Permit `"••
~ CITY OF TIGARD. ELECTRICAL PERMIT
PERMIT #: ELC2007 -00285
COMMUNITY DEVELOPMENT DATE ISSUED: 4/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AC -01704
SITE ADDRESS: 12720 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: LABORTORIES
Project Description: 2 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: 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: 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:
SPRINGER, JERRY C WILLAMETTE ELECTRIC INC
7400 SW FAIRWAY DR PO BOX 230547
WILSONVILLE, OR 97070 TIGARD, OR 97281
Phone: Contact #: PRI 503 624 - 3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 4/27/2007 $53.50 LIC 75059
[TAX] 8% State Surcharge 4/27/2007 $4.28 SUP 1965S
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: � Permittee Signature: 711 e ,rp
OWNER INSTALLATION ONLY c___7
,. ,
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.
APR 6 2007 7:14AM WILLAMETTE ELECTRIC INC. 5555555555 p.2
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I`IJ,ne: 5u3.039.4:71 l in.. 503..: APR 2 , . A. , .."- , • Ualc•I I, it, v, O
: 9 Ihcr Permit:
InspectionI -iue: 503.6. . --„ ���
{ � �. },t. ialeftra;tyfliy. h, y/r Bi Sec Page 2 for
Internet: www.ci.tigard.or.us CITY 0 • .`•.; r • Notlflediivictlod: f supplemental Informlatio
tym . INC O. •
O New cons:) uction Kg Addition /altcrationlreplacement Please check all that apply:
• Demolition D Other:
1.3 Service over 225 amps, conun'l 0Hazardous location
_ - - 1= ]Service over 320 amps - rating ❑Buildng ova 10,0110 sq. IL.
Citiliii r' it. , gtittirlet c':• - of 1- ant. 2-family dwellings 4 or more new residential
0 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
builder ❑ Other:
y I ❑Occ load t over 99 persons ❑Manu faewd structur o
• Multi-family ❑ Master bui]
- r3'- s S1or' -, 't: ii ... 3.•4'1 •- H.F o" - 'ii `.-4 r'='-•r >: ark
.i RV
-'. -. r �'iS ... W : ; ❑ Egress/lighting p l an P
Job no.: 9, . J Job site address: t - - --
/ � fiG t r , -
• d G r .,. ❑ Health-care facility ❑ Other: Submit 2 sets of plans with any of the above.
City / State/ZIP: Th above temporary construction service.
ove are not applicable e to i,4-7-,-!......;......:- y
(:. . - .� �.�' tT.t*. �.]'<Y '1,wrS.2y�.F i ;r 1 Project name: 0 q. °. a,p 7 r .'i l' 7i � at t_ ...1 : 1 : - •
Suite/bldg. /apt. no.: . .
' L. 10,,r) AtI°'OP� Deso•IDtlon Qty. Fee. Total
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: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40
• Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non - residential 75.00 2
. - Tj' _ d _ Y:rx'� :i L'{ : ' s G AT `r.•1�: 1:Rt 41 ` .-t �-!}}� . ' iii ce =`+ Each manufactured or modular •
-. K L . .,ti .. i
y � dwelling, service and/or feeder 90.90 2
ipo'i €a , '! t �'d+t Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
;l.•, t(;: " g a _• , w� , (' d = � - J. - - -. ry a : r I •Sear �r , �I . . , ; x< 2U1 amps to 400 el rt. I06.85 2 • •r ' - mow. rf ' ° - ; ,L, - `� 401 amps to 600 amps I 160.60 • 2
Name: 601 amps to 1,000 amps i 240.60 2
Address: Over 1,000 amps or volts .. I . 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 alms 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 4.49, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
s:•;itrt ,,, o •t , ` {` ;, -'�` U , yt �� , t.+'Eti?r 1 . =, • a ;;vk A. Fee for branch circuits with
( r :1° ..; t' k ?ix , r" F` �r '.��' . - u l ,r 'r---- - _'..iut'.dw 7�' ,.,_ , service or feeder fee. each
6.65 2
Business name: branch circuit
B. Fee for branch circuits 5‘.
Contact name: without service or feeder fee, 1 46.85 2
first branch circuit _
Address: Each acd'I branch circuit / 6.65 14r2
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 circuit(s) or Iimited
,
• - - :. ' ,:r. panel, alteration, or
_ _ �:;;.r,t > :.- fi +.:? s'• ` !@ is 1 1- G "' --. _ ; ,' .,4-t!.; _ - Describe: Page 2
fir `S�'. '..... _.+ �Ri :. . �_. -:x ^i �� u f °'
energy
- -• extens scri e: Pa e 2
Business name: (,J,' 11 �a,"s elf e L / et. !'s' =.. I-A c
Address: P U 6 4) 23 0 -CV) • Each additional Inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: To 9 0, 41 a t'' 7 Z ? I Investigation per hour (1 lir inn) 62.50 , P
Phone
593 ) 61.1-. A ti .11 FaX ( J , ) 6 2 `w - T 7 j ? Industrial plant per hour r 73.75 '
3 ,. •
CCB Lic.: '�y �•�` `I Electrical Lic.: 3 -ZS d: Suprv. Lic.: Z Z 6 , . , S . - Subtotal - ,-Al
• ' - "" flan review(25 %ot•permitfee)
Suprv. Electrician signature, requireds' �'_ � _.... .. • �•--- '•-- ^" " " "�'
( State surcharge (8% of permit fee)
Print name: ! r`,.... .:;; f'- Date: - - y
°' TOTAL PERMI FEE
Authorized signature: This permit application expires if a permit is out obtained within 180
- -- _ - -- - - - -- - - -- -- days alter It hit been accepted as complete
Print name: Date: • Fec methodology set by Tii- Cowity Huilding Industry Service Roa
•• Nuirber of inspcctitms per permit allowed. �1 iAl3uildinaN PcrmilC•nl. C -I'at nitA pp clot. 12/43 aaD_aFlSr la/02'C )M /WCs
!'iiS'
r1.7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00285
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/27/2007
Phone: (503) 639 -4171 ��
Inspection Requests (24 Hrs.): (503) 639 -4175 I
INSPECTION WORKSHEET FOR DATE: 514 /2007 TIME: 7:00AM PAGE: 30
.
SITE ADDRESS: 17720 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LABORTORIES
DESCRIPTION: 2 circuits.
OWNER: SPRINGER, JERRY C, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-6243631
Inspection Request Scheduled For: Date: 5/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 047649-01 503- 624 -3631 N
Corrections /Comments /Instructions:
XII
PASS ❑ PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • N 0 V L t Date: D• t ' on Phone #: (503) 718- 2 +t{10