Permit ELECTRICAL PERMIT
' CITY OF TIGARD 4 �` PERMIT #: ELC2006 -00282
�•I � DEVELOPMENT SERVICES DATE ISSUED: 5/18/2006
"III 13125 SW Hall Blvd., Tigard, OR 97223 503 - 6394171
PARCEL: 1S134AD-06201
SITE ADDRESS: 10450 SW NIMBUS AVE RA ZONING: I -
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: Electrical TI, (7) branch circuits. Job No. 764
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: 6 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 SEPOWELL
PORTLAND, OR 97242
Phone: Contact #: FAX 503 - 233 - 8002
PM 503 - 563 -7215
FEES
Description Date Amount Reg #: ELE C23
[ELPRMT] ELC Permit 5/18/2006 $86.75 LIC 163254
[TAX] 8% State Surcharge 5/18/2006 $6.94 SUP 4389S
Total $93.69 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be donein accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for mor an 180 days. • TTEN • N: Oregon law requires you to follow rules adopted by the Oregon Utility Notificatio ' - ter. Those rules - - -
fort ' OAR 952 t • .ugh • r - 952 - 001 -0100. You may obtain copies of these rules or direct questions t. • at 503 -246 -6 • : • or
1- 0- 332 -2344.
I ued By: 1 / tit � Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
C • TOR IN ALLATION • 1 —
SIGNATURE OF SUPR. ELEC'N: WI" DATE: h /e/4(
LICENSE NO:
f�
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1
•
Electrical Permit Application FOR OFFICE tSI.00NLY
Received
City of Tigard Date/B . 5 / g p4 Permit No.: 2. .g$ 2
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' ■ = Phone: 503.639.4171 Fax: 503.598.1960 D . Other Permit:
TI G n It D Inspection Line: 503.639.4175 Date Ready/By. INIII El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
' TYPE OF WORK PLAN REVIEW
El New construction IL _ddition/alteration/replacement Please check all that apply:
❑ Demolition ` /❑ Other: ❑Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION 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
❑ 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.: 710 Cf Job site address: f0t/S p .§u./ IL Albv. ❑Heath care facility
fp ay ❑der.
Submit 2 sets of plans with any of the above.
City/State/ZIP: 1 x ,A 01 4 ° 7 -2.2.3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: R_ A- Project name: E FEE* SCHEDULE
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: I Lot no.: Ea. add'I 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
I ' ■ dwelling, service and/or feeder 90.90 2
O�1 &%;° t 27 / 1 �1/ C (Q � ve �c �ri4 i C. Services or feeders installation, alteration, and/or relocation
Gv6lCalk / f' ' ' A /sp��c, 4 200 amps or less 80.30 2
❑ PROPERTY OWNER " � I r ❑ 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
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 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 6.65 2
Business name: branch circuit
B. Fee for branch circuits Cont act name: without service or feeder fee; 46.85 4.pc 2 .
Address: first branch circuit _
Each add'I branch circuit 1 `0 6.65 47, 9a 2
City/ State/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
extension. Describe: Page 2 2
Business name: r T ��� / _ ` L
�X � Each additional inspection over allowable in any of the above
Address: J S S ��r..i p /� Per inspection 62.50
N City/ State/ZIP: T)_ t i 6_ r / 0,‹ e 7 7 2 Ye_ Investigation per hour (I hr min) 62.50
Industrial plant per hour 73.75
Phone: (F2 /) s 6 3 7z I Fax: 3) — 9 Z— -
1` ELECTRICAL PERMIT FEES*
,`� (� t,( CCB Lic.: 3 .25 Electrical Lic.: . __
�‘\ Suprv. rv. Lic.: y3�1 � Subtotal: 6c . Suprv. Electrician signature, required: � Plan review (25% of permit fee):
Print name: a at � State surcharge (8% of permit fee): tO • 9 T
/ TOTAL PERMIT FEE (�
Authorized signature �` // This permit application expires if a permit is not obtained within 140 •
d ays after it has been accepted as complete
Print name: I al ` , . 9 Date: /� �, Fee methodology set by Tri County Building Industry Service Board
•• '� •• Number of inspections per pernit allowed.
I :\ Building \Pennits\ELC- PumilApp.doc 03/23/06 •0.46I5TO I /05 /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*
❑ 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:\ Building\Pamits\ELC- PamitApp.doc 03/13/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006- 002132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5111312006
Phone: (503) 639 -4171 Alv „I li�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/19/2006 TIME: 7:05AM PAGE: 2
SITE ADDRESS: 10450 SW NIMBUS AVE RA CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: EII)
DESCRIPTION: Electrical TI, (7) branch circuits. Job No. 764
OWNER: ROBINSON, CONSTANCE N \_.tk(4500 PHONE #:
CONTRACTOR: FOX ELECTRIC COMPANY PHONE #: 503-563-7215
Inspection Request Scheduled For: Date: 6119/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 031927 -01 971 - 563-7215 Y
Corrections /Comments /Instructions: b 0
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ° J Date: t • 010 Phone #: (503) 718- 2�`�b-