Permit , CITY OF TIGARD • ELECTRICAL PERMIT
PERMIT #: ELC2003 -00602
�460,1h DEVELOPMENT SERVICES DATE ISSUED: 9/26/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250
SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Walk in freezer evaporator coils: (1) 200amp service and (7) 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: 7 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:
TIGARD PROPERTIES INC . ELECTRICAL DIMENSIONS INC
2106 SE OCHOCO ST PO BOX 12146
MILWAUKIE; OR 97222 3961 N WILLAMS AVE ,
PORTLAND, OR 97212
Phone: Phone: 282 -7255
I - . Re #: LIC 44008
,-'' SUP 2964S
FEES ELE 26 -432C
Description Date Amount
R equired Inspections
[ELPRMT] ELC Permit 9/26/03 $126.85
[TAX] 8% State Tax 9/26/03 $10.15 Elect'I Service
Rough -in
Total $137.00 Elect'I Final
1
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
A ll 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- -'344. / _
Issued By: 4. L — ,. . r , L Permit Signature: c O £? 4 4 ."-yu
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:
1
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: L/ DATE:
o3 v — ' 7
LICENSE NO: 3c C
Call 639 -4175 by 7:00pm for an inspection the next business day .
•,
t
Electrical Permit App 'cation A
Date received: ° A Permit no.: L y .1',z2.--- ° .
A e11 1I . .4 1,1 1 1 il City of Tigard Project/appl. no.: Expire date:
. —
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR � 23 �� / Date issued: ' . Receipt no.:
Phone: (503) 639 -4171 C. i `
Fax: (503) 598-1960 �� � , 1� li
file no.: Payment type:
" <f Op
Land use approval: � � ` e
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory AeCommercial/industrial 4 ❑ Multi- family 0 Tenant improvement
❑ New construction 5 !"J • Addition/alteration/replacement ❑ Other. ❑ Partial
JOB SITE INFORMATION
Job address: 60 Ti6tAl2P FLAZb Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 'Block: 'Subdivision:
Project name: $4FE... 4.'/ - I Description and location of work on premises: trdl,lL IN re6E202. SvpagAze. CAI
Estimated date of completion/inspection:
- - -- - CONTRACTOR APPLICATION - - " - FEE SCHEDULE
Job no: 1 r A I /,a Fee Max
Business name: {�rI ( �1J 11�IG Descri Qty. (ea.) Total no. insp
I 13 / New residential - single or multifamily per
Address:' cia4 12t 4t dwefng twit. Indudes attached garage.
City: ' Tf jl7 I State:OQI ZIP: 97727 Service included
CCB n oj,�t 2 -�]2 s q. ft. or less 4
� I Fax: L 1 E-mail: ma:
Each additional 500 sq. ft or portion thereof __
CCB no.: 44 e I Elec. bus. lie. . no: 2.--&-- 4 4 32..G Limited energy, residential . _1111. 2
City /me 11C. n0.: 1 — 74- E a c h m nu energy,
ured homor non-residential ... 2
Each manufactured home or modular dwelling
Signature of supervising ectricran (required) Date/444a Service and/or feeder 2
Sup. name (print): �� ; Services or feeders — installation,
Su
P L � � _ License no: �4 _ alteration or relocation:
PROPERTY OWNER 200 amps or less :• • 6230 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: ZIP: • Over 1000 amps or volts 2
Phone: I Fax: E -mail: Reconnect only I
Owner installation: The installation is being made on property I own Tempor'a'l' sees or feeders - .
which is not intended for sale, lease, rent, or exchange according to installation, alieration,orrelocation.
200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2.
Owner's signature: Date: 401 to 600 ∎.s 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: - A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit & -412 46SZ 2 .
City: I Ste: • . I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 18a O Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories O Feeders. 400 omps or more *Description:
O Occupant load over 99 persons U Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other: Per inspection I I I 1
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ s �s
O Visa Cl MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been • State surcharge (8%) .... $ 10. od
Expires
accepted as comp TOTAL $ ? j 7. r -
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440-4615 (61001'COMM)
Electrical Permit Fees: Limited Energy Fees: r ,
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or 1 ❑
portion thereof $33.40 Burglar Alarm
Limited Energy $75.00
Each Manuf'd Home or Modular 2 Garage Door Opener'
Dwelling Service or Feeder $90.90
Services or Feeders 173 Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less I $80.30 p� 2
u/ El Vacuum Systems'
201 amps to 400 amps $106.85 _ 2
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Fee for each system $75.00
ti
Installation, alteration, or relocation $66.85 2 (SEE OAR 918 - 260 -260)
200 amps or less •
201 amps to 400 amps $100.30 2 Check Type of Work Involved:
401 amps to 600 amps $133.75 2 •
•
Over 600 amps to 1000 volts,
El Audio an Stereo Systems
see "b" above.
Branch Circuits • Boiler Controls
New, alteration or extension per panel Ei
a) The fee for branch circuits Clock Systems
A
with purchase of service or a • .• ,
feeder fee. / i {
/ t
Each branch circuit _ $6.65 /l 2 El Data Telecommunication i ` i c • •
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $ 46.8J HVAC
Each additional branch circuit $6.
•
Miscellaneous El Instrumentation •
(Service or feeder not included) $53.40
Each pump or inigation circle Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy ❑ Landscape Irrigation Control'
panel, alteration or extension . $75.00
Minor Labels (10) $125.00 •
Ei Medical
Each additional inspection over . •
• the allowable in any of the above ❑ Nurse:Calls.
Per inspection $62.50
Per hour $62.50 Outdoor Landscape Lighting'
In Plant $73.75 ❑
Fees:. n, El Protective Signaling
Enter total of above fees $ 1210.65 ❑ Other
8% State Surcharge $ (D IS Number of Systems
25% Plan Review Fee $ / • No licenses are required. Licenses are required for all other installations
See "Plan Review' section on
front of application.
13 � ob Fees:
Total Balance Due $ Enter total of above fees S
❑ Trust Account # 8% State Surcharge S
Total Balance Due
•
•
is dstsVomu\elc- fees.doc 10 /09/00
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (113).639 -4171 MST
BUP
Received Date Requested 1 AM PM BUP
Location 1 I 6 Patel ...sts Suite MEC
Contact Person Q 4, // Ph ( ) ag'a - PLM
Contractor Ph ( ) X a% SWR
BUILDING Tenant/Owner 3- 0 0 (p o_
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
Susp'd Ceiling ■
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
FAIL
C
S ervice
Rough -In
UG /Slab
Low Voltage
Fire Alarm
%B' 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•ART _ FAIL
Sift r] Please call for einspe on RE: , • Unable to inspect — no access
•
Fire Supply Line
ADA
Approach/Sidewalk Dat - i Inspector
Other:
Final DO NOT REMOVE this Inspection record fro the Job = a.
PASS PART FAIL