Permit CITY OF TIGARD . p ELECTRICAL PERMIT
ERMIT #: ELC2003 -00090
'rift DEVELOPMENT SERVICES DATE ISSUED: 2/26/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1S136AD-05800
SITE ADDRESS: 11465 SW PACIFIC HWY
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install sensors to existing tank monitor, (5) branch circuits and (1) limited energy.
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: 1
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: 0 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 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:
EQUILON ENTERPRISES LLC NORTHWEST PUMP + EQUIPMENT
PO BOX 4453 2800 NW 31ST
HOUSTON, TX 77221 PORTLAND, OR 97210
Phone: Phone: 227 - 7867
Reg #: ELE 26 - 852C
LIC 64567
FEES SUP 4884S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/24/03 $102.85
[ELPLCK] ELC Pin Rev 2/24/03 $25.71 Rough -in
[TAX] 8% State Tax 2/24/03 $8.25 Elect'I Final
(additional fees not listed here)
Total $197.44
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 otifi tion 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 clues I ons t. OUNC at (50 , c6699 or
1 -800- 332 -2344. C `ice
��
Issued By: / / Permit Signature: Ah.
w
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: eS4/5
Call 639 -4175 by 7:00pm for an inspection the next business day
• To Pr c - ,.5 -° 3
Electrical Per Application I FOR OFFICE 11SL ONLY
Reoerd Electrical
Da te/B . k o'�!J Q� Permit No.: C.ee,I,00 3- og 9
City of Tigard Planning Ap- -van Sign —
13125 SW Hall Blvd. Date/l3 Permit No.:
Tigard, Oregon, 97223 Plan Date/B : Review, 7 Z other
� O Zi P ermit No.:
Phone: 503 - 639 - 4171 Fax: 503. 598 - 1960 Post - 1ievi Land Use
G4. ea,G
Internet: www.ci.tigard onus "';r'+:: jl oateB : case No.:
24 -hour Inspection Request: 503 639 - 4175 ` c Contact
page 2 for
• Nar»elMetnod: ' /�(,;; . 15app)ementnl Information.
.i::; ?::•', ..,;' .:i' '.."1; 'OF444 nl ,111'...';Y a,.�• ., :• , i ..,
The above arc not applicable any of the above.
: ' fT INRO '4
• New construction • ■ Demolition • Service over 225 amps- i e a I th care acili t " ( ,,.; ;.; :
• Addition/alteration/re • lacement commercial ��ka[tlt -care facility
• Other: 0 Building location
�`, i s '! ;�:: ? ,:; ':i ;;y: � r � ; / fin 6 N; ❑ Service over 320 amps - rating of 0 Buildin over 10,
1 • : i' Olaf•:•; i ' ::,•"'':,:•,'•' l & 2 family dwell': ig,s four or more residential feet,
■ 1 & 2- Family dwelling osidential units in
? ; � Commercial/Industrial 0 over 600 vr, its nominal one structure ❑ Building over three stories
� • AcceSS • Buildin I• Multi-Famil Feeders
amll ❑ Occupant load over 99 rsons ❑ a0 amps or more
U Master Builder 111 Other: p Egress/lightin plat ❑ Other: rfacUued structures or RV park
�,; ,.'; :':.; .; r. :•:I ?,:3.0 I�' T m ,' . 6: A - 6 u; °' : B P ❑ Other:
' Job site address: �•'� ' :` • � �'•`''t- S ubmit sets of plans wills
[� //�(� 7 , T b a able W temporary
#: 1—I L.O w r j• i N : ' .4.. ' .. l b ,. .nu•N ,, ap t / ablet r construction service.
Suite H ,
Y .. ..i.•..... u.. ., ':' r�LAy.f w�Nlryl ell,{ o S!•!111'n 11 .., ; ��L•_ 9 : .r q. •r -
Bldg./Apt.#:
.'.; .�,,.,., ,�:., c... ",''t :i. ::., ,
Project Name: i� g Number of inspections per permit allowed
ltiG 1l O x) Description Qty Fec (ea.) Total T
Cross street/Directions to job site: New residential-single ur utulti family per
dwelling unit. Includes I dumbed garage.
Service Included:
•
1000 sq. ft. or less 145.15 4
Each additional 500 sq, PI or portion thereof 33.40 1
Subdivision: Lot Al:
Loaned energy, residenuld 75.00 • 2
Limited energy, non resicl :ntial 75.00 2
Tax ma ./ • arcel #:
.k ,iw'. a' Each manufactured ed home or modular dwelling
.1 "t':4!:aiv ';t�lt"c '. ii. :,.i:i,U1!:3sa I:a'.' service and/orfe eder
90.90 2
NMI Services or feeders - lino illation, •
♦ - alteration or relocation: •
•EQ,anJ 148 N i 4 CI( 200 amps or less 2
201 amps w 400 amps 106.85 2
,! 401 amps to 600 amps ------ 160.60 2
iNI y 1 .. r : ';�!`,1:..: it l l l;! li e . r.j 1,,! ;, , i, i !;;'�,,t, ` +;., -. i 601 amps to 100o amps
2
Name: 1000 amps or volts 454.65 2
Reconnect only 1 66•85 2
Address: Temporary services or renders - installation,
City/State/Zip: alteration, or relocation:
200 amps or less 66.85 1
Phone: Fax: 201 amps to 400 amps 100.30 2
i; , d , : 3 401 to 600 amps - 133.75 2
_ . : .0 i" 4. ° j "•` = Branch circuits - new, alteration, or
Name: extension per panel:
Address: A. Fee for bunch circuits ,:ith purchase of
service or feeder fee, et. :h branch circuit 6.65 2
Ci /State /Zi • : B. Fee for branch circuits without purchase of
Phone: I Fax: service or feeder foe Cirri branch circuit 1 46.85 ys L 2
Each additional branch circuit LJ 6.65 n�K4€1.4.0 2
E Misc.(Sorvi
.T , �. ,; ce or feeder no': included); C: :;',...:J..jaa J� igt;.'�.:L,Wiiii' :14 -' 'I 1. .e1`3 : "4a, ` . p }1:l i Eachpp
„ ;''I`i;'.i l'i';' i • I'.: t :+ 53.40 2
Job No: Each sign um ur outl li�htin i 53.40 2
-
Signal circuit(s) or a limito:l energy panel,
Business Name: i . i r I alteration, or extension � , 1
Page 2 7 2
Address: "• " i _ 2 Description: ii Y. M L7� I -
�1 � _ /. Each a In
p dditional ins ectien over the allowable an of the above:
a �s y I'J� � 10 Per inspection per hour (mjit. 1 hour) 62.50
Pht : . _ _ -7•- v , ,I Fax R93 tiBa
!kV, hivestiun
CCB Lic. #: ic. #: C.
�
ervisin e1 . :.;;•!'; ;:' .. ii ..': l ° , ,,,, , a, g:y.k ,�.g, r > ,;
Sup g e ctrician r wy,. �I:I 1e 'cailipljlnaatflt ',: , '' �.�:.N�s; ;
..'I::
sit.. afore re. uired: ./11� ,11 �f±t* % _ Subto
�� ■��,� + a Plan Review (25% of Permit free) $ $ .11
t1.�7>171CT-n1'" :1 =r i'a
` k7 State SurcL:arge (8% of Permit Fee) S / 1 ,
oTAL PERMIT FEE S 1
Authorized ," Notice: This permit n upllention expires if a permit is not obtaine thin
Si , - y ; �`_ / Dat - ti) 180 days after it has bleu accepted as complete.
t •IFeo methodology set. by Tri•Countjy Building Industry Service Board.
1tt T O - aLh
(Please print name)
i : Forms\ElePermitApp.doc 01/03
TO/TO 39dd DIb10313 1101d tEZ8L96It'S SZ :80 E00Z /0Z /Z0
IG ARD 24 -Hour
Inspection Line: (503) 639 -4175
DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested �-s AM PM BUP
Location '/(D Suite MEC
Contact Person - �� -✓Lp — Ph ( ) d S- a ( 8R PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC - D de) ` v
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
R Ceiling
C Y Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alar
ASS ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
`
d
r
Approach/Sidewalk D /� _ -' Inspector / - - Ext
Other:
Final DO NOT REMOVE this inspection record tem the site.
PASS PART FAIL