Permit ri.
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00021
°. COMMUNITY DEVELOPMENT
DATE ISSUED: 1/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AB-00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 300 ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT : JURISDICTION: TIG
PROJECT: PROFESSIONAL LIABILITY FUND
Project Description: (7) 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: 6 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:
OPUS NORTHWEST LLC BERGELECTRIC CORP
1500 SW FIRST AVE SUITE 1100 6026 NE 112TH AVE
PORTLAND, OR 97201 PORTLAND, OR 97220
Phone: 503 - 916 -8963 Contact #: PRI 503 - 255 -1818
FAX 503 - 255 -1919
FEES
Description Date Amount Reg #: ELE 37 -682C
IELPRMTI ELC Permit 1/10/2008 $86.75 LIC 1 10521
[TAX] 12% State Surchar 1/10/2008 $10.41 SUP 5121 S
Total $97.16 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 46.6699 or 1.800.332.2344.
Issued By: Permittee Signature: A • / , . -
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.
L E 1 v L., . 1
Electrical Permit Ap a Ion , FOR OFFICE USE ONLY
• 11, City of Tigard ',r",s ! 0 20 08 Received Permit N. •
. ° 13125 SW Hall Blvd. 'Tigard OR 97223 Plan R / GO p ; r op . — r
�Ig Plan Revie•
Phone 503 6394E !a, swot S 126tiiJA -� Date/B . Other Permit
TIGARD
Inspection Linc: 5 . 9.7 Date Ready /By IMI ® See Page 2 for
Internet: ww t r • .:19 NG DIVISION V Notified/Method Supplemental Information
• ' • ^ TYPErOFAWORK'.;;5- ' •F >> ,, •t PLAN:REVIEW, - ,•r ,
slew construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w/items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current
❑ Mannas and boatyards
`CATEGORY OF.CONSTRUCTION ' ' • - . '' , ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ['Fire pump. ❑ Installation of 75 KVA or
JOB' SITE INFORMATION',_AND LOCATION. ❑ Emergency system. larger separately derived system
- ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: (03D0 Job site address:/60 p {� R d 100HPormore occupancy
l U .{Jt19h051 Qri/�/ ❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: i �� t7r72 / ❑ Health-care facilities 0 Supply voltage for more than
✓ ❑Hazardous locations 600 volts nominal
.
Suite /bldg. /apt. no. Project name: -- 0.14.. �• L ❑ Service or feeder 600 amps or more.
410 ir« I .�A 1 CYO , _ " Y. t 'EE •SCHEDULE • .'_ • % Cross street/directions to job site: oe °o I Qty. I Fee. I Total I •
w residential single- or multi- family dwelling unit.
ludes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Ea. add'I 500 sq. ft or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential
• DESCRH'TION: OF :' WORK;.; (with above sq ft) 75.00 2
Limited energy, multi - family 75 00 2
residential (with above sq. ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
' - 0 PROPERTY jO,WNER -;; ; ,' : ;' -, }' E0 ,TENANT ' ' , 201 amps 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: Temporary services or feeders installation, alteration, and/or
relocation
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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
" B APPLICANT ' i . i above service or feeder fee, 6.65 2
' - `'' ' '` ❑''CONTACT • P E RS O N
each branch circuit
Business name: gergelectric Corp. B. Fee for branch circuits
Contact name: • ('.,t�/I without service or feeder fee, / 46 85 y6.8 2
/1'Lt V'e_ first branch circuit
Address: 6026 NE 1 1 2 th Ave.
Each add'I branch circuit if 6.65 �9, 9 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 97220 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) 503 - 255 -1818 Fax: : ( ) 503- 255 -1919 Reconnect only 66.85 2
E -mail: pia/ay/v.1 t,
.t Qbcarlso(.O��ri (16 Pump or irrigation circle 53.40 2
" - ` ,, `!'. • { .. - '...CONTRACTOR i r ;:*;,,',4,''
,, ', . , , : ' . _ Sign or outline lighting 53 40 2
Business name: Signal circuit(s) or limited -
Bergelectric Corp. energy panel, alteration, or
Address: extension. Describe: Page 2 2
6026 NE 112th Ave..
City /State /ZIP: Portland, OR 97220 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) 503-25 1 Fax: ( ) 503-255-1919 Investigation per hour (I hr min) 62.50
CCB Lie.: 1 1 0521 Electrical Lic.: 37_682ry I [c.. 2/5 Industrial plant per hour 73.75
ELECTRICAL PirRM1T „FEES ' t
Suprv. Electrician signature, required: , 7x” Subtotal: 86•'75
Print name:t;J\Il Date: / -
d - 68 lg.. 1b State surcharge.(8Kof permit fee): 20 L./
Authorized signature: TOTAL PERMIT FEE. 53
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it'has been accepted as complete. t v ' /�
• Number of inspections allowed per permit
I \ Building \Permits\ELC- PermitApp doe 0523/06 440-461 5T( I I /05 /COM/WEB
j 1 -
f CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008- 00021
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1110/2000
Phone: (503) 639 -4171 p
Inspection Requests (24 Hrs.): (503) 639 -4175 ° _
INSPECTION WORKSHEET FOR DATE: 9/15/2008 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 300 CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: PROFESSIONAL LIABILITY FUND
DESCRIPTION: (7) branch circuits.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503 -916 -8963
CONTRACTOR: BERGELECTRIC CORP PHONE #: 503
Inspection Request Scheduled For: Date: 9/15/2008 Pour Time:
Code # Inspection Description - Confirm # Contact # Message
199 Electrical final 075454 -01 503.849 -8478 N
•
Corrections /Comments /Instructions:
P LL " la .GtfitiN (L. ems.
tAa l dt ► c' & bo 5're..
N,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cj'1 Nik, 13 LE" Date: I I& 1 Phone #: (503) 718 - ViLit