Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00034
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/6/2007
PARCEL: 1 S134AA - 02100
SITE ADDRESS: 10340 SW NIMBUS AVE NC ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Voice and data.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ROBINSON, CONSTANCE A + BROADWAY ELECTRIC - COCHRAN INC
ROBINSON, LYNN + BELL, KAY ET 626 SE MAIN
BY INSIGNIA COMMERCIAL GROUP PORTLAND, OR 97214
BEAVERTON, OR 97008
Phone: Contact #: PRI 503- 234 -6564
FAX 503- 238 -2098
FEES Reg #: ELE 37 -546C
LIC 72942
Description Date Amount SUP 3447S
[ELPRMT] ELR Permit 2/6/2007 $75.00
[TAX] 8% State Surcha 2/6/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 O AR 952 - 001 -0100. You may obtain co des of these
rules or direct questio s to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 4 . 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.
Ah■ AIMS.
•
.:"-- . ,- a a ■ U
Electrical P ApplicatioiAB,;11- `? ' - !_)) FOR OFFICE USE ONLY
City of Tigard i o e zoo Received ''
ilfZIS
Date/B
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi " -
e
' U 4 �.- Date 0- ALcp...li:1t
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
Inspection Line: 503.639.4175 -Rim,- Date Ready/By: EM La See Page 2 for
rn
Inteet: www.ci.tigard.or.us BUIMIM .-:-_; ' „ , ...r.. Notified/Method: Supplemental information
,.. . ' '..,'.. . ' • . ',T, . - 1 ., . _T : OF - WORK . : % „.,.. . - • ,:' .".i7 t , , ., c' : ‘...'::',;
0 New construction Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l ['Hazardous location
0 Demolition 0 Other:
['Service over 320 amps - rating 0Buildng over 10,000 sq. ft.,
, , _,, - • - CAtEGO OF 'CONSTRUCTION ' . .--, ' :,:"- .... ; .."..-' -: of 1- and 2-family dwellings 4 or more new residential
.. . .. ,,
0 1- and 2-family dwelling Commercial/industrial 0 Accessory building ElSystem over 600 volts nominal units in one structure
I:Building over three stories ['Feeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other:
00ccupant load over 99 persons 0Manufactured structures or
'JOB INFORMA TION AN]) LOCATION : °E plan RV park
,
Job no( cizac( I _Job site address:( 6 p4 WI ik
_ . ■ 0Health-care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: 1 1 Cl i ,I, ' Skild C The above are not applicable to temporary construction service.
J . . . . • . FEEli ,,SCREDULE' i' ::
Suite/bldg./apt. no.: Proj ) Project name: ,i c a f _ A 14 ‘ f c
Description I Qty. I Fee. I Total I ..
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: 1 Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
, Limited energy, residential 75.00 2
Tax map/parcel no.: .
Limited energy, non-residential 75.00 . 2
DESCRIPTION OF WORK • . Each manufactured or modular
. \ID \ (IC \ MiRk, N•S\ 1 dwelling, service and/or feeder 90.90
Services or feeders installation, alteration, and/or relocation 2
200 amps or less 80.30 2
•
• - - El. PROPERTY OWNER • i 0 TENANT, ' :,-.; ',. 201 amps to 400 amps 106.85 2
• 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
Phone: ( ) I Fax: ( ) relocation
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
O',ApPLICANT .. - i , yf CONTACT PERSON . A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
'
B. Fee for branch circuits
Contact name:, VI i itt .n lc H . without service or feeder fee,
46.85 2
Address: '? kA, st-e, b-dti\r•-) each branch circuit
>€
Each add'I branch circuit 6.65 2
City/State/ZIP: 1 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
-.
Phone: EIS ) Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: V I n M v IA
9
1 PiefthdflIfAcUWA Signal circuit(s) or limited-
.. CONTRACTOR : . , .. . , . ,; .,,:,, -. energy panel, alteration, or
. .
extension. Describe: I Page 2 - 15 2
t ,
Business name: V..
C
1 4•C 6. ....4 0,....1 '' ke c...\-
Each additional inspection over allowable in any of the above
Address: C, 2 5 E . X K
1 ••• N. fasVt% Per inspection 62.50
City/State/ZIP: "P Nc- 4 ,... 4 , CP.- C O 2-V4 Investigation per hour (i hr min) 62.50
Phone: (co3 ) 2.3L% -C LA Fax: ($63) 23S -2_c-1.5.3 Industrial plant per hour 73.75
PERMIT FEES*:.
CCB Lic.: 7 2.ck42_ Electrical Lic.: 31-5 t Suprv. Lic.: . 3'-(44. - f 5 . Subtotal 1G
Suprv. Electrician signature, required: V ..).... L .‘ ,.. , Plan review (25% of permit fee)
State surcharge (8% of permit fee) (0
Print name: V._ Sr\-\ V... c.b.X-0: Date:
TOTAL PERMIT FEE
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 permit allowed.
i:\Building\Pcrmiis\ELC-PermitApp.doc 12/03 440-4615T(10/02/COWWEB
,,
CITY OF TIGARD }
BUILDING DIVISION PERMIT #: ELR2007 -00034
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7J6/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/9/2007 TIME: 7 :04AM PAGE: 54
SITE ADDRESS: 10340 SW NIMBUS AVE NC CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: COCHRAN INC
DESCRIPTION: Voice and data.
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: BROADWAY ELECTRIC - COCHRAN INC PHONE #: 503 -234 -6564
Inspection Request Scheduled For: Date: 2/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 043173 -01 503. 250 -3981 N
Corrections /Comments/ Instructions:
c
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � ," a L- Date: Z- -1 '6n Phone #: (503) 718- X14