Permit a CITY OF TIGARD
II
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00064
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/7/2007
PARCEL: 2S103DD -01201
SITE ADDRESS: 13920 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT: JURISDICTION: TIG
PROJECT: GOODWILL INDUSTRIES
Project Description: Voice /Data & Phone /Paging.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: • CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 2
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 Reg #: ELE 26 -122C
LIC 44823
Description Date Amount SUP 3496S
[ELPRMT] ELR Permit 3/7/2007 $150.00
[TAX] 8% State Surcha 3/7/2007 $12.00 REQUIRED ITEMS AND REPORTS
Total $162.00
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: -- Afid9_,... Permittee Signature: J j '�
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.
__ 11:51 FAX 5036592824 STONER ELECTRIC [j002
Electrical Permit ARMED FoR oPF10 USK ONLY A
Fne - C c) 7 eft-. rem° itNo.: �V 7 -a (/ q . I l
•
City of Tigard nateE�• _ - V '
13125 SW Hall Blvd., Tigard, OR 9722_ 3 Plan Rel.
p 20 01 Other Permit:
Phone: 503.6.99.4171 Fax S03.598.1 81111 `' ream 8v
inspection Line: 503.639.4175 j N GD%VIS%Ot% A -- Dale Reach' Br hms el SeeFsge2 for
Line: 03.63 OF 7IG Notfied/Mhod -
OF WORK
• • PLAN RE'ClEvY
►! ' ew construction ❑ Addition /alteralion/replacememt Please check all that apply:
❑Sarvicc over 225 amps. camel ❑Hazardous location
• Demolition 1:10then Qscryice over 330 amps - Nntg ❑Building over 10.000 sq. fl.,
• ' C.ATECORY OF CONkTRPCTION , - of 1- and 2 -family dwellings .1 or mom new residential
❑ 1 - and 2 litmily dwelling ommercial/industria1 0 Accessory building T ❑system over 600 volts nominal units in one Mtuetme
QBuilding over three stories ❑Feeders, 400 amps or more
❑ Multi - family Master buil r- ❑ Other. ❑l)cxupant load over 99 persons ❑1,tanufacturcd struclurea or
• ' . JOB SITE 'INFORMATION,. AND LOCATION ClEgmoigNing plan RV park
Job no.'
_ ) ❑Pcallh�cArefacitiry ❑Criher.
6,0 9 �� J Jnh site address: /3 �a (�t/ //�' r .G —
. 1 19 Submit 2 Beta of ilitY with any of the above.
City/StateJZlp: t a b / / /A / The above are not applicable to temporary construction service.
FEE* SCflEDLTLE
Suite/bldg./apt no.: / Project mute: 4 • D t0 ' /l , i t ' Deseriptioa I Q,,. 1 lean I Total 1
Cross feel /directions to job site: New residential single- or molts- family dwelling unit.
- Includes attached garage.
• 1,000 sq. fl. or Less 145.15 4
Subdivision: 1 Lot no.: Ea, add"l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
fax map/parcel no.: Li encnn non- residential 75.00 2
• • DESCRIPTION OP RORI: Each manofacmred or modular
e dwelling. service and or feeder 90.90 2
V b s. / 0 f /0 a, Ql a,, Q/ ® )i d y t e �,f - / I/l� exy�s or _ -$ feeders alteration, and/or relocation
200 amps or l.- 80.30 2
^
201 amps to 400 amps 106.85 _ 2
-! . ' $O OR7VER I ❑ TENANT 401 amps to 600 asaps 16 2
Name: te / // 601 amps to 1.0110 amps 240.60 2
C' Over L000 amps or %wits 431.0,5
- .
2
Address: / 34a0
kecumtrctonh 66.85 2
City/State/LIP: Temporary services or feeders instatllarion. alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less - 66.85 1
Owner instillation: This in-4011010a is being made on propel' that 1 own which is not 401 amps to 400 amps 100.30 2
intended for sale, lease. renL ore chaw e. according to ORS 4.17. X14, 670_ and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date Branch circuits— new, alteration, or extension, per panel
• . ,' , . ❑ APPLICANT . . • L ❑ coNrAcT PERSON a. Pee for branch cinasna erin!,
service or feeder fee, each (,.GS 2 ,
Business name:' branch circuit
B. Fee for brooch circuits
Contact name.: without service or feeder fee, 46.85 2
Jinn brawl circuit
Address: _
Each addl branch circuit 6.65 2
City/State/Z1P Miscellaneous (service or feeder nut included)
- Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) sign or outline lighting 53.40 2
E -mail: • Signal circuit(e) or limited
: " • . CO NTI?L -tCTOR energy panoi, alteration. or R"."' �,� �D
• extension. Describes Page 2 1 v02
Business name: STONER )ELECTRIC _ 1
Each additional Inspection over allowable in any of the above
Address: 1904 SE OCHOCO
Per inspection _ 6150
City /State/ZiP :MILWAUKEE, OR Instigation per hoar II hr mm t 62.50
Phone: (503) 462-6500 I Roc (503) 659-4968 Industrial plant per hour 73.75 • _ ELECTRICAL PERMIT FEES* -
CCB Lic.: 44823 I Electrical Lie.: 26 -122C I Suprv. Lie.: 3 -196 Subtotal / y O 00
Sultry. Electrician s4 nature. required: m a ,�..��_ Plan review (250o of permit feel
1)aLe j0 7 State surcharge t8 °9 of permit fee) /a.0 D
Print moue: MICHAEL FALCONER -
Ir
TOTAL PERAO•i' Fes:
Authorized natre: Tins permit application expires do permit is ma obtained within 1811
- days ells it had been a =apled aS complete
hint name: f Date: • Fee methodology set by Tri.Coonty Beading Tedumy Service Board
**Number of inspections per pmeit allowed.
i :\BullainiPemimetc- PccnitApp.doo i2/03 44o.461sT(losrtico awe t
CITY OF TIGARD
i BUILDING DIVISION PERMIT #: ELR2007- 00064
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/20017
Phone: (503) 639 -4171 4 �°
Inspection Requests (24 Hrs.): (503) 639 -4175 �''�
INSPECTION WORKSHEET FOR DATE: 6/11/2007 TIME: 7:00AM PAGE: 42
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: Voice/Data & Phone/Paging.
OWNER: GOODWILL INDUSTRIES, PHONE #: 503 -238 -6190
CONTRACTOR: SI ONER ELECTRIC • PHONE #: 503-462-6500
Inspection Request Scheduled For: Date: 6/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 049953.01 503 - 806.1386 N
Corrections /Comments /Instructions:
N
4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `--' . Nita Date: b" A. - J Phone #: (503) 718 - 1-114
CITY OF TIGARD ;, .
BUILDING DIVISION PERMIT #: ELR2007 -00064
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2007
Phone: (503) 639 -4171 ill
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/17/2007 TIME: 7:00AM PAGE: 72
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: Voice/Data & Phone/Paging.
OWNER: GOODWILL INDUSTRIES, PHONE #: 503-238-6190
CONTRACTOR: STONER ELECTRIC PHONE #: 503-462 -6500
Inspection Request Scheduled For: Date: 511712007 Pour Time:
Code # Inspection Description # - s Contact # Message
135 Low voltage 048465 -01 503- 475 -3358 N
Corrections /Comments /Instructions: — -
RE MA i 6e' S 1 eS ( .
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr • 1 66 1-6 - Date: 5In l7) Phone #: (503) 718- 136
CITY OF TIGARD
.l. - I .
BUILDING DIVISION - PERMIT #: ELR2007 -00064
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/7/2007
Phone: (503) 639 -4171 t" 't
Inspection Requests (24 Hrs.): (503) 639 -4175 � I a.•
INSPECTION WORKSHEET FOR DATE: 5/15/2007 TIME: 7:00AM PAGE: 75
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: Voice/Data & Phone/Paging.
OWNER: GOODWILL INDUSTRIES. PHONE #: 503-238-6190
CONTRACTOR: STONER ELECTRIC PHONE #: 503.462 -6500
Inspection Request Scheduled For: Date: 5/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 048279-01 503 - 475.3358 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C.T 1`� Date: 't4,- 0 Phone #: (503) 718- 944