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Permit ` CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00617 .- DEVELOPMENT SERVICES DATE ISSUED: 8/23/2005 � ° 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: (2) 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: 1 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: SHURGARD STORAGE CENTERS INC P B ELECTRIC INC 21669 REDWOOD RD 1108 SE DOGWOOD LN CASTRO VALLEY, CA 94546 OAK GROVE, OR 97267 Phone: 510 - 733 -5600 Phone: (503)786 -4499 FEES Reg #: LIC 85896 Description Date Amount SUP 4541S ELE 3 -428C [ELPRMT] ELC Permit 8/23/2005 $53.50 [TAX] 8% State Surcharge 8/23/2005 $4.28 REQUIRED ITEMS AND REPORTS Total $57,78 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: ."p, ,-jq 51 Permittee Signature: ..t 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. u Electrical Permit Appll � 1 Ill` ()l l It 1. . 1 'i: o i • t Received / City of Tigard '� E v nare� : _ q 4.. Permit No.. s pQ 13125 SW Hall Blvd., Tigard. OR 97223 A nt , arimn■ Plan Review Othet Permit: M. o;, Phone: 503.639.4171 Fax: 503.598.1960 2 2 i° D ° : Inspection Line: 503.639.4175 1U t -r i � � Date Ready/ay: )u�: 1a Sae Page 2 fin- Internet: www.ci.ligafd.or,us 13adfied/Mcthod: Q1TY OF .l( SopPlemenwl Information 1 #4"D PLAN REVIEW [] New construction *Addition/alteratio re :. r ent . Please check all that apply: ❑Servicr over 225 amps. cumm'I ['Hazardous location ❑ Demolition 0 Other: _ []Service over 320 amps - rating ❑tluildng over 10.000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential 600 volts nominal units in ono structure ❑ I- and 2- family dwelling ,`�Comme'rcial /industrial ❑ Accessory building OSystcm over Q Faders. 400 amps or more ❑Building over three slorie5 ❑ Multi- fancily 0 Master builder ❑ Other: ❑occupant load over 99 persons ❑Manufucturcd structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Ith care fa cility Other: • Job no.: I Job site address: r rj c) s Lti [ k' emit 2 sets of plans with any of the above. • tY Ci /State/ZIP. Ir} rt , 7 — Z The ab ove arc not applicable to temporary construction service. FEE* SCHEDULE Suits/bldg. /apt. no.: ( Project name: stale I Qiy, I vee. J r°wl ( " Cross street/directions to job site: 1'1 W ,. 9- e , ,;_,. ( v . * New residential single- or multi- family dwelling unit. Includes attached garage. + 1,000 sq. A. or less 145.15 4 Subdivision: I Len no.: Pa. add'I 500 sq. ft or portion 33A0 1 _ Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non- residential 75.00 2 DESCRIPTION OF WORK l;aeh manufactured or modular dwelling, service and/or feeder 90.90 - 2 _ Services or feeders installation, alteration, and/or relocation 200 amps or leas 80.30 2 TENANT 201 amps to 400 amps 106.85 2 ❑ PROPERTY OWNER _401 amps to 600 amps 160.60 2 Name: Li >2./E C 4 ,4-7r.> S—T.Z ,L. _ 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 reloca 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, per panel pPLICANT ❑ CONT PER SON A. Fcc for branch circuits with service or feeder fee, each f 6.65 W' ' 6 ' Cr- 2 Business name: ra E c_ C'T ;,Q , ! / tom branch circuit B. Fee for branch circuits / ( Contact name: 7 ' 1 €� C W lee �- without service or feeder fee. / 46.85 I an ` M / c _ / 7 � 2 each branch circuit Address: o rev ©L" ► �\ Each add'I branch circuit _ 6.65 2 City /State/ZIP: ) id 7 , t e -• p)e 7 77 (.7 Miscellaneous (service or feeder not included) ' ( y► 1� (- Pump or irrigation circle 53 2 Phone: c5 C z e „ - S z . J ' Fa : (5 ) 75 Co Co ne Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - energy panel, alteration, or CONTRACTOR RACTOR extension. Describe: Page 2 2 Business name: S bbs r'. -_ - Each additional inspection over a in any of the above Address: _ Per inspection 62.50 , I, City /State/ZIP: Investigation per hour (l hr min) 62.50 Q Phone: p er; ( Industrial plant per hour _ 73.75 - ( ) I _ ELECTRICAL PERMIT FEES* 1 0 CCB Lie.: ( I Electrical Lie.: _ c./Z$d Suprv. Lic.: '// 5 Subtotal f � 3,5--0 S Electrician signature, required: e� Plan review (25% of permit fee) r a I State surcharge f8% ofof peril fee)fex) �' Z , rint name: / �./ 1 I '� j /CSC (7 �C _Date: �__ _� TOTAL PERMIT FEE S i 76; Authorized signattl Er,...) _ This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri -Coup Building Industry Service ward Number of inspections per psi allowed. imuiidIneermn.\ELC -PO App.dec 12/03 440 -461 ST(lW02/COMM'F9 Z00 2] 500999LCO5 XVd 8C :5T 5002/ZZ/90 CITY OF TIGARD - BUILDING DIVISION PERMIT #: ELC2005 -00617 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2005 Phone: (503) 63. 4171 a , �li'l Inspection Request - .4 Hrs.): (503) 639 -4175 _ ` L. INSPECTION WORKSHEET c DATE: 9/12/2005 TIME: 7:04AM PAGE: 39 SITE ADDRESS: 15700 SW PAC ` ,C HWY CLASS OF WORK: SUBDIVISION: WILLOW BROOK RM LOT #: 016 TYPE OF USE: PROJECT NAME: SHURGARD DESCRIPTION: (2) branch circuits. OWNER: SHURGARD STORAGE C= TERS INC, PHONE #: 510 - 7335600 CONTRACTOR: P B ELECTRIC INC PHONE #: (503)786_4499 Inspection Request Scheduled For: I 'le: 9112/2005 Pour Time: Code # Inspection Description Con', # Contact # Message 199 Electrical final 01540 - 503-936-5226 N 1) Corrections /Comments /Instructions: . Q—\ ) -- L . 9P 55 );)_. \ LI' \ N 3 (-sto)ch) Py466 • s - 2,3 — irikL/43 phwy PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ' (✓ Inspector: l )Z � Date: - lJ Phone #: (503) 718 -