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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00970 �, DEVELOPMENT SERVICES DATE ISSUED: 12/20/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110DC -00300 SITE ADDRESS: 15700 SW PACIFIC HWY ZONING: C -G SUBDIVISION: WILLOW BROOK FARM LOT : 016 JURISDICTION: TIG Project Description: Temporary service. Temporary service. 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: 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: SSC PROPERTY HOLDINGS INC P B ELECTRIC INC BY SHURGARD OF KING CITY/TIGAR 1108 SE DOGWOOD LN ATTN:38004 OAK GROVE, OR 97267 SEATTLE, WA 98109 Phone: Contact #: FAX 503 - 786 -6005 PM (503)786 -4499 FEES Description Date Amount Reg #: LIC 85896 [ELPRMT] ELC Permit 12/20/200' $66.85 SUP 4541S [TAX] 8% State Surcharge 12/20/200' $5.35 ELE 3 -428C Total $72.20 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations co ntained 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 Ore.. n 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 direct questions to OUNC at 503 - 246 -6699 or 1- 0-33 -2344. • Issued By: Permittee Signature: .#.v 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. ! - , Awn: 15. bark, i Electrical Permit Application 1.01< 01 II' I.' City of Tigard RtC IV Fitly.=.20 ti; 616 p.iiNo.- __ 0 A - 0097V 009 7 13 25 SW Hall Blvd., Tigard, OR 97223 Pbul Revirth Ph. . 503.639.4171 Fax: 503.598.1960 . . •' . % •J i D. : • Millialli Other Paean: • 1.- -.".. Lino: 503439.4173 ! 1- -. Ds" ' '' 211.1.111111115:1511 See Page 3 for . .-, - • www.ci.tigard.or.us ,......... Supplanaibil blf61102111011 AM ffileffirrAMDDi : k , ::.: : 1 i ' -.' ';';:::-. .H:i '" ::' . - ' . H New construction 0 Adak, - ,- , . - Please - check all that apply: Demolition i'..I Other: . 1 7 ',ph ■ It , 0 • ['Service over 225 amps, cotrun't ['Hazardous location ■ . _ .. . I ['Service ova 320 amps - rating OFivild110 ever 10 sq. ft. P ".. t:°*'''.3:!':-Orri-i:'::::-:;',.::::',?::\; or 1- and 2-family dwellings 4 or more new residential ft- and 2 dwelling NI Commercial/in . :-,, "al 0 Accessory building °System over 600 volts nominal unitS in one structure 0Building ova time stories [Weeders, 400 amps or more Muld-ftmlly 0 Master builder Ci Other: I:Occupant load over 99 persons OMentdecnticd struclurm cr {..: DEVenillellinli Plan RV park J04 no.: f Job site address: 1 s-700 11 p„ 14 I °Healthare facility DOther Submit 2, scts of pbms with any attic above. Cify/State/ZIP: T otar d og_ 9 i _ 4, I The shove are not applicable to temporazy construction service. , P .. ...i..v ..,.14FE4*•:'SCREDV.10: .:::.) S • tr./bldg./apt. no.: 4 Project mune: " ., ' ,• ,, . itq 0- ' ...+ poserpuss Qtr. Fee. Tana w " CrUss street/directions to job site: ' New residential single- or muld-famlly dwdling unit. Includes attached garage. 1,000 sq. ft. or L u 11= 145.15 KII s .. ivigion: •Lot n.: Ea. add'I 500 sq. ft. or ponion IIM 33.40 lell Limited energy, residential Mill 75.00 EMI Li :. map/parcel no.: Limited energy, mzn-residmtial EN 75.00 ES §13:,:::"...:::>:: EMINIKEICIMBillii Each manufactured or modular NM 111 i i p. MMIIIIIIIIIMIIIIM ) • , , 4 glin111111 dwell' . : service and/or feeder ■ 90.90 M Services or feeders Installation, alteration, and/or relocation 200 amps or less Mill 1 06 8 0 0 El : .;; :i; . 'i ;,:10.:filopijitheitozidienj,., 'ff.; ::.....:: .:i'; li.:.....-:.. 0 ... ......- :;...:,,,, • ,..," 2 ° 1 win to 4 ° 0 omPs II 401 amps to 600 amps NE 160.60 Name: 601 amps to 1,000 amps Ile 240.60 IMP A4dress: Over mp 1,000 as or volts 454.65 2 Ciy/Stste/ZIP: i Temporstry or I Installa ' 66 , al: don, andior • relocation o'htes1=Will 66.85 Malin . , er installation: This installaiion is being rnado . n property that 1 own which i5 TI 201 amps 4 to 00 amps IIM 100.30 I 111 in. . ed for sale, lease, rent, or exchange, according.. ORS 447 449 670, and 701. 401 amps to 600 amps Mil 133.75 1E1 o .er signature: Date: Branch circuits - new, alteration, or <Stanton, per panel :''. !.;:;? Mil .3._ 22 *oottopojiistisy.:.!ff,i, 1:M k Fee fbr branch circuits with g ..mt savicc or feeder lee. each 6.65 2 B , iness name: II branch circuit - B. Fee for branch circuits C4ntact name: ?hA p ? leg 4 without service or feeder leo. 46.85 2 A4dress: ISE each branch circuit Each add'I branch circuit 6.65 2 Cty/State/ZJP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 11 1 10 ne: (50) ' , - 2.2. (0 Fax: : ( ) I Sign or outline lighting 53.40 2 E4nail: MIIIIIMILIII. Signal circuit(s) or limited- . :.•.:, Y '' . 6 ; ' VIVIV;:? : ;?■0 CY:! T ';', 1 4 .': ::::; .. !'. 7 . i ''..` . . 4 Niii CilagY P and. altaatitm (I Sainess name: E - 'kr i c _fll.IIIIIIMMIII extension. Describe; Page 2 2 Address: 110% SE. - .1) ronA i ' 1 Each additional i , ,. ."011 111111 over allowable in any of the above Per inspection 62.50 ° Oa- (rose OK ' 7 .2-L7 investigation per hour 0 hr min = 62.50 i Pl ( 5°5 ) ( 131) - 5 2,24 / , J Fax: 1 5°2 7g 6 400 5 htdustrial plant per hour 1111. 73.75 . 11 4B LW.: cg 521 G. ! Electrical Lb.: 3- il. f eit I Suprv. Lic.: 0 -1-5 1 +1 Subtotal (sip .15 S4prv. Electrician signature, required: 1 _ Plan review (25% of peanut fee) .. -4411 State surcharge (8% of permit fcc) 5 , 5 PAntname: Phi i • : - - ,&. ) C -66 ' Authorized signature: Milli TOTAL PERMIT FEE , 2-0 This permit application expires Ira penult is not obtained within ISO days attar it has been accepted as complete POt name: 9)-4 s..) 1 6601W Date: 12,.. 2,0_ p • Fm methodology tel by Tri-Counw Building Indurary Savice Board •• Number di:median Der ommit allowed. TOOQN S00998LC0 S XV.4 82:17T S002/0/T CITY OF TIGARD A _ BUILDING DIVISION PERMIT #: ELC2006-00970 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2005 Phone: (503) 639 -4171 Ij�l Inspection Requests (24 Hrs.): (503) 639 -4175 "__ INSPECTION WORKSHEET FOR DATE: 12/21/2005 TIME: 7:01AM PAGE: 1E SITE ADDRESS: 15700 PACIFIC HWY CLASS OF WORK: SUBDIVISION: WILLOW : 00K FARM LOT #: 016 TYPE OF USE: PROJECT NAME: SHURGAR► 'STORAGE DESCRIPTION: Temporary so ' e. Temporary service. OWNER: SSC PROPERTY )LDINGS INC, PHONE #: CONTRACTOR: P B ELECTRIC INC PHONE #: (503)786 -4499 Inspection Request Scheduled For: Date: 12/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 0' 858 -01 503-936 -5226 N Corrections/Comments/Instructions: likie Te 5 - t, 1 :6 Nap itizAW E gae„i 6F- p ©k V 6 O ? P � � '.'LPASS iii PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: , v w Li Date: 1 211-1 ' 0 Phone #: (503) 718- 6P Z194, re: CITY OF TIGARD Ai . BUILDING DIVISION PERMIT #: ELC2005-00970 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2005 Phone: (503) 639 -4171 �;; j�l Inspection Requests (24 Hrs.): (503) 639 -4175 IL. I INSPECTION WORKSHEET FOR DATE: 12/21/2005 TIME: 7:01AM ___.--- - PAGE: 61 SITE ADDRESS: 15700 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 016 TYPE OF USE: PROJECT NAME: SHURGARD STORAGE DESCRIPTION: Temporary service. Temporary service. . OWNER: SSC PROPERTY HOLDINGS INC, PHONE #: CONTRACTOR: P B ELECTRIC INC PHONE #: (503)786 -4499 Inspection Request Scheduled For: Date: 12/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 110 1 emporary electrical service 02383501 503.936.5226 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G+ t IV cA "Er Date: Y2 0 Phone #: (503) 718- X44