Permit i- ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2006 -00446
�� DEVELOPMENT SERVICES DATE ISSUED: 9/11/2006
�I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102CC - 00500
SITE ADDRESS: 13500 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: TIGARD MARKETPLACE LOT : JURISDICTION: TIG
Project Description: New service and create 2 new shells. Job No. 4617
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: 2 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: 3 EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: 0 PLAN REVIEW SECTION
1000+ amp /volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: X CLASS AREA/SPEC OCC:
Owner: Contractor:
13500 PACIFIC CORP HILLSBORO ELECTRIC
BY CAP ADVISORS 21185 NW EVERGREEN PKWY #110
38345 W TEN MILE RD, STE 170 HILLSBORO, OR 97124
FARMINGTON HILLS, MI 48335
Phone: Contact #: PRI 503- 439 -9666
FAX 503- 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -4399C
[ELPRMT] ELC Permit 9/11/2006 $642.40 LIC 134481
[ELPLCK] ELC Pln Rev 9/11/2006 $160.60 SUP 4941S
[TAX] 8% State Surcharge 9/11/2006 $19.39
REQUIRED ITEMS AND REPORTS
Total $822.39
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. /f
Issued By: 4k4' b2 0:f Permittee Signature: ./]X�. ('"at/
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.
Annrnvnd ninnc.7re.rarliirad nn ♦inn .. k ci.n +ha - 4ima Af each inspection.
Electrical Permit Application FOR OFFICE USE ONLY .
City of Tigard EMI R e«ived _ J � /'� ` [� l `J b 2 EG DatdBV:� g / l / 6.3 / - Permit No.: C6 (7 2(/U 1] a J . 0 131_5 SW Hall Blvd., Tiprd, OR 97 E. Plan Review / Phone: 503.639.4171 Fax: 503.598.1960 * ...1 1 1.1(11 1 B
Datev �� a� Other Permit:
Inspection Line: 503.639.4175 ( t Date Ready/By: r n twist el See Page 2 for
Internet: www.ci.tigard.or.us AuG 1 L- ` - Notified/Method: PAP/r , - 1 U Supplemental Informa
TYP ' Vs M ik3eir y / 4 . PLAN .REVIEW .
❑ New construction A d � a�tC�t y . Fdrt}p}, bidila • % • Please check all that apply:
WT ❑ Demolition ❑ • - � 111 . e rvice over _ -5 amps, comm'I ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
• CATEGORY OF CONSTRUCTION • - • of 1- and 2- family dwellings 4 or more new residential
❑ i- and 2- family dwelling (Commercial /industrial ❑ Accessory building DSystem over 600 volts nominal units in one structure
M builder ❑Building over three stories Weeders, 400 amps or more
Multi - famil
❑ Multi-family ❑ ❑ Other:
JOB SITE INFORMATION 'AND LOCATION
DOccupant load over 99 persons ❑RVnuf Lured structures or
DEgress/lighting plan park
r J� ❑Health care facility Other:
Job no.:�/� Job site address: �J36)0 rzte `-YI c /kV/ ry
Submit 2 sets of plans with any of the above.
City/ State/ZIP: - � D . 73, The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: �l 1 Project name: 77 , 4 G Meteket Plate FEE• SCHEDULE
Description I Qty. I Fee- I Tout I
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energ, non - residential 75.00 2
• . DESCRIPTION OF WORK:: -:: r =. ; ._ . .. Each manufactured or modular
(�/ , (s i - a ye _ ' 1 In ) (5 dwelling, service rs installation, feeder 90.90 2
�V .0 J (_ !.(.K pt , I 6d'ly�(�7 Services or feeders installation, alteration, and/or relocation
r 3r f (4.41Art f} 200 amps or less Z 1 80.30 'j 2 MAO
,. r ❑ PROPERTY OWNER . :::.:: °_ -- : . -
201 amps to amps 106.85 2
-
_ X01 400
_ . ❑ TENANT; -.
401 amps to 600 amps _3 1,\., 160.60 _ 2 q81 AO
Name: 601 amps to 1,000 amps 2 40.60 JiiQ 2 211046
Address: Over 1.000 amps or volts 454.65 2
Reconnect only 66.85 2
City / State/ZIP: Temporary services or feeders installation, altera tion, 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 amps 100.30 2
intended for sale, lease, rent, or exchange, 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, pe r panel
':. ?. .:_-:-::,•:•••••, . _ •.APPLI CANT;` .. .:' .?,:.:�::;' ❑ CONTACT PERSON s.... •
A. Fee for branch circuits with •
service or feeder fee, each
Business name: branch circuit 6.65
Contact name: B. Fee for branch circuits
withind service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
E -mail: Sigm or outline lighting 53.40 2
Sipal circuit(s) or limited -
::.'.
energy Panel, alteration, or
Business name: extension. Describe: Page 2 2 C
Hillsboro Electric L.L.C.
Address: 21185 NW Evergreen PKWY Ste #110 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/Z1 P: Hillsboro, OR. 97124 Investigation per hour (I hr mm) 62.50
Phone: (5 0 3) 439-9666 Fax: (5 0 3)601-3680 Industrial plant per hour 73.75
•." ELECTRICAL' PERMIT FEES *.` "':-: :•
CCB Lic.:13 4 4 81 Electrical Lic.:3 4- 4 9 9C uprv. Lic.: 49 41 S Subtotal . 41A, q6
1
Suprv. Electrician signature, required: ti� Plan review (25% of permit fee) 1 /6 t).. hod
a State surcharge (8% permit fee) name: Joey Vi tacco Date: v —1-0 to
b ) I • � �� 3 /
/
U TOTAL PERMIT FEE 3 °' , .2j9
Authorized signature: This permit application expires if a permit is not obtainkd within 180
days after it has been accepted as complete
Print name: I Date: • Fee methodology set by Tri - County Building Industry Service Board
•• Number of inspections per permit allowed.
is Wuilding \Pamits\ELC- PcrmitApp.doc 12/113 440.4615T(IiR)2/COMIWEB
CITY OF TIGARD K
BUILDING DIVISION PERMIT #: ELC2006 00446
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/21005;
Phone: (503) 639 -4171 A N y Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/21/2006 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 13500 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: TIGARD MARKETPLACE LOT #: TYPE OF USE:
PROJECT NAME: TIGARD MARKETPLACE
DESCRIPTION: New service and create 2 new spec spaces. Job No. 4617
OWNER: 135,00 PACIFIC CORP, PHONE #:
CONTRACTOR: HILLSBORO ELECTRIC Kg i ti, PHONE #: 503- 439 -9666
Inspection Request Scheduled For: Date: 11/21/2006 Pour Time:
Code # Inspection Description Con ' # Contact # Message
115 Electrical service 040116-01 971 - 219 -8708 Y
— t99 F;I`PAL -- .�
Corrections /Comments /Instructions:
1-b ED N PO
.. / . ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &. v N hQ l.sa Date: 11 ' 2 1 ' 0 Phone #: (503) 718- 2 -t its'