Permit CITY OF TI G w RD ELECTRICAL PERMIT
VH PERMIT #: ELC2006 -00612
DEVELOPMENT SERVICES • DA ISSUED: 10/26/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S136CC - 02100
SITE ADDRESS: 11744 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 200amp service, (4) branch circuits.
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: 1 W /SERVICE OR FEEDER: 4 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
WESTERN PCS CORP. OREGON ELECTRIC GROUP
75353 NE AMBASSADOR PL. 1010 SE 11TH AVE
PORTLAND, OR 97220 PORTLAND, OR 97214
Phone: 503 - 284 - 8714 Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit I0/26/200( $106.90 L[C 203
[TAX] 8% State Surcharge 10/26/200( $8.55 SUP 4460S
Total $115.45 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: �� c..�.�.L _ti Permittee Signature: 711.--
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.
I
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Electrical Yerm h l -.au>_� 0E1
City of Tigard oat C
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13125 SW Hall Blvd, Tigard, OR 9T 2 6 � 0 0(h(*� - t 1 Plan By / Other Paint
Phone: 503.639.4171 Fax: 503.59 W++ ' y ""
1 I 503,639.4175
Inspection Lin Dace Reusy /ey See pnka z for
e: _, __
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internee www.citiga d.or.us u.' .. L A U.):l . ,,.?*`t � _ - Notifieei/Merihod
'E OF' , : PLAN REVIEW
Please check all that apply:
El New construction ® Addidon/altcratioNr+eplaeement ❑Service ovcr 225 amps, cwmm'l ❑Hamrdous location
❑ Demolition ❑ Othcr. Oscrvice over 320 amps -rating ❑Buildng over 10,000sq. it,
• CATEGORY OF CONSTRUCTION . of 1- and 2- family dwellings 4 or more new residential
El System over 600 volts nominal units in one structure
❑ 1- and 2- family dwelling IN Commercial /industrial ❑ Accessory building ❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: _ ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE iNIORMATION AND LOCATION • • ❑Egr as/lighting plan RV park
11 ❑RmIth-earc facility ❑Other:
Job no.: 12236 pub k ite address: 1,1 } 51.1 'Po r Tt ile W 1� Submit 2 scts of plans with any of the above.
City / State/ZIP: C p a YCf OK ( 3/ 3 J The above are not applicable to temporary construction service. •
� t FEE* SCHEDULE Suite/bIdg./apt. no.: I Projes<:t name: e �,�fi �
ri ► 1 'r D1�JPrv- pet° 1 ow. Fee. I Tend
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. it or less 145.15 4
Subdivision: Lot no.:
Fa. add'l 500 sq. it or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parccl no.: _ Limited energy, non-residential
75.00 2
• DESCRIPTION OF WORK • . Each manufactured or modular
dwelling, service and/or feeder 90.90 2
ADD A PERMANENT SERVICE TO PERMIT ELC2006- 006O4 Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 go. SO : 2
• TENANT . 201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER L Q 401 amps to 600 amps 160.60 2
Name: CRICKET COMMUNICATIONS 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: 2
_ - _Reconnect only 66.85
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) L 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 a xchange, 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 , ❑ CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each - 1 6.65 •1,0u 2
Business name: branch circuit _
- B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: Each addi branch circuit 6.65 2
- City/ State/ZIP: miscellaneous (service or feeder not included)
pump or irrigation circle 53.40 2
_
Phone: ( ) I Fax: : ( ) _ Sign or outline lighting 53.40 2
E-mail: _ Signal catuit(s) or limited -
CONTRACTOR . . . energy panel, aftpation, or
extension Describe: Page 2 2
Business name: Oregon Electric Group
Address: 1010 SE 11th Ave Each additional Inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Portland, OR 97214 Investigation per hour (1 hr min) I 62.50
23
Phone: (503) 49900. L Fax: (503) 535-2763 industrial plant per hour 1 _ 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 203 ] Electrical Lie.: 26-95C I Suprv. Lie.: 4460S Subtotal 117 (I) . 4 0
Suprv. El ' • e • a e : - req ' • : M 0.l' 1A LI • 11 C pt - C Plan review (25% of permit fee)
/ /��� t�� =r te � Date: 10/26/06 6 State surcharge (8% of permit fce) ga . 5 D
Print name: f
TOTAL rEnivarr PEE I 1 5. 45
Authorized signatu This permit application expires If a permit is not obtained within 180
/ ` days after Ir has been accepted as complete
Print name: 'r.-W Date: 10/26/06 • Fee methodology set by Tri- County Building indusby Service Bo • •
•• dumber i nsp eot,ems permit al owed � , ,
iMill44maWeemit3113L • : . SApp.dne l+ 1 / `�4046llT(10/OLCOM/V/En •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00612
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/26/2006
Phone: (503) 639 -4171 4 ��
Inspection Requests (24 Hrs.): (503) 639 -4175 F :..
INSPECTION WORKSHEET FOR DATE: 10/30/2006 TIME: 7:05AM PAGE: 50
SITE ADDRESS: 11744 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTERN PCS MONOPOLE
DESCRIPTION: 200amp service, (4) branch circuits.
OWNER: WESTERN PCS CORP., PHONE #: 503-204 -8714
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503- 234 -9900
Inspection Request Scheduled For: Date: 10/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 =� • - ice 038993 -01 503 - 849-3291 Y
C. - ons /Co •• - structions: Gl'ItI4
•
❑ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
(PA)
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr'. N 6 Date: I 01 "MI G(0 Phone #: (503) 718- L
L