Permit CITY OF TIGARD ELECTRICAL PERMIT
<S, PERMIT #: ELC2006 -00155
/t DEVELOPMENT SERVICES DATE ISSUED: 2/24 /2006
ilt 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1 S134AD - 06200
SITE ADDRESS: 10565 SW NIMBUS AVE S ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: (4) new exterior building lights.
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 PERHOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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 + BROADWAY ELECTRIC - COCHRAN INC
ROBINSON, LYNN + BELL, KAY ET 626 SE MAIN
BY INSIGNIA COMMERCIAL GROUP PORTLAND, OR 97214
BEAVERTON, OR 97008
Phone: Contact #: FAX 503 - 238 - 2098
PRI 503 - 234 -6564
FEES
Description Date Amount Reg #: LIC 72942
[ELPRMT] ELC Permit 2/24/2006 $53.50 SUP 34475
[TAX] 8% State Surcharge 2/24/2006 $4.28 ELE 37 -546C
Total $57,78 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: _,421-1-
ij Permittee Signature: r -Q
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. •
_EYectrical Permit • �a l� ED A F(112 01:1 I ; F. ()NI.)
City of Tigard 2 0(16 _ ^'� y Permit No.: 1 • -- ‘7 0 Q Ai r
13125 SW Hall Blvd., Tigard, OR 97223�-EB 2 '"7.%.-.:. Plan Review Other Permit:
..
Phone: 503.639.4171 Fax: 503.598.1960 TIGARD j \ Date/By: Inspection Line: 503.639.4175 CVT' ,
OF e e _ '� I„ Date Ready/By: rwis: ® See Page 2 for
Internet: www.ci.tigard.or.us BUIL DING Dt'iI`' Notified/Method: I } ur Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- 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
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑Health -care facility ❑Other:.
Job no.: 140606 - 10278 Job site address: 10565 SW NIMBUS Submit 2 sets of plans with any of the above.
City /State/ZIP: TIGARD The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: SCROLLS BUSINESS CENTER
Description I Qty. I Fee. 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'I 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
INSTALL dwelling, service and/or feeder 90.90 2
NSTALL 4 NEW EXTERIOR BUILDING LIGHTS
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER l ❑ TENANT 201
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
Contact name: without service or feeder fee, I 46.85 j�� �rj 2
• first branch circuit
Address: Each add'I branch circuit / 6.65 (p . (p5 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax :: () 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: BROADWAY ELECTRIC
Each additional inspection over allowable in any of the above
Address: 626 SE MAIN -
Per inspection 62.50
City/State/ZIP: PORTLAND Investigation per hour (I hr min) 62.50
Phone: (503) 230 - 8209 I Fax: (503) 238 - 2098 Industrial plant per hour - 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 72942 I Electrical Lic.: 7 -546 Suprv. Lic.:3 -5 Subtotal 5'3,
Suprv. Electrician signature, required: \(_ Plan review (25% of permit fee)
State surcharge (8% of permit fee) `t _ 2g
Print name: `/ Date:
C��./���n �� 21-22210cP TOTAL PERMIT FEE , 7
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: I Date: • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
CITY OF TIGARD ?L
BUILDING DIVISION PERMIT #: oZ deb'- 00 / 67 -S -
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 41!
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1 S to S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - a- - D G Pour Time:
Code # Inspection Description Confirm # Contact # Message
q ci /e/ 5- 0...D_ - - 7 3 5
Corrections /Comments /Instructions:
Cc
.,
1•
• PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t\.7`•l..0 Date: al 1A(D Phone #: (503) 718 - 1 - 4'