Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00050
COMMUNITY DEVELOPMENT DATE ISSUED: 1/23/2007 •
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134AD - 06201
SITE ADDRESS: 10450 SW NIMBUS AVE RA ZONING: I -
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: 15 branch circuits. Power to cubicles.
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: 14 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:
CONSTANCE ROBINSON FOX ELECTRIC COMPANY
1525 SE POWELL
PORTLAND, OR 97242
Phone: Contact #: PRI 503 - 563 - 7215
FAX 503 - 233 -8002 •
FEES
Description Date Amount Reg #: ELE C23
[ELPRMT] ELC Permit 1/23/2007 $139.95 LIC 163254
[TAX] 8% State Surcharge 1/23/2007 $11.20 SUP 4389S
Total $151.15 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 Notificatio Center. Those rules re set forth in
OAR 952 - 001 -0010 throu •h OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU ■ at 03.246.6699 .80 .332.
Issued By: 'i / � Permittee Signature: A/
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.
a-` •
Electrical Permit Application Folt OFFICE i sly ONLY
City of Tigard e/ . /tea j./10 l� ,,� �' - //.�60 1111 . ° 13125 SW Hall Blvd, Tigard, OR 9 CEi���
Play Revi Pt:
Other a
Phone: 503.639.4171 Fax: 503.59 .I DateB .
TI C. n t D Inspection Line: 503.639 Date Ready/By. HI See Page 2 for
Internet: www.tigard-or.gov JAN 2 3 2007 Notified/Method �' Supplemental Information
TYPE OF WLCY Or TIGARD PLAN REVIEW ,
❑ New construction 1101 AdditionialtginaNWMAtSION1 Please check all that apply (submit a sets of plans w/iitems checked below):
12 Demolition Other: where Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION ex«eds 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: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION • ❑ Emergency system. larger separately derived system.
' / ,,// v' - CI Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: /d / O
sw N/� /fi
lhvl •e- six or or more. occupancy.
❑ Six o more residential units. 0 Recreational vehide parlor.
City /State/ZIP: ❑ Healthcare facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: FA. Project name: D ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qt7. I Pee. 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
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
0 / / Limited energy, multi - family 75.00 2
r ani AR-!� priv.,r - A D / "/ C G4C /f residential (with above sq. ft.) -
// p ^ Services or feeders installation, alteration, and/or relocation
- 200 amps or less 80.30 2
❑ PROPERTY OWNER l ❑ 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
Owner signature: Date: Branch circuits – new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT ' ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
• without service or feeder fee,
Contact name: first branch circuit 46.85 2
Address: Each add, branch circuit / 6.65 , /D 2
Miscellaneous (service or feeder not included) _
City/State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: • Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
�/� Signal circuit(s) or limited -
Business name: r ftee4G A- 7 -O energy panel, alteration, or
Address: /Sa S' --5'e /2 -// extension. Describe: Page 2 2
City/State/ZIP: /� r 7t , (9/2 t 7 20 Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone:
(53 ) a 30) 3 Fax: (523) 2J3 3 ra Z Investigation per hour (1 hr min) 62.50
CCB Lic.: /6,....3„ Electrical Lic.: 23 Su rv. Lic.: � /. ff. Industrial plant per hour 73.75
/ ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: / Subtotal: /.3%)../i Print name: Date: 43A7 Plan review (25% of permit fee): ..f410 — State surcharge (8% of permit fee): ;: // • aD
Authorized signature: = � TOTAL PERMIT FEE: /. / `jam
Date: X2V , This permit application expires if a permit b not obtained within 180
Print name • days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:lauitdmgTamin\ELC- Permiwpp.d« 0923/06 44446151*(1 tros/COM/WEB
Electrical Permit Application - City of Tigard .
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all 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*
El 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
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ 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: ding PumiIn\ELC.PermitAppdcc 03123/06
r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El_C2007 -00050
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/23/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/26/2007 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 10450 SW NIMBUS AVE RA CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: EID
DESCRIPTION: 15 branch circuits. Power to cubicles.
OWNER: CONSTANCE ROBINSON. PHONE #: NA
CONTRACTOR: FOX ELECTRIC COMPANY PHONE #: 503- 563-7215
Inspection Request Scheduled For: Date: 1/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042566.01 971 -563 -7215 Y
Corrections /Comments /Instructions: •
' fl 0 L.O
"\PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: I c Phone #: (503) 718- 241