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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: E 9/2007 00215 DATE ISSUED: 4/9/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S126DB-02800 • SITE ADDRESS: 09370 SW GREENBURG RD 423 ZONING: C - P SUBDIVISION: PP1991 LOT : 001 JURISDICTION: TIG PROJECT: DR. CAROL GUNN Project Description: TI - (2) branch circuits. 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 HMI 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: FRANKLIN COMMONS ASSOCIATES RELIANT ELECTRIC LLC BY NORRIS + STEVENS 20200 SE OLDENBURG LN 520 SW 6TH STE 400 SANDY, OR 97055 PORTLAND, OR 97204 Phone: Contact #: PRI 503 - 701 -4562 FAX 503 -668 -4190 FEES Description Date Amount Reg #: ELE C59 [ELPRMT] ELC Permit 4/9/2007 $53.50 LIC 162814 [TAX] 8% State Surcharge 4/9/2007 $4.28 SUP 5067S Total $57.78 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 - .n :.: - s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OA' 952 - 001 -0010 • ough . • 952- 001 -0100. You may obtain copies of these rules or direct questions to OU C at 503 246.66 or 1.800.332.2344. Issu • • By: L / �� ��� , Permittee Signature: 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: NTRACTOR INSTALLATION ONLY �� SIGNATURE OF SUPR. ELEC'N: � DATE: 7 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, t: _,. 1: tar of Tigard Received /�O MA . � i ,/ .,, iy 9 / . IN 7 Date/By: J Permit No.: ( (iGGIJ ( /l/ ° 13125 SW Hall Blvd., Tigard, OR 9 7223 Plan Review 1 Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit: T I CARD. Inspection Line: 503.639.4175 Date Ready /By: luri ® See Page 2 for Internet: www.tigard- or.gov Notified/Method: / / Supplemental Information TYPE OF 'WORK PLAN REVIEW El New construction '.�ddition/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 ` commercial /industrial ❑ Accessory building amps for all other installations, buildings. ❑ Multi- family /❑ Master builder ❑ Other: 0 Fire pump. U Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ['Addition of new motor load of ❑ "A ", "E ", "I -2 ", "l -3 ", Job no.: Job site address: �j 1 OOHP or more. occupancy. G 37 {�QQI�� t£ ['Six or more residential units. 0 Recreational vehicle parks. City /State /ZIP: �'� (:)Q.— 0 (1 2:2_3 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: 4 Z 3 Project name: ----- , �-44 L N ❑ Service or feeder 600 amps or more. job site: I Qtp. I Fee.. I Total- I " FEE' SCHEDULE Cross street/directions to J � ..,�.k A C- c - e - (y'�6CA - 1 - Gt Description \ S 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'l 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.) �_ Limited energy, multi - family 75.00 2 .5, ` `- -, - c - 5C.V ( c� � residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT ' 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,00.0 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 ❑ ' CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: �� ` ,0-. e.—k.R -, j„{-_e B. Fee for branch circuits without service or feeder fee, r 46.85 lQ 2 Contact name: �t -L-. \ f0.v.-4-V.Ckw.. first branch.circuit Address: " 2.00 CAPE-7,---)13.10-1 Each add '1 branch circuit k 6.65 (.6"(e.5 2 "l Miscellaneous (service or feedernot included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: (fP S( L 2 j4 0 Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR, Sign or outline lighting 53.40 2 t T ��T s LLB Signal p a ne l, a) er or t o n , Business name: or �\ GZv� energy panel, alteration, or . Address: 202C-:)C' c - 0 � O -- )(� ` - extension. Describe: Page 2 2 City/State /ZIP: 61' .)b� ©.e q / OSs ut∎v Each additional inspection over allowable in any of the above ` Per inspection 62.50 Phone: (5 02 Re O t { - u O Fax: ) (( � 4 Q o Investigation per hour (1 hr min) 62.50 CCB Lic.: i t,Zg( t, ( Electrical Lic.: CI — Suprv. Lie.: C (475 Industrial plant per hour 73.75 1 ELECTRICAL PERMIT FEES .Suprv. Electrician signature, required: Subtotal: 7 5 . 5 Print name: o� - o f l� � Date: /4 ..G.i -- 7 Plan review (25% of permit fee): �-v v� 1 State surcharge (8% of permit fee): If. 2- Authorized signature: TOTAL PERMIT FEE: 57- 7 • ( This permit application expires if a permit is not obtained within 180 Print name: �" 1 a. LELlrlw t _f_. Date: y accepted p days after it has been acce ted as complete. * Number of Inspections allowed per permit. 1:\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 l /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIALWORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls Fl Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations • I.'Building\Permos\ELC- PermitApp.doc 03/23/06 - - - . CITY OF TIGARD BUILDING DIVISION • PERMIT #: ELC2007-00215 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/9/2007 Phone: (503) 639-4171 .„40,0 Inspection Requests (24 Hrs.): (503) 639-4175 . INSPECTION WORKSHEET FOR DATE: 5/1/2007 TIME: 7:00AM PAGE: 41 SITE ADDRESS: 09370 SW GREENBURG RD 423 CLASS OF WORK: SUBDIVISION: PP1991-018 LOT #: 001 TYPE OF USE: PROJECT NAME: DR. CAROL GUNN DESCRIPTION: TI - (2) branch circuits. OWNER: FRANKLIN COMMONS ASSOCIATES, PHONE #: CONTRACTOR: RELIANT ELECTRIC LLC PHONE #: 503-701-4562 Inspection Request Scheduled For: Date: 5/1/2007 Pour Time: Code # Inspection Description 7 Confifm Contact # Message 199 Electrical final ( 047405-01 503-860-4240 Corrections/Comments/Instructions: • PASS I I PARTIAL APPROVAL fl CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: • 1\) Date: 5 Phone #: (503) 718- 141t6 . , e CITY OF TIGARD BUILDING DIVISION • 1 PERMIT #: ELC2007 -00215 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/9/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ivit INSPECTION WORKSHEET FOR DATE: 4/1212007 TIME: 7:00AM PAGE: 39 SITE ADDRESS: 09370 SW GREENBURG RD 423 CLASS OF WORK: SUBDIVISION: PP1991 - 010 LOT #: 001 TYPE OF USE: PROJECT NAME: DR. CAROL GUNN DESCRIPTION: TI - (2) branch circuits. OWNER: FRANKLIN COMMONS ASSOCIATES, PHONE #: CONTRACTOR: RELIANT ELECTRIC LLC V, \--\--- PHONE #: 503 - 701.4552 Inspection Request Scheduled For: Date: 4/12/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 125 Wall cover 045388 -01 503 - 860-4240 '''- Y Corrections /Comments /Instructions: L-6, V22'% 0 PASS 1 I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CT Nell' L Date: 4 Q Phone #: (503) 718- uttic, . ,