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Permit
1 ta ... CITY OF TIGARD � ELECTRICAL PERMIT PERMIT #: ELC2007 -00754 COMMUNITY DEVELOPMENT DATE ISSUED: 11/8/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S127DD-00100 SITE ADDRESS: 09730 SW CASCADE AVE ZONING: C -G SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: SHANE COMPANY Project Description: (2) branch circuits for parking lot lights. 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: 1 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: T MICHAEL + ASSOCIATES LTD A & D ELECTRIC ATTN: JOHN WEGMAN 8507 SW WAKKILA TERR. 9200 E MINERAL AVE, SUITE 200 BEAVERTON, OR 97007 ENGLEWOOD, CO 80112 Phone: Contact #: PRI 503 - 227 -0534 FAX 503 - 227 -1941 FEES Description Date Amount Reg #: ELE 34 -644C [ELPRMT] ELC Permit 11/8/2007 $53.10 LIC 155486 1ELPRMT] Investigation F 11/8/2007 $53.10 SUP 3522S [TAX] 8% State Surcharge 11/8/2007 $4.25 REQUIRED ITEMS AND REPORTS Total $110.45 • This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other ap licable 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 i 'w rk is suspended for more th B© ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. T' o rules are set forth in OAR 2- 001 -0010 throe. h O • ' '52- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 53.24..6, 9 or 1.800.332.2344. J Iss d By: ' 1 ‘ ; `4 ' Permittee Signature: . f" / ---71'' / i 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 INST • LATION ONLY SIGNATURE OF SUPR. ELEC' I' I 4 0 ,' ., ( 61.7' 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 FOR OFFICE USE ONLY `J Tigard Date/By: l( Q e e4e2014' / _OQ 75 City of Ti and Permit No.: 1111 - a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review • Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T1 G A R D Inspection Line: 503.639.4175 Date Ready /By: �lun ' VI See Page 2 for Internet: www.tigard - or.gov Notified/Method: l l✓• Supplemental Information TYPE OF. WORK , PLAN REVIEW . ` ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF' CONSTRUCTION ` , exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling El Commercial /industrial El Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: �23 r, ) � � S Six or or more. occupancy. ^ >° �(/(�, CI or more e residential units. ❑ Recreational vehicle parks. City/State /ZIP: '� j •_ f (e 9 f j ❑ Health -care facilities. ❑ Supply voltage for more than ffViilll / ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: C] Service or feeder 600 amps or more. 0. e FEE SCHEDULE Cross street/directions to job site: ©/ r ter, Description I Qty. I Fee. I Total l • �/ New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION: OF WORK - (with above sq. ft.) tr 4 n v � / Limisd energy, muoq. f 2 L 4 ^ (I-( residential (with above ve s sq. ft.) 75.00 Cf (`/ Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 '0 PROPERTY OWNER, ❑ TENANT 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/State /ZIP: 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 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ' U. CONTACT PERSON above service or feeder fee, 6.65 2 � � c Tn Fee branch branch circuit Business name: A y l .L.- � B. Fee for branch cir Contact name: without service or feeder fee, ) 46.85 V` 8'S 2 Al"-'t, * 1 yl - ' f ` e'.� first branch circuit 1 Address: g`S� (2 6- �i // 7 ,.-,� Each add'I branch circu l 6.65 6.65 2 �` Miscellaneous (service or feeder not included) City/State /ZIP: &ei.A 1+�TA-1- I✓f � 0 ie 9 "c.) G ? Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: (93) c2 ,27 -6 5-3 `1' / Fax:: (S ) v "7 I id Reconnect only 66.85 2 E -mail: j / Pump or irrigation t� G`f �e o.t/� ( ?��' p circle 53.40 2 g CONTRACTOR Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: qt.]) 7c ...,L r,` C T G energy panel, alteration, or Address: D co '7 �'� �av` /fit �Trr� extension. Describe: Page 2 2 City/State /ZIP: .34;,„..A i (l C.{ 1 `� n e e 9 r 2 o e)' 7 Each additional inspection over allowable in any of the above ` Per inspection 62.50 Phone: ( „_9, as "7 -o53 ( Fax: (.3 ) u7•/7// Investigation per hour (1 hr min) 62.50 CCB L / q 00 : r g P4' Electrical Lic.: �T'} T L. Suprv. Lie.: 5.;--.97,25 Industrial plant per hour 73.75 /�/ / l I ELECTRICAL . ElPcttd ICAL PERMIT FEES : . Sup ci an signature, required: I 7 `� 8 / - /0/i //b ¢ � Ft Ti E._ Subtotal: 53, / ice 111 Print name: , J � a • .•: i. D ate : // Q 7 �� ��� . .. 53 l 0 " State surch arge (8% of permit fee)' f/, 2 Authorized signature' -/ TOTAL PERMIT FEE: - .- )1114 4.: r AV � This permit application expires if a permit is not obtained within 180 Print name: -• - Date: L - / /�� (� ! * Number of inspections allowed per permit. f / O l. \Buildingwermits\ELC- PermitApp doc 05/23/06 440- 4615T(I 1 /05 /COM/WEB / l/ Electrical Permit Application - City of Tigard r • /. Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: R ESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: COM WORK ONLY: , Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical . ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \BuildiugWermits\ELC- PermitApp doc 03/23/06 • CITY OF TIGARD . .. BUILDING DIVISION PERMIT #: EI_ts20C17..6f)754 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/18/2007 Phone: (503) 639 -4171 j iii 0' � ,I Inspection Requests (24 Hrs.): (503) 639 -417 _ INSPECTION WORKSHEET FOR DATE: 11/13/2007 TIME: 7 :01AM PAGE: 9 SITE ADDRESS: 09730 SW CASCADE AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: SHANE COMPANY DESCRIPTION: (2) branch circuits for parEdng lot lights. OWNER: T MICHAEL .} ASSOCIATES LTD, PHONE #: CONTRACTOR: A & D ELECTRIC kE VV , PHONE #: 50:227 -0534 Inspection Request Scheduled For: Date: 11/13/2007 Pour Time: Code # Inspection Description _____C_onfirm # Contact # Message 199 Electrical final 05954401 503 - 339.7765 ' Y Corrections/Comments/Instructions: att & , ........„ ,46, 1 k_'.1.. , 141.4J iw.„1, ,,,:- 1■. ' vitiMaiMr.fkIDMIKMMoiWA . 1•; n�1 i V 11 F i t4 L h ek _____________________ p . c -- /v tilts-10i is PASS ❑ PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS TION n ADDITIONAL FEES ASSESSED Inspector: _7--.1 N Le Date: Li, i lie) Phone #: (503) 718- CITY OF TIGARD .. A BUILDING DIVISION ''.: PERMIT #: ELC2007•00764 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: itta Phone: (503) 639-4171 /siallitiltit Inspection Requests (24 Hrs.): (503) 639-4175 ,_. INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 09730 SW CASCADE AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: SHANE COMPANY DESCRIPTION: (2) branch circuits for parking lot lights. OWNER: T MICHAEL + ASSOCIATES LTD, PHONE #: CONTRACTOR: A & 0 ELECTRIC PHONE #: 503-227-0534 Inspection Request Scheduled For: Date: 11/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 105 Underground/slab cover 059407-0N\ N 1 Corrections/Comments/Instructions: OGTE .., C. Ut STAN 4 r I Cr IS ibtD EQ0 Al r'to I 0) Namti k ttGuttsvi‘V-, 4 LorA i . ' Ls. s ■ i %L., PO .10 • (..‹.. PAS fl PARTIAL APPROVAL [7 CANCEL fl NO ACCESS FAIL [ CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: G ---- - r iA 6Q) 1 ---e Date: ‘14` i .01 Phone #: (503) 718- 2-11440