Permit CITY i O r TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 - 00203
COMMUNITY DEVELOPMENT DATE ISSUED: 4/8/2008
'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AB-00300
SITE ADDRESS: 16083 SW UPPER BOONES FERRY RD ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT : JURISDICTION: TIG
PROJECT: FANNO CREEK PLACE
Project Description: Building B. Installing (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:
OPUS NORTHWEST BERGELECTRIC CORP
1500 SW FIRST AVE STE 1100 6026 NE 112TH AVE
PORTLAND, OR 97201 PORTLAND, OR 97220
Phone: Contact #: PRI 503 - 255 - 1818
FAX 503 - 255 -1919
FEES
Description Date Amount Reg #: ELE 37 -682C
[ELPRMT] ELC Permit 4/8/2008 $53.50 LIC 110521
[TAX] 12% State Surchar 4/8/2008 $6.42 SUP 512IS
Total $59.92 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 503 246 6699 or 1 800 332.2344
` Perm Signature:
Issued By: I � _ i � 9
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.
PPR -08 -2008 07:50 From: 5032556633 To : 5035981960 P.2'3
. : ` Electrical Permit Appiic:�� tiL �! FOR oFFicFUSF (ENI. `
City Of Tigard Receives
ant No..
Date/13 . �i. 6� x �Lt!, $ - c419vZ
IN .......• 13125 SW Ball Blvd , Tigard, OR 972l3p R 8 2008 Plan Review
Phone 503 639.4171 Fax' 503 598.1960 Date/B . Other Permit
T I GA A D Inspection Line. 503.639 4175 T IG AFID D;Ua Re tdyrliy- furls. 10 See Page 2 for
Internet: www tigarel- or.gov CITY O Nolilied /MellinII Supplemental Inform atiue
a •
t rv (llrinw,.. r.��rK'r�+F1' W4F�i.. k �T!�' 7%' i lKlt �f y�',i1 � il" 1 +, f 'v.m !r :, y , nr{t i• y Y �l , / 7 � v r '�
✓, r• ;., �r '+rtie1i11111 'i�.e :1�t �. �,v, � It1. + ,+�':11�'�F±"1"'� 4y �2 4 ,. , e_,y, aG. , 3. rr,.•. fir. x1��;
t x H d v � / r i1 ., 1 ' t7 I iC . 4 .+ '� t : 1 ✓ �' k.� •!. n : !
Please check all that apply (submit j sets of iv/items checked below)
❑ New construction '4 Addition /alteration/replacement
El Service .0
Service or feeder 40llp nl error° ❑ Building over three stories
❑ Demolition CI Other;
F where the available fault current ❑ Marinas and boatyards.
1 jtRy'r
xe 7 e F, 4','411/4L% 1.. nnnrrrrrr�t ,b ra N ,''' ,U .}t #+'
1 • r $ ,i , + / (� p p A t , y7[0�����,!� r t y j f t 1 ■ azxerb 10.000 mum at 150 volts or ❑ Floating buildings.
» . • 1_ • rot• 6.�a1►.t , 161..8 ..1.I .,, r n.. L less to ground, ore eeeds 14,000 ❑ Commereiol -use ogrccultunl
❑ I- and 2- family dwelling P: Comntercipl /industrial ❑ Accessory building amps for all other installations buiidin(ys.
❑ Multi- family ■ Master builder ❑ Other: ❑ t ire pump. ❑ installation of 75 KVA or
� N' I t t r ti �+' s 1� , .. Emer ens system larger separately derived m.
,, a �'r � , � �y t•-r< �i�� 7c;,rr r : r ro a 4"d y� "C�^•'t-+t-'+ aFy�m�� g Y Y� 8 � Y �
;;+'rn r b r+ k VIMM i :ti1e�!� f ('!i' M F f x . k{ k r v.r 1 :1 tF� t3.3',IE4; Addi
n . °:Seer wra9l.w:rc:i>w.i: ❑ two uf new nation load of ❑ "A" - P" °)- 2 ",''1 -3"
Job no.: + co Job site address: Nom s i 1 npelo .,.. • 4 ormolu. occupancy
"'Tf - 1 _, more rcstdential units.
ID Recteatinnal vehicle parrs.
City /State/ZIP: �I/y , oR Q - 7 � ' Health-care facilities ❑ Supply voltage for more than
� . = l h 1:1 Hazardous locations. 600 volts nominaL
Suite:/bldg. /apt. no.. 1 Project name: 7 f [.f 1 n O t _ Q ❑ Service or feeder 600 nmvs or morn
REMEIMMEIMa
Cross streetMirections to job site. Desolation Qtr. Fee. Tatar -
New residential single- or multi- family dwelling unit.
B (1.1 t ( 6 Includes attached garage.
Subdivision: I Lot no.: 1 ,000 sq. R. or less 145.15 4
1 ?a. add'I SW sq. tt. or portion 33.40 1
Tux map /parcel no.: 1 Limited energy, residential
+ rr 3y. 1e �t'I 1 $� ri ax,x t.:ilvt rer 1 S7 w,r�f t Fii.x
1 iv�t�1�E �t +r..'a*� is U gilt St, r, iS� 1� r�i. 3' r x.1 51 , (�y inv r i with above a • . ft.
7500 2
1 Limited energy, multi - family
'4/ / Cz J _ residential (with shove se. 1L) 75.00 2
Services or feeders Installation alteration, and/or relocation
�� ,,y''�, 200 amps or lees 80.30 2
1'; ra�� :.Q A "' , f':,Ir�iy t `f �K. rJ 1 rrrw,t�nl' r •c '�.7 a , ^r
/ac ., a.l k; „,d,; rkw " , !� a5.w.., ' u,,,F +,w 1 ' _ _ .: eA r' .et �atg ir. ,k 201 amps to 400 amp
mps ( l><i.85 Z
Nat": (1/t0 North �"/ l / 401 amps to 600 amps 160.60 2
I / ' �_ 601 amps to 1,000 amps 240.60 2
Address: i - S / // - A / , , Over I ,000 amps or volts 454.65 2
City/State/ZIP: /3 6 1 U g lo Temporary services or feeders installation, alteration, and/or
f relocation
Phone: ( ) Fax: ( ) 200 amps or Icss 1 66 85 I 1
Owner installation: 'This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 1 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 75 2
Owner signature: clone: Date: Branch Circuits- new, alteration or extension, per panel
p A_ Fee for branch circuits wait n ' 5 ,'...any t Y ♦F7 4 �'" + } q,� =fIN`, E ti ' ,W. , 11 � b
,.,,',,i aoveservICcor f
e.l:ul .{i � �1$IHI�I IMx e4tiu�i�lw� 4 I� d7vtJlnf Afr. fjlrl 4 Jlutiilm .tn �+ }' t r 1 ■ C 1
�1.� -��' r�' ,�,rlh�xr�t a ,.,m 6.65 2
each branch circuit _
Business name: Bergelectric Corp, 13. Fee forbears h circuits
Contact name: ! � x(,5
without service or feeder fee, ` 46.85 2
first branch circuit
Address: 6026 NE 112th Ave Each add'l branch circuit 1 6.65 t.0 . (05 2
Miscellaneous (service or feeder not included)
City /State/ZIP' Portland OR 97220 Each manufactured or modular
dwelling, service and /or feeder 90'90 2
Phone: (503) 255 -1818 Fax:: (503) 255 -1919
Reconnect only 66.85 2
5-mail; _ �t Pump or irrigation circle 53.40 2
Si 1IL,.. +4C;a � Ell ".w•�rilEi �`F:il �w { ,M 1 7.1t r at r . ,5 +.t, d l,rs.r xt ,�':.,.f�. �aY•+y{ 9 � , v
x t v , y { , �.;) Sig o r outline lighting 5340 2
Business name: Bergclectric Corp. Signal circuits) or limited
energy panel, alteration, or
Address: 6026 NE 112th Ave extension. Describe' Page 2 2
City/State/ZIP: Portland OR 97220 Each additional inspection over a llowablc in any of the above
Phonc: (503) 255 -1818 Fax: (503) 255 -1914 Per inspection 62.50
Investigation per 1loUr (l hr min) 62.50
CCB Lie.: 110521 Electrical Lie.: 37 -682C Suprv. Lie.: 51215 Industrial plant per hour 73.75
Suprv- Electrician signature, , required EM }'" fit' ��` .'I` IRi
Subtotal: .3 , ,
Print name: Jeremy Richmond r Date: Plan review (25% of permit fee):
J,ir�� `J'����i�� State surcharge (12 %ofptmut foe). 42 _ Authorized signature: �(( �
TOTAL PERMIT FEE: q, 9
Print name: , A// Date; This permit appq soon expires if a permit is out obtained within 120
' t b I $111, days after N has been accepted as complete.
taD 7di°gd',;r„aas1Q.C-Pam�tpvD.do 05/23106 • Number of inxpecteuns allowed per permit
44046 yr °ims,WM/wen
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008- 0f)203
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/8/2008
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs.): (503) 639 - 4175
INSPECTION WORKSHEET FOR DATE: 9/155/2008 TIME: 7:00AM PAGE: 20
SITE ADDRESS: 16083 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: FANNO CREEK PLACE
DESCRIPTION: Building B. Installing (2) branch circuits.
OWNER: OPUS NORTHWEST, PHONE #:
CONTRACTOR: BERGELECTRIC CORP PHONE #: 503-255-1818
Inspection Request Scheduled For: Date: 9/1512008 Pour Time:
Code # Inspection Description ' • - ' m Contact # Message
199 Electrical final 075463 -01 503849.8478 N
Corrections /Comments /Instructions:
1 p. n N\ /
\ UJrV
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gr �/ bV- Date: 4 1II6 Phone #: (503) 718- 1.y Y%