Permit C ITY OF TIGARD ELECTRICAL PERMIT
7
" PERMIT #: ELC2007 -00083
COMMUNITY DEVELOPMENT DATE ISSUED: 2/6/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD -03500
SITE ADDRESS: 06600 SW HAMPTON ST ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT : 037 JURISDICTION: TIG
Project Description: Low voltage for relocating reader to specimen dept. door.
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: 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:
PACIFIC REALTY ASSOCIATES SELECTRON INC
15350 SW SEQUOIA PKWY #300 -WMI 7225 SW BONITA RD
PORTLAND, OR 97224 TIGARD, OR 97224
Phone: Contact #: PRI 503 - 639 -9988
FAX 503 - 684 -4357
FEES
Description - Date Amount Reg #: ELE 26- 497CLE
[ELPRMT] ELC Permit 2/6/2007 $75.00 LIC 64341
[TAX] 8% State Surcharge 2/6/2007 $6.00 SUP 974LEA
Total $81.00 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:
ilf
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:
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.
4 ..
Electrical Permit A's s (;rf �� �1 t � rFO O FFICE U SE O hIL Y 1 , a;`. ,
as . s• ... ,� . „ ; aid 4. fits ' ., , a � ,Y :. ` ,v;
�Q
City of Tigard • Receive
_ Date /B /� O 7 6' p Permit N...1 t j r� , 2 .00 ' 2
13125 SW Hall Blvd., Tigard, OR 97223 r 0:7; 2007 //�i r \ Plan Review Other Permit: •
Phone: 503.639.4171 Fax: 503.598.1960. ✓Ni I 'F Date /By
Inspection Line: 503.639.4175 CI OF TIG� v�� . ' E` ' Date Ready/By: 1uris: 0 See Page? for
� ® sn G Di v
Internet: www.ci.tigard.or.us Notified/Method: Supplemental lnformation
�u
vim • e? =� °'� '•,, ���--- „, - TYEE'�OF; . - '°',";'':':,C
1 n�� PLANE R•E•VIFW.- ^Y ' . . per
❑ New construction ,,,(({ Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l El Hazardous location
❑ Demolition ❑Other:
❑Service over 320 amps - rating ❑ Buildn over 10,000 sq. ft.,
s`CATEGORY CONSTRUCTIONk> ='
of 1 and 2-family dwellings 4 or more new residential
❑ 1 and 2 family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family Master builder ❑ Other: I
❑Occupant load over 99 persons ❑Manufactured structures or 1
t :JO ITE aINORMATIO L
=OCATION` ,—., RV
` � °� = • • - ' ,`'a�` �-
.,.. = <,t. , ,. S ,, F N
. - ., .>_ ,•. -. ..., .,. ” , .. . ,. , -� DE p lan ark P
'' II ❑Health -care facility ❑ Other:
Job no.: b2 ( Job site address: W.() b S It�I tt�rr.P �oyl
Submit 2 sets of plans with any of the above.
City /State /ZIP: -- kY'1'I - 6. bR. Cirr).- The above are not applicable to temporary construction service.
Suite, /bldg. /apt. no.: � . .� ,.., . . .. _ " . _. :: "o :' ; ;; '. ,.
P roject name: Q , . �•1t F A s r n FEE *'`•;SCHQty e . ';. , < .f' ` *
` `
I� -:� Description Qty. Fee Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes-attached garage. _ _____ _ _
1,000 sq. .ft or less 145.15 - 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion • 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
1: , : , .,,,•• .. _ .. .,_,,• : ,,. ,.,.. ... ON energy, non-residential 75.00 2
u � , µ�„ •tz v ", +µ Limited nergy non 'dential
„,_ .;;,,,5 ,
DES "WORK4;S` 5 ; ' 1 : 4 i:1, ? ., Each manufactured or modular
nn I dwelling, service and/or feeder 90.90 2
fei'0L3 �" - c e l 7v' SIX- c_1 'V� + day-. Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
.,•. t -•.a^i" :',t.e j , , 201 amps to 400 amps 106.85 2
❑,:.PROPERTY~ °OWNER « , ❑ TENANT'. x k
�.... .,... . 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 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 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 401 amps to 600 amps I I 133." 1
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
4. "' :;> ! - . *fay ';s;: °.14 >. y 3',,,..• ;•a...,., _ -t F f or branch circuits with
; #s �. °' r��, �' �; APPIsICANT.:• S:� _ ��'�mr` ='; "`� �F, -, � ® �, <r �' :m ; A. Fee � • � � 1"CONI'ACT'AP >ERSOIY,. � ,;
: - - s • ' . :,.. , ... _ .. tea= b �€c , 1r. t,i v °zt� -.. - ' ' .�' -
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits -
Contact name: without service or feeder fee, 46.85 2
Address:
each branch circuit
Each add'l branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
x% - >:j,,.:.3.,, �3, _ .'1- = : R• `, r,':- _ ' *r'h'.
-- ';ii'>� `� <.� .,at energy panel, alteration or
,, _,. ,..._ �CONTRACT'OR"�,.'...' w, <E� ,ta' gYP , - � p �
extension. Describe: I Page 2 -- 1, 6 ° 6° 2
Business name: Sele_c k- - , ) hL
7 7._,_S 3, j 1�� Each additional inspection over allowable in any of the above
Address:
' ` Per inspection 62.50
City /State /ZIP: - i U Z Q17) Investigation per hour (1 hr min) 62.50
Phone: )t - c Fax: Industrial plant per hour 73.75
; ;ELECTRICAI::4. - 1 IT;;FEES Nt. «=
CCB Lie.: L,,.43,..4 I Electrical Lic.: �G'-i L� ,4 Suprv. Lic.: EA - Subtotal - _
Suprv. Electrician signature, required: - - ', �_,, Plan review (25% of permit fee)
_ -,� -.- .
CI
b , State surcharge (8% of permit fee) DOS
Print name: i l�hh � Date: �',),,) O�
` TOTAL PERMIT FEE 1 co
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per pennit allowed.
i ' \Bmiding\Permits\ELC- PermitApp do* 12/03 440-4615 T(1 0/02/COM/W EB
CITY OF TIGARD
BUILDING DIVISION PERMIT #:W..,4 20 O 1 1,d(:0 13
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 -,- ..���%�;
Inspection Requests (24 Hrs.): (503) 639 -4175 .. . '. -,
INSPECTION WORKSHEET FOR DATE: 1 , 1 . Q -A TIME: PAGE:
SITE ADDRESS: (A VIO CLASS OF WORK:
SUBDIVISION: \\NW bO 5 a , LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: \, 1 ). O Pour Time:
Code # Inspection Description Confirm # Contact # Message
\ c
•
Corrections /Comments /Instructions:
V
PASS 1 1 PARTIAL APPROVAL n CANCEL 1 1 NO ACCESS
1 FAIL 1 f CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
/ �--,
Inspector: . \ V t-- Date: 1 " 3' 0 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #:t,, , 00A3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .J *.
INSPECTION WORKSHEET FOR DATE: - 0 TIME: PAGE:
SITE ADDRESS: 6 6 ®Q S L) tA'q i t t , ( CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
• Inspection Request Scheduled For: Date: � • 6' t ') Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/Comments/Instructions:
k / t )
X PASS I I PARTIAL APPROVAL I l CANCEL I f NO ACCESS
I I FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
i
Inspector: Date: 1 6 1 4 Phone #: (503) 718- iipi