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Permit
C ITY OF TIGARD ELECTRICAL PERMIT • PERMIT #: ELC2007 -00617 • ` `= COMMUNITY DEVELOPMENT DATE ISSUED: 9/5/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 134AA -02100 SITE ADDRESS: 10340 SW NIMBUS AVE NB ZONING: I - P SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : JURISDICTION: TIG PROJECT: PST Project Description: 3 branch circuit 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 9/5/2007 $60.15 LIC 109116 [TAX] 8% State Surcharge 9/5/2007 $4.80 SUP 3868S Total $64.95 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: 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. ........, ;:. , ,.....— V' \ 1 v ii -- 7 . 1) Electrical Permit • t r. t a:' t Ir_ Foli 01.1.10.: [Isl.: (NI. V 04 Tigard ( ? 0 2001 DatetB Receive CIO , , io Permit No: ..... ._ ... u,,,., 9. 0610/ l315 SW Hall Blvd., Tigard, OR 97223 ..it `' * Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ' ; ' s '�J1'' DatDate/13 . Other Pe . Inspection Line: 503.639.4175 O 1 Y � ' . Date Ready/By. . See Page 2 for Internet: www.ci.tigard.or.us e— ""h , J i I - - Notified/Method: �' ® Supplemental Information ''B te'k PLAN REVIEW ❑ New construction (a Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location OService over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of l- and 2- family dwellings 4 or more new residential ❑ 1 - and 2- family dwelling H Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: / O37 7) J L) 1 & 01-care facility ❑der. Submit 2 sets of plans with any of the above. City/State/ZIP: PD N � LA ,4 D if.... q 7 Z2-3 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg. /apt. no.: Project name: Mc1C'ess e.44 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: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular . f.A.l) a (1(� ` G � � 7 6 D ( i ) LA . ( I dwelling, service and/or feeder 90.90 2 ` J' -' � 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 D ,(�. � - 401 amps to 600 amps 160.60 2 Name: M S b CO N.,541$44, Gt C, /# lO 2 L!(V eS 1 vs'4/ 601 amps to 1,000 amps 240.60 2 • Address: 10- U S w NI 144 u, 5 Some, L-3 Over 1,000 amps or volts 454.65 2 y 7 Reconnect only 66.85 2 City / State/ZIP: D led' ) ' ( © . y� 47 z 7J Temporary services or feeders installation, alteration, and/or Phone: ( `` Fax: 4-1.5.."— relocation s � J ) �� L G ( ,5O �g 71 200 amps or less 66.85 l Owner installation: is installation is being made on property that I own w ich 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 ❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each �j 6.65 2 Business name: branch circuit �� Contact name: B. Fee for branch circuits without service or feeder fee, 1 Address: each branch circuit 46.85 4 2 Each add'I branch circuit a_� 6.65 / 3, 5p 2 City/Statc/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or 4, -id L!/�[/ extension. Describe: Page 2 2 / Business name: Address: P-0. /3 t9x �y Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: 6 v . e N O sry l 7D 76 b7 y Investigation per hour (I hr min) 62.50 Phone: (5 0)) 9.-7 - )) 73 I Fax: (5 ) — Z) _/S3 v Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* . CCB Lic.: /061 )J6 Electrical Lic.: C-• 24 Suprv. Lic.: v6 ire Subtotal (ten_ /c Suprv. Electrician signature, required: / Plan review (25 %ofpermit fee) Print name: M G }� ��/ Date: �/ _ S�� O i State surcharge (8% of permit fee) Z./. la) I . ` / , r TOTAL PERMIT FEE CO`i'• - Authorized signature: / This permit application expires if a permit is not obtained within 180 Y c _ days after it has been accepted as complete Print name: / Y� l 14 u b ! , e,/V Date: q - ) ) • Fee methodology set by Tri- County Building Industry Service Board • • Number of inspections per permit allowed i:\ Building \Permits\ELC- PennitApp.doc 12/03 440.4615T(10/02/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* El Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system. $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: El Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical El Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is Building \Permits\ELC- PermitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00617 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/5/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/20/2007 TIME: 7:00AM PAGE: 43 SITE ADDRESS: 10340 SW NIMBUS AVE NB CLASS OF WORK: SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE: PROJECT NAME: PST DESCRIPTION: 3 branch circuit OWNER: ROBINSON, CONSTANCE A +, PHONE #: CONTRACTOR: GUILD ELECTRIC INC PHONE #: 503 957 - 1173 Inspection Request Scheduled For: Date: 9/2W2007 Pour Time: Code # Inspection Description Confir Contact # Message 199 Electrical final 0 6010 -01 03-752-0251 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: MO L Date: 91 Phone #: (503) 718- ZIlitt CITY OF TIGARD - ,. • BUILDING DIVISION PERMIT #: ELC2007 -00617 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/5/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 -_.. INSPECTION WORKSHEET FOR DATE: 916/2007 TIME: 7 :00AM PAGE: A SITE ADDRESS: 10340 SW NIMBUS AVE NB CLASS OF WORK: SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE: PROJECT NAME: PST DESCRIPTION: 3 branch circuit OWNER: ROBINSON, CONSTANCE A +, PHONE #: CONTRACTOR: GUILD ELECTRIC INC PHONE #: 503-957 -1173 Inspection Request Scheduled For: Date: 916f2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 125 Wall cover 055241 -01 503 -957 -1180 N Corrections /Comments /Instructions: A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • W QU LE Date: C il b l Phone #: (503) 718_1_446