0 installation of 75 KVA or 0 Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION • El Addition of new motor load of ❑ "n" is " t - '. ' I -3 Q 6W HAi T Q 2 0 rth ❑ Sixo rormom. occupancy. Job n0.: 80016-104 Job site address :�2 v ..- ++�>�- 87 ! t i s , Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: TIGARD OR El Health-care facilities. El Supply voltage for more than El Hazardous locations. 600 volts nominal, Suite/bldg. /apt- no.: j Project name: NICHE BUILDING D Service or feeder 600 amps or more- FEJE SCHEDULE - Cross street/directions to job site: Iereripdea 1 I Fee I Teter 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. It or leas 145.15 4 Ea, add' l 500 sq. ft or portion 33.40 1 Tax map /parcel no.: ' Limited energy, residential • DESCRIPTION OF WO with above sq. a) 75.00 2 Limited energy, multi -family 75.00 2 NEW AC CIRCUIT IN NICHE BUILDING residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT • 201 amps to 400 amps 106.85 2 • Name: CITY OF TIGARD 401 amps to 600 amps 160.60 2 601 amps to 1,000 ;unps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 _ City / State/ZIP: TIGARD OR Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or loss 66.85 1 Owner installation_ This installation is being made on property that 1 own which is not 201 amps to 400 1 00.30 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 ex tension , per panel Owner signature: — _ Date: A Fee for branch circuits with • 0 APPLICANT I ❑ `CONTACT PERSON' • above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for bt•,tncil circuits without service or feeder fee, 1 46.85 46.85 2 Contact name: first branch circuit Address Each add'I branch circuit — 6,65 2 _ ..—. Miscellaneous (service or f eeder not i ncluded) City / State/ZIP; f Each manufactu red or modular 90.90 2 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 Signal circuit(s) or limited - Business name: OREGON ELECTRIC energy panel, alteration, or Address: 1010 SE 11 AVE extension. Describe: Page 2 2 City /State/ZIP: PORTLAND OR 97214 — Each additional inspection over allowable In any of the above Per inspection 62.50 Phone: (503) 234 -9900 Fax: (503) 535 -2763 investigation per hour (1 hr min) 62.50 -- _ 73.75 CCB Lic.: 203 Electrical Lic.: 26 -95C Suprv. Industrial pleat per hour . Lic.: 4549C ELECTRICAL PER FEES. • Suprv. Elcetrician signature, it qui subtotal: 46.85 Plan review (25% of permit tee): Print name: RICHARD MCELLIOTT Date: 26-09 State surcharge (12% of permit fcc): _ 5,62 Authorized signature: TOTAL PERMIT FEE: 52.47 This permit application expires it a permit Is not obtained within 180 Print name: RICHARD MCELLJOTT I Date: 1 -26-09 _ r days after It has been accepted as complete. 66P -d Z00/100'd ti15 -1 £9129£9£05 OAS 01410313 80 -Woad WdZ5:170 600Z- 9Z -NV CITY OF ��U�� n n o n�rm TIGARD BUILDING DIVISION PERMIT #: BC2009'00036 18125SVV Hall 8|vd.. Tigard, OR Q7223 DATE ISSUED: 1/26/2009 Phone: (503) 639 Oareivitii � Inspection Requests (24 Hrs.): (503) 639-4175 - INSPECTION WORKSHEET FOR DATE: 2/5/2009 TIME: 7:00AM PAGE: 30 SITE ADDRESS: 08720 SW I3URNHAM ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CITY OF 1]GARD NICHE DESCRIPTION: (1) b ranc h circuit for aft. OWNER: CITY OF TIGARD, PHONE #: 503-6394171 CONTRACTOR: OREGON ELECTRIC CONSTRUCTION INC PHONE #: 503-2349900 Inspection Request Scheduled For: Date: 2/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 080283-02 603-535'2660 N -----�� P 20c1-0S03— Corrections/Comments/Instructions: � %/A PASS 7 PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS | | FAIL fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: ,C� IN) b8 ^ *� � ______ Date: 2-^5"1 Phone #: (503) 718- ��