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Permit CITY OF TIGARD COMMUNITY DEVELOPMENT ELECTRICAL PERMIT ° PERMIT #: ELC2007 -00103 D ATE ISSUED: 2/16/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 103 D D -01201 SITE ADDRESS: 13920 SW PACIFIC HWY ZONING: C -G SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT: JURISDICTION: TIG PROJECT: GOODWILL INDUSTRIES Project Description: Temp service. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: ta 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: 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: GOODWILL INDUSTRIES STONER ELECTRIC 1943 SE 6TH AVE 1904 SE OCHOCO STREET PORTLAND, OR 97221 MILWAUKIE, OR 97222 Phone: 503 - 238 -6190 Contact #: FAX 503 - 659 -2824 pRI 503- 462 -6500 FEES Description Date Amount Reg #: ELE 26 -I22C [ELPRMT] ELC Permit 2/16/2007 $66.85 LIC 44823 [TAX] 8% State Surcharge 2/16/2007 $5.35 SUP 34965 Total $72.20 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: 160 ,�� Permittee Signature: _S.F --P _ A \cic 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. 02/16/2007 10:33 FAX 0 001 • Electrical Permit A p l � � ` — ro R o v i R T I sr, U \ I.1 City of Tigard � 1 Q0 13 6 r:, ° is Permit No. i 125 S W Hall Blvd., Tigard, OR 97223 ` r 8 _ / / r Phone: 503.639.4171 Fax: 503.598.1960 `` `; a = ' . _ /' - -r �) I - : Data Reedy/By. rmia. °lerPermit Inspection Line: 503.639.4175 — 1111.- : ® See Paget for Internee www.ci.tigard.or.us O ' '(i(U e Q ,� • - _ _.. Notified/Method: Supplemental Information TYP. New construction 0 Addition/alteration/replacement Please check all that apply: ❑ Demolition Other. ❑Service over 225 amps, comm'l ❑Hazardona location ... • t:rvrce over 320 amps rating ❑ Buildng over 10,000 sq. R, CATEGORY,: OP ` CONSTRUCTION Y, : :: of 1- and 2 -famil dwe • Y dwellings 4 or more new residential ❑ 1- and 2- family dwelling 4 Skt ommercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure Building over three stories ['Feeders, 400 amps or more ❑ Multi- family ❑ Master builder ❑ Other true •:::.;:.:.::',:•::: _.. .: *booboos or :.. :JOB;SITE > L OCATIO1V ::: :::.:: ;':': > :: ::::`:: pool load over 99 persons trfactured . _ ... ❑Et��8h�8 plan RV park Job no.: 1 Job site address: 4k,„5„64,0), facility ❑ /392, $ C]xeau ocher: CitylState/Zl Submit I. sets of plans with any of the above. I & �¢-�• ! t The above are not applicable to temporary construction service. Suite/bldg./apt. no.: � Projectname: ;:: NEE':SCHEI)UL•E• f : :::: ::::: Bb�t.& ! L - ( . Desetplb 1 Qtr I Fee I .. 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'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 :: DESCRIPTION OF:: WORK : :; :: : :.' -.:`.: :. :; :: :; :: :. : :: :: Each manu orniodular 51'C- dwelling, service and/or feeder • 90.90 2 Services or feeders Installation, alteration, and /or relocation • 200 amps or less 80.30 2 ❑:PROPERTY.: OWNER`:. ,: : :.. L,, ::..:'.:. ,`,,::: -:0.: TENANT 201 snips 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 Reconnect only 66.85 2 Temporary services or feeders installation, alteration, and /or Phone: ( ) I Fax: ( ) relocation 200 amps or less / 66.85 44.$5 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 Owner signature: Branch circuits amps alteration, 2 : :' :::.: -:. Date: cs -- non, or extension, per panel : . :.: :: .: : _ . : :0 :APPLICANT.: .;: : : :.,:.: ., CO A Feefor branch circuits with • ❑ : . NTACT : :::: :` ; :: service or feeder fee, each Business name: branch circuit 6.65 2 Contact name: B. Fee for branch circuits without service or feeder fee, 46.85 2 Address: first branch circuit Each addl 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 t Sign or outline lighting 53.40 2 Signal ' ::. : : .::::::::: : .�ONTRAC'COR;:ii::.. :::...;.:: :_'.,::::::r:. : .. ::.�: : ::... circuit(s) or :: energy panel, aeration, or Business name: STONER ELECTRIC extension. Deacnbo: Page 2 2 Address: 1904 SE OCHOCO Each additional inspection over allowable in any of the above Per inspection 62.50 - City/State/ZIP: MILWAUKIE, OR Investigation per hour (1 hr min) 62.50 Phone: (503) 462-6500 I Fax (503) 659 -4968 Industrial ply per hour 73.75 : ELECTRICAL :PERMIT.:FEES " :::: :: :.::' :: .': CCB Lic.: 44823 I Electrical Lic.: 26 -122C Suprv. Lic.: 3496 subtotal M. is Suprv. Electrician signature, re q uired: lylK.l+a./ 2,2...,,,..,„.„,,. Plan review (25% of permit fee) 19— Print name: MICHAEL FALCONER Date: Z,//&,/,-7 State surcharge (8%of permit fiee) 6 -.-3y, 5 -- TOTAL PERMIT FEE `i� ^ 4 Authorized signature: � This permit application aspires ifs permit is not obtained within 180 Print name: days after It has been accepted as complete I Date: • Fee methodology sat by Tri County Building Industry Service Board **Number of inspections per permit allowed. i•• 1 Huildhsg 'ritAEI.C- remiitApp.doc 12/e3 44061 S'IYIM07lCObt/YV® CITY OF TIGARD • BUILDING DIVISION AT : PERMIT #: ELC2007-00103 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/2007 Phone: (503) 639 -4171 Z Inspection Requests (24 Hrs.): (503) 639 -4175 '`:_.. INSPECTION WORKSHEET FOR DATE: 3/2/7A07 TIME: 7 :00AM PAGE: 64 SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE: PROJECT NAME: GOODWILL INDUSTRIES r DESCRIPTION: Temp service. 2/22/07, ADDING ADDITIONAL TEMP SERVICE FOR JOB TRAILER. JOB NO. 53281C OWNER: GOODWILL INDUSTRI S., PHONEY: 503-238-6190 CONTRACTOR: STONER ELECTRIC Q - `t . PHONE #: 503 - 462 -6500 1u `v r r ! nspection Request Scheduled For: Date: 3/212007 Pour Time: ., Crr�e # Inspection Description rm_# Contact # Message ' 11t, Temporary electrical service 044224 -0I \ 503-804 -6572 Y Corrections /Comments /Instructions: . \a ' Q /71) 1 ■ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ ' ' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G .NtQ LE Date: 1 'V on Phone #: (503) 718 - L --Li`ki