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ELECTRICAL PERMIT
CITY OF TIGARD
a COMMUNITY DEVELOPMENT PERMIT #: ELC2008 -00405
DATE ISSUED: 7/17/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136CD-01500
SITE ADDRESS: 11660 SW PACIFIC HWY ZONING: C - G -
SUBDIVISION: TIGARD BOWL LOT : JURISDICTION: TIG
PROJECT: TIGARD BOWL
Project Description: Installing (6) branch circuits. 8/26/2008 ADDED (1) low voltage system for ceiling monitor insallations.
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: _ SIGNAUPANEL: 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: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 5 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:
POWERS PEARL LLC A B ELECTRIC
11660 SW PACIFIC HWY PO BOX 805
TIGARD, OR 97223 BANKS, OR 97106 -0805
Phone: 503 - 639 -2001 Contact #: PRI 503 - 314 -7174
FAX 503 - 647 -2554
FEES
Description Date Amount Reg #: ELE 34 -35C
[ELPRMT] ELC Permit 7/17/2008 $80.10 LIC 00000955
[TAX] 12% State Surchar 7/17/2008 $9.61 SUP 28035
Total $89.71 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.
P �T mittee Si nature:
Issued By g ap� A'
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.
Electrical Permit Application � O FC l ll 01.1-IC I: 1 l O N L 1
City of Tigard R i"� 3 PermitNo.: ^ r
r I)ate/B " "" u ' 0‘105- 13125 SW Hall Blvd., Tigard, OR •
G Plan Review Other Permit:
: 0 . Phone: 503.639.4171 Fax: 503.5 • r �, + � � ®® I Date/By. :
e
TI i r l� Inspection Line: 503.639.4175 y ., Ready/By: t See Page 2 for
Internet: www.tigard -or.gov �� O ` , , ).. ad/Method: Pi , Supplemental Information
TYPE OF WOR ` A, PLAN REVIEW
❑ New construction ❑ Addition/alteratio ntt Please check all that apply (submit 2 sets of plans w /items checked below): Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ ❑ Other ® where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
les ground, other installations. 14,000 ❑ commercial - use agricultural 1 and 2 family dwelling ❑ Commercialindustrial ❑ Accessory building
amps for all other insmllations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: I Job site address: //(j� O 514 Aci l C /y N l Six or or more.
❑ uP y.
! y Sot or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: v6A� 0 ci 77-i-3 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: -77(V��1t / A kp / ' v (sew( S �( ❑ &M or feeder 600 amps or more.
FEE SCHEDULE
Cross strzxt/directions to job site: .� Denp�a
I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family
75.00 2
residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
I 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less t 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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, •- 46.85 2
first branch circuit Address: Each add'l branch circuit 6.65 ... , W .-- 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: , �j �G) C../ energy panel, alteration, or iii.
Address: 7 c 2. 1 p extension. Describe: Page 2 2
City/ State/ZIP: � 17/ Each additional inspection over allowable in any of the above
/'��� 1 Per inspection 62.50
Phone: (0 ) -",/it - 717y I Fax: ( '0 ) 17 rj5 y f � J Investigation per hour (t hr min) 62.50
CCB Lic.: / Electri.: • it `" Suprv. Lic.: p$a 5 Industrial plant per hour 73.75
T r required: ` /114�, ELECTRICAL PERMIT FEES
Suprv. Electra 1: a Subtotal: W 1
J
Print name: Date: Cl Plan review (25% of permit fee):
5 / 4: State surcharge (12% of permit fee): 1 e
Authorized signature: .--I r— TOTAL PERMIT FEE: 4 7 (
This permit application expires if a permit is not obtained within 180
Print name: CIAi � � S�i.orf��� Date: days after It has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00405
If 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/17/2008
Phone: (503) 639 -4171 ;' I( I
Inspection Requests (24 Hrs.): (503) 639 -4175 `
INSPECTION WORKSHEET FOR DATE: 9/12/2008 TIME: 7:00AM PAGE: 4
SITE ADDRESS: 11660 SW PACIFIC HWY CLASS OF WORK: I
SUBDIVISION: TIGARD BOWL LOT #: TYPE OF USE:
PROJECT NAME: TIGARD BOWL
DESCRIPTION: Installing (6) branch circuits. 8/26/2008 ADDED (1) low voltage system for ceiling monitor insallations.
OWNER: POWERS PEARL LLC, PHONE #: 503 - 639-2001
CONTRACTOR: A B ELECTRIC G,Rt PHONE #: 503 -314 -7174
I
Inspection Request Scheduled For: Date: 9/12/2008 Pour Time: '
Code # Inspection Description Confirm. # Contact # Message
195 Misc. inspection 075433 -01 ', 603- 314 -7174 N. Y
I q Fi g-'•
Corrections/Comments/Instructions:
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A 1
.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
Inspector: ' 1 V Ve Date: 9 [i Phone #: (503) 718- 11D