Permit CITY OF TIGARD ELECTRICAL PERMIT
J . ° PERMIT #: ELC2007-00013
COMMUNITY DEVELOPMENT DATE ISSUED: 1/4/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135CA-02304
SITE ADDRESS: 11500 SW GREENBURG RD ZONING: R -4.5
SUBDIVISION: BOETCHERS ADDITION LOT : 003 JURISDICTION: TIG
Project Description: Circuit to elec. gate.
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:
BOELLING, KAREN E BEAR ELECTRIC
JOHNSON, ROBERT A P.O. BOX 389
11500 SW GREENBURD RD DONALD, OR 97020
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 678 -1355
FAX 503 - 678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
[ELPRMT] ELC Permit 1/4/2007 $46.85 LIC 20919
[TAX] 8% State Surcharge 1/4/2007 $3.75 SUP 49025
Total $50.60 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 � _ : _ _ L Permittee Signature: cr
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.
01/04/20 THU 9:32 FAX 5036781108 Bear Electric, Inc. fa001/002
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Electrical Permit Application .
•
p , � F OR OF_FICE USE ONLY • •
City of Tigard REGE t Received � / :. .
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: I 1 .b Permit No.j+ e f ,
Phone: 503.639.4171 Fax: 503.598.1960 / �; vie
JAN , Date/13 : Other Permit: —
Inspection Line: 503.639.4175 _i'L!� i 1 DatelB
Internet: www.Ci.tigard.or.us c -��' Date Ready/By; 0 See Page 2 for
CITY OF TFUPtHU Notified /ivfethod: GIV Supplemental information
,: _ �...r i, . y'- T^.-• : - } ,-•..•„t •sx� c;ti„n ":f.;14.77-- ,, �'•r^ , . z ?,•�e `.ra s�+".{ •-".r' - ..i>' 1n'�."A
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'y�::.l~,..' ' _ ...v^f2� ��+�s��_� >_..� ��c„u:; ' :ua' �a- :t���r.��.ta�''�r,`u � u :r_"�.ic,'Yynr�.�••,r' 3 Sz'.��,�, -- �� ='�`': ifi"V... � :i xP ;�� ��`'..C.., '
❑ New construction Addition /alteration/replacement T Please check all that apply:
ni Demolition ❑Other: ❑Service over 225 amps, comm'l ['Hazardous location
? '" Y .. "' s. * :, , ^ - <- : . - - e . .. y se r¢, =y _ ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
4:7% -- '' ,` "•«`-'<s• -- z�.'._ w.- -+a .2r - .. , .� , ?R?w_,,s�,•-`� -� ,P' .' of 1 - and 2- family dwellings 4 or more new residential
1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi- family ❑ Master builder ❑ Other: ❑Building over three stories [Weeders, 400 amps or more
{ ' ` ``; 80]05+ Try e ' t' 2 - .' =;e,. 17y 44,V7*
., ` ` ' - T`et ,.: ❑ Occupant load over 99 persons ['Manufactured structures or
:� _- . ,may " ,•' :.. ' °x .- ❑ E gress/l i g htin g p RV park
Job no.: Job site address: t tt S � S' ' V '" ( 1 - GIN n „ ❑He plans alth - care facility ❑
f Submit 2 sets of with any of the above.
City/State/ZIP: — f �� / 7 '-! �aR The above are not applicable to temporary construction service.
S uite/bldg /a .. n o.: `. . _ -'- -- - . J _ - , ; -, •7 : a' z-x` T , i . :: ,..
o P __L__________. Project n rlt -/- . - , i�,�► . _ - -,-
Description 1 Qty. I Fee. 1 Total 1 "
Cross street/directions to job site: U S F F b r- O q t , may , New residential single- or multi - family dwelling unit.
T Includes attached garage.
_ . ..... - 0 s . ft. or less _ . 1 4
1,000 q 1 1
4515
Siibdiviszon: ,_ _._._.. _:_... __..... . .
Lot no.: Ea. ad3'T'S0 s ft &: portion • 3 3.40' 1 -
Tax map/parcel no.: 1 Limited energy, residential 75.00 2
_yr �� t' x ,,� _ _ Limited energy, non - residential ` 75.00 2
t N o - k eras _ i • y Y . : " vim` �; 'a.r. 't( s-`.•2 -� a o .'w' :�' .�Y >� '•t�ass5° r. S - �'•_ esvy .•*
Each manufactured or modular
� b � � i 2� $ � 'C � dwelling, service and /or feeder • 90.90
N 2
- Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 I 2
rn:; , ., s • , W4 • 0 : 4 ), ll;(9 T PiRi
_ .._ V
... t r".1 " :s3'. &;lf" ' ,4; :.ti..: oxr ex'., , 20 amps to 400 amps 10685
' ate=: ?- .r3.' ..+: ux.:z..ec, l 2
> . --, xw':1 ^' it - - t o s: r ._
. > .?,-. , . � r :� ' mp .
.:: .. .,... ..._ �=.�, :i lu" ... •e? ��• i�: �s� ".ix.K.'T^. p , .g. - '. , - ..,.. -:ra. e �cY'v. :t ?zi. ✓i"� '
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: Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation . .
200 amps or less I 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 I 133.75 I 2
Owner signature: Date:
Branch circuits -new, alteration, or extension, per panel
. - - - • - .: • f C , ' `' A. Fee for branch circuits with • yam `" � " service or feeder fee, each
each
Business name: branch circuit 6.65 2
Contact name: B. Fee for branch circuits ti�''
•
without service or feeder fee, t 46.85 ! Li as 2
Address: each branch circuit
Each add'l branch circuit 6.65 I 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 ! 2
E Sign or outline lighting 53.40 2
Signal circuit(s) or limited - •
� ra1;,t�SF�' , - „� -Z- -�: kf_ '9' il''lt.�'��,v�va �{C Y Y2' �- .:.. :•�..'a�,t ., x�:,vJ ��re� a � � ,
:�' :� ..�•.:�: a.: -w.. ���� •'..�:._.,� :'.` <.�`z� u��'K :'`- �i��::�'�`.��;, `�� energy panel, alteration, or
t mo e
d';,;
Business name: �. ( f a C r ; extension. Describe: • Page 2 2
Address: O (3 r7t>L 3 G Each additional inspection over allowable in any of the above
City/StatelZll' :� Per inspection 62.50 I
�'� `� d Tee 6 c 2_0
Investigation per hour (1 hr min) 62.50 i
Phone: (e)7.) j) ( S-'' -- ) & r Fax: (5 7 ) (o'78 / 1 0 e industrial plant per hour 73.75 II
�c t e Electrical Lic. :?�{, t d . Sup 1 ' ` k' :, :: - :< ' :;;. :.. .
'( ��,�. __ CC Z Suprv. tic.: 3 �Z 5' Subtotal LI 6 - <
CCB Lic.:
Suprv. Electrician signature, require . /` .e ( permit ) 3. } S
Plan review (25% of ermit fee
Print name: r . Date: State surcharge (8% of permit fee)
LA qt ZCI _v r TOTAL PERMIT FEE 5D 60
Authorized signature:
This permit application expires if a permit is not obtained within 150
Print name: 1 days after it has been accepted as complete
Date: . Fee methodology set by Tri- County Building Industry Service Board
" Number of insnections her nermit allowed
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00013
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11412007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1119/207 TIME: 7:0'IAM PAGE: 28
SITE ADDRESS: 11500 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: SOD - CHERS ADDITION LOT #: 003 TYPE OF USE:
PROJECT NAME: ALPHA COMMERCIAL DEV
DESCRIPTION: Circuit to elec. gate.
OWNER: WELLING, KAREN E PHONE #:
CONTRACTOR: BEAR ELECTRIC 73�G4,A PHONE #: 503 - 678 - 1355
Inspection Request Scheduled For: Date: 1/19/2007 Pour Time:
Code # Inspection Description Confirm # . Contact # Message
115 Electrical service 042299-01 503-452-8003 Y
Corrections /Comments /Instructions: 'PT
TA: K. S Wat.L k, c (!_
Nt Q- LL et(L �� � a 1p �
I PASS H PARTIAL APPROVAL XCANCEL n NO ACCESS
FAIL f CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 1 V IQ) Date: \ I Phone #: (503) 718 -
^r INF
/
CITY OF ��nm n ��n nn
/
BUILDING DIVISION PERMIT #: 3
13125SVV Hall Bhd, Tigard, ORO7223 ` DATE ISSUED: 1/412007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 039'4175
INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7:03AM PAGE: 10
SITE ADDRESS: 11500 SWGREENBURG RD CLASS OF WORK:
SUBDIVISION: BDtTCHBR38DD|TlQN LOT #: 003 TYPE OF USE:
PROJECT NAME: ALPHA C0KHk0ERC\AL
DESCRIPTION: Circuit to elec. gate.
OWNER: BOELLNG. KAREN E, PHONE #:
CONTRACTOR: BEAR ELECTRIC PHONE 503-678-1356
Inspection Request Scheduled For: Date: 1/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042032-01 503-678-1356 N
Corrections/Comments/Instructions:
•
•
I | ��
PASS / / PARTIAL �� CANCEL �� NO ACCESS
-
WFA|L gjCALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00013
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/4/2007
Phone: (503) 639 -4171 emu-
Inspection Requests (24 Hrs.): (503) 639 -4175 t
INSPECTION WORKSHEET FOR DATE: 112412007 TIME: 7 : 02AM PAGE: 17
SITE ADDRESS: 11500 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: BOETCHERS ADDITION LOT #: 003 TYPE OF USE:
PROJECT NAME: ALPHA COMMERCIAL DEV
DESCRIPTION: Circuit to elec. gate.
OWNER: BOELLING, KAREN E, PHONE #:
CONTRACTOR: BEAR ELECTRIC PHONE #: 503 -678 -1355
Inspection Request Scheduled For: Date: /02412007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042457 -01 603- 678.1355 Y
Corrections /Comments /Instructions:
L� F- j 0 1 -\oV5E;
•
Xc PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
'' `
Inspector: ae Date: \ 2-9 O) Phone #: (503) 718 - 2.1\$0