Permit CITY OF TIGARD ELECTRICAL PERMIT
.7111 l �J PERMIT , COMMUNITY DEVELOPMENT ISSU ISSUED: 12 5/2 07
DATE ISSUED: 12/5/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134AA-01800
SITE ADDRESS: 10240 SW NIMBUS AVE L13 ZONING: I -
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : 002 JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: TI
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: 2 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:
ROBINSON, CONSTANCE A + GUILD ELECTRIC INC
ROBINSON, LYNN + BELL, KAY ET PO BOX 674
BY INSIGNIA COMMERCIAL GROUP BEAVERTON, OR 97075
BEAVERTON, OR 97008
Phone: Contact #: PRI 503 - 957 -1173
FAX 503 - 291 -1532
FEES
Description Date Amount Reg #: ELE C21
[ELPRMT] ELC Permit 12/5/2007 $60.15 LIC 109116
[TAX] 8% State Surcharge 12/5/2007 $4.81 SUP 3868S
Total $64.96 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 : .ays. ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 8 01 -001 0 throu• . - - 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 =y: - /r '/ 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:
ONTRACTOR 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/By: /,Q 6.- d7 Permit No.: � 60 8x' /
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' : _ Received
li . Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I G n IZ D Inspection Line: 503.639.4175 Date Ready/By: 3uris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: ....1-, 9 Supplemental Informat
TYPE OF WORK PLAN REVIEW
❑ New construction ig 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 is Commercial /industrial ❑ 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: 0240 S W N I M1 �3 Six or or more residential Recreational 305 L- ❑ Six or more residential units. ❑ Recreation al vehicle parks.
I I '
City/State /ZIP: 'Act o a e 2 i '3 ❑ Health -care facilities. 0 Supply voltage for more than
, -1 7 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: s ,(, ( k \:- ed Description I Qty. I Fee. I Total I •
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.)
Limited energy, multi - family 75.00 2
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: g oat, l t StAARO Ti\lsr N.q 401 amps to 600 amps 160.60 2
t g �o M lhetcra l �7fo�o 601 amps to 1,000 amps 240.60 2
Address: !t, k ISO I-4 ve ))'�'J /ay 0-61J A1 � �, L Over 1,000 amps or volts . 454.65 2
City/State /ZIP: c� 9 $ _ "C7 Temporary services or feeders installation, alteration, and/or
J C�.Igoevto t relocation
Phone: ( (3 (t Y - 9 / Fax: 1 p? k —9 1 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 arnps 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
A APPLICANT I erCONTACT PERSON above service or feeder fee, 6.65 2
�d Cs sr B. each branch circuit
name: Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 If 2
�LIk kd.7( first branch circuit
Address: C P3 4 G4T" .. f` Each add'l branch circuit 2.. 6.65 `3, 3v 2
-
Miscellaneous (service or feeder not included)
City/State /ZIP: *as:tuft:1%w L oz_ c 8 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (6-63 ) ' c � 1Z Fax: : ( ) 24 f_ ( Z Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
1 L ` I Signal circuit(s) or limited -
Business name:
GU tld (.n.cst eA Cats, f energy panel, alteration, or
Address: Q ',0 ■ 6 0,7¢ extension. Describe: Page 2 2
City/State /ZIP: �j f �N CI 9 OS Each additional inspection over allowable in any of the above
+ Per inspection 62.50
Phone: (SO3 ) 7 $g_ 777 g I Fax: (SO3 ) 2.41 I S32 Investigation per hour (1 hr min) 62.50
CCB Lic.: /01/ /4o Electrical Lic.: G • 2 1 Suprv. Lic.: 3S6s,,s Industrial plant per hour _ 73.75 _
ELECTRICAL PERMIT MIT FEES
Suprv. Electrician signature, required: 41,..,/x/ Subtotal: (
I cm u ,, / e s a y Date: / _ 3 - C/ Plan review (25% of permit fee):
Print name:
/ State surcharge (8% of permit fee): •2/
Authorized signature: 0, <2!�^^'lJ ■ ., TOTAL PERMIT FEE: /„ . ?n
Print name: KXA bt' , � ' ( Date: /27-11/4--07 permit application yafer it e if n a permit is not pl t te. w ' 0
,�� D days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23 /06 440- 46t5T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information -
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for Al residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ 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- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
p Intercom and Paging Systems •
•
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
•
❑ Protective Signaling
❑ Other - •
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
I: \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00821
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2007
Phone: (503) 639 -4171 , 1 J. f ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 12/10/2007 TIME: 7 :01AM PAGE: 47
SITE ADDRESS: 10240 SW NIMBUS AVE L13 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: SPFC SPACE
DESCRIPTION: TI
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: GUILD ELECTRIC INC PHONE #: 503- 957 -1173
Inspection Request Scheduled For: Date: 12/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 061153. t 603.389.8229 Y
/)'
Corrections /Comments/ Instructions: -,..
__ - ,5 vvAl0 P'M
1
..
PASS ) El PARTIAL APPROVAL [I] CANCEL El NO ACCESS
❑r / ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ 6 '. N 6i3 i_- Date: 1210 - kV) Phone #: (503) 718- 2`ill b _
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL-C2007..00871
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/5/2007
Phone: (503) 639 -4171 ll'
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ' "'f L
INSPECTION WORKSHEET FOR DATE: 12/6/2007 TIME: 7:06AM PAGE: 40
SITE ADDRESS: 10240 SW NIMBUS AVE L13 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: TI
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: GUILD ELECTRIC INC PHONE #: 503-957 -1173
Inspection Request Scheduled For: Date: 12/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Coiling cover 060946-02 503. 360 -8229 V
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G Mg Date: II Q' al Phone #: (503) 718-1-itil
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC20U7•00821
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17J512007
Phone: (503) 639 -4171 /a e fi,
Inspection Requests (24 Hrs.): (503) 639 -4175 A- `:
INSPECTION WORKSHEET FOR DATE: 12/6/2007 TIME: 7 :06AM PAGE: 41
SITE ADDRESS: 10240 SW NIMBUS AVE L13 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: TI
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: GUILD ELECTRIC INC PHONE #: 503 -957 -1173
Inspection Request Scheduled For: Date: 12/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 060948 -01 503-380 -8229 Y
Corrections/Comments/Instructions:
1 E m10 Q-1(9
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C ----- ` L E Date: 11 '' - "1 Phone #: (503) 718- 1-91.4/