Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00257
i 2 DEVELOPMENT SERVICES DATE ISSUED: 5/11/2006
`�I �! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 110 D C -00300
SITE ADDRESS: 15700 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: WILLOW BROOK FARM LOT : 016 JURISDICTION: TIG
Project Description: Replace building lights for buildings A thru F, (13) branch 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: 12 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
• PRI (503)786 -4499
FEES
Description Date Amount Reg #: ELE 3 - 428C •
[ELPRMT] ELC Permit 5/11/2006 $126.65 LIC 85896
[TAX] 8% State Surcharge 5/11/2006 $10.13 SUP 4541 S
Total $136.78 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
suspend- • • mor- • an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules . - set forth in OA - 95 : • X 00 ! through OAR 952 - 001 -0100. You may obtain copies of these rules or • • - . • • - _fi s to OUNC at
503 ' 46 -6699 • 1 -800 -3 344
Iss ed By: J , f4!4 ! � � j Permittee Signature:)(
- 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 INSTALLAT • • c • ' /
SIGNATURE OF SUP . ELE " : DATE: S //- ("Z2_
NO:
LICENSE
• Call 503- 6394175 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.
Electrical Permit Application Folz OFFICE USE ONLY
City of Tigard Received No.: "6-e504,25-
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �d , mit
111 o .• • Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Perrot:
TI G n It D Inspection Line: 503.639.4175 Date Ready/By: NM El See Page 2 for
Internet: www.tigard- or.gov Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ldition/alteration/replacement Please check all that apply: . .
❑Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. it,
CATEGORY OF CONSTRUCTION of I - and 2- family dwellings. 4 or more new residential
❑ 1 - and 2- family dwelling emmercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure •
❑ Multi- family ❑Master builder El Other: ['Building Building over three stories Feeders, 400 amps or more .
❑Occupant load over 99 persons ❑Manufactured structures or •
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting RV park .
Job no.: Job site address: / 7 ��w ❑Health -care facility ❑der:
/ r Submit 2 sets of plans with any of the above:
f/,
City/State/ZIP: �/ t 55 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: ii — r1 I Proje r am _ FEE* SCHEDULE
Description I Qty. I Fee. I Total I ••
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: x S J !Z az. g 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 manufactured or modular .
--- -P dwelling, service and/or feeder 90.90 2
G .'4_ / A-37 L 1 r M Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps • 106.85 2 _
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
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, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with b
�� .. service or feeder fee, each G a
Business name: Li t - 1 r / r _ branch circuit / " 1 • 2
B. Fee for branch circuits �j
Contact name: // t `A 9t�e4] C without service or feeder fee, 46.85 y4' d u ' 2
�•� first branch circuit
Address: C �A L . .7 rt_B .J /€.— ‹::',e— 9 70 627
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (. E,15 _ 7 3 (- s�� Fax: : ( ) • Sign or outline lighting 53.40 2
E -mail: / Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
Business name: extension. Describe: • Page 2 2
•
i 1 I /
Address:
437/ — / P.--- � Each additional inspection over allowable in any of the above
Per inspection 62.50
City/Stat Investigation per hour (I hr min) 62.50
Phone: ( ) ■ Fax: ( ) Industrial plant per hour 73.75
J� _ ELECTRICAL PE FEES*
CCB Lic.: 63 �a�I(Iiectrical Lic.: 3 - 5a9 .Lic.: A---(//5 Subtotal: JA6. G
Suprv. Electrician signature, reqt1607 Plan review (25% of permit fee):
—
Print name: Date: State surcharge (8% of permit fee): /0. /e,
TOTAL PERMIT FEE ( f l g
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has bear accepted as complete •
• Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
• • Number of inspections per permit allowed.
I:\ Building \Permits\ELC- PcnnitApp.doc 03/23/06 4404615T(l I/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information •
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for a ll residential systems combined........ $75:00
•
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
El Garage Door Opener*
Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other. -
•
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system •
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ - Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
•
- El In
❑ Intercom and Paging Systems
•
El Landscape Irrigation Control*
El Medical
•
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations •
I:\ BuildingTemiib\ELC- PamitApp.doc 0323/06
CITY OF TIGARD
BUILDING DIVISION 1. #: ;: t; 00&.002 .I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: (i/ 11/2.0Ot
Phone: (503) 639 -4171
A $_,i�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,
INSPECTION WORKSHEET FOR DATE: 6/12/2006 TIME: '7:03AM PAGE: 17
SITE ADDRESS: 16700 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 016 TYPE OF USE:
F PROJECT NAME: .S} t11RGtRD
DESCRIPTION: Replace building lights for buitdiugs A thru F, (13) branch circuits.
OWNER: SSG PROPERTY HOLDINGS INC, PHONE #:
CONTRACTOR: P E3 ELECTRIC INC PHONE #: (603)7136.1499
Inspection Request Scheduled For: Date: 6/1212006 Pour Time:
• • • - Inspection Description Confirm # Contact # Message
Electrical final 029790 -01 603.93& -5226 Y
Corrections /Comments /Instructions: `i•1 \n (-->
)C
C \
NPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
✓ ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . ` Ae•(-6
Date: & 7 1 ' 2 j " 66 Phone #: (503) 718 -21