Permit It
CITY OF TIGARD /� ELECTRICAL PERMIT
IIII `n CITY ®1 1 �0.7�/��®
PERMIT #: ELC2006 00641
COMMUNITY DEVELOPMENT DATE ISSUED: 11/9/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DA -02100
SITE ADDRESS: 06960 SW VARNS ST ZONING: C -P
SUBDIVISION: VARNS ACRES LOT : 003 JURISDICTION: TIG
Project Description: (5) branch ciruits, (1) low voltage for data /telecommunications.
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: 1
MANF HM/ SVC/ FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: I 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:
HEALTH RESOURCES, INC ALL PRO ELECTRIC INC
PO BOX 987 PO BOX 280
TUALATIN, OR 97062 6327C SW CAPITOL HWY
PORTLAND, OR 97239
Phone: Contact #: PRI 503- 246 -0361
FAX 503 - 246 -0406
FEES
Description Date Amount Reg #: ELE 26 - 1099C
[TAX] 8% State Surcharge 11/9/2006 $11.88 LIC 148108
[ELPRMT] ELC Permit 11/9/2006 $148.45 SUP 46305
Total $160.33 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.
Issued By: ' Permittee ignature: cij ,? , C' • r f-'
,` \
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.
Nov 09 06 09:46a All Pro Electric, Inc. 503 - 246 -0406 p.1
N
Electrical Permit Applica ra)i_ .: FOR OFFICE USE ONLY
r° City of Ti d r Received ---0 _ A . ./
III 13125 SW Hall Blvd., Tigard, OR 9722 (f 0 L1 2006 Plan Review '
0 Phone 503.639.4171 Fax. 503.598.1 6b Date
Bv: erPermit
llcAFttu
Inspection Line: 503.639 CIT� OFTIGARD Date Ju
/By: ' - ® See Page 2 for
Internet www.tigard- or.gov t DIVISION
Notified/Method: Supplemental Information
tiat TYPE OFRK PLAN REVIEW
❑ New construction ® Addition/alteration /replacement Please check all that apply (submit 2 sets of plans wiitans checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
CI - and 2 - family dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
g ® Commercialiindustrial ❑ Accessory building amps for all other installations buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Eire pump. ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency Addition o system. larger separately derived system.
❑ Addnionof new motor load af ❑ "A ", ")", "1- 2 ", °1 -3 ",
Job no.: 06 -3350 I Job site address: 6960 SW Varn St. I00BP or more. occupancy.
❑ Six or more residential units ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous !Deadens. 600 volts nominal.
Suite/bldg. /apt no.: Project name: Tri Star ['Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
_ Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: - i Ea add'! 500 sq. R. or portion 33.40 1
Limited energy, residential
75.00 2
DESCRIPTION OF WORK twill above sq. ft.)
Limited energy, multi- family 75 00 2
Install data /telecommunication, update lighting and electrical devices residential (with above sq. f )
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
Name: Tri Star Search 401 amps to 600 amps 160.60 i 2
601 amps to 1,000 amps 240.60 1 2
Address: 10300 SW Greenburg Rd., Suite 120 Over 1,000 amps or volts 454.65 i 2
City /State/ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)802.6000 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that T 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, per panel
Owner signature: Date: A. Fee for branch circuits trnh
Eg APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: All Pro Electric, Inc. B. Fee for branch circuits
I Contact name: Kevin Poole without service or feeder fee, 1 46 85 46.85 2
first branch circuit
i Address: PMB 280, 6327C SW Capitol Hwy Each add'I branch circuit 4 6.65 26.60 2
Miscellaneous Iservice or feeder not included)
I City/State/ZIP: Portland, OR 97239 Each manufactured or modular
90.90 2
dwelling, service and /or feeder
Phone: (503) 246 -0361 Fax: : (503) 246 Reconnect only 66.85 2
E -mail: allproelectric @comcastnet Pump or irrigation circle 53.40 , 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Descnbe: i Page 2 75 '� 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: 148108 I Electrical Lic.: 26 -1099c I Suprv. Lie.: 4630s Industrial plant per hour 73.75
ELEC'T'RICAL PERMIT FEES
Suprv. Electrician signature, required: � �� Subtotal: 148.45
Print name: Kevin E Poole [ Date: 11/07/06 Plan review (25% of permit fee): 0.00
State surcharge (8% of permit fee): 11.88
Authorized signature: ( TOTAL PERMIT Fhb: 16033
Print name: Sherri G Poole Date: 11/07/06 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per pemut_
1:1BulLicePermit tELC- PermdApp.doc 05,21/06 4404615F(Iiro5/C OM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006.00641
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639 -4171 . 144,W °
Inspection Requests (24 Hrs.): (503) 639 -4175 ,„ IL.
INSPECTION WORKSHEET FOR DATE: 8/21/2007 TIME: 7:00AM PAGE: 19
SITE " 06960 SW VARNS ST CLASS OF WORK:
SUBDIVISION: VARNS ACRES LOT #: 003 TYPE OF USE:
PROJECT NAME: TRI STAR
DESCRIPTION: (5) branch ciruits, (1) low voltage for data/telecommunications.
OWNER: HEALTH RESOURCES, INC, PHONE #:
CONTRACTOR: ALLPRO ELECTRIC INC PHONE #: 503- 246 -0361
Inspection Request Scheduled For: Date: 8/21 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054401 -01 503 -516 -7635 N
Corrections /Comments /Instructions:
® ? o,oV r o i. t `a<Z-V n.1 y (F`0& S ti b - P .
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Pmt- 6 5 -IthIL -e) . S S a` � 2 �1 13 ,
n PASS ❑ PARTIAL APPROVAL \ ❑ CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: �7 N v® i Date: *01 Phone #: (503) 718- 2446,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2036- 00641
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1.19/2006
Phone: (503) 639 - 4171 , 1,1
Inspection Requests (24 Hrs.): (503) 639 -4175 .t511111'
+r` '`'I �..
INSPECTION WORKSHEET FOR DATE: 12/4/2006 TIME: 7:03AM PAGE: 2
SITE ADDRESS: 06960 SW VARNS ST CLASS OF WORK:
SUBDIVISION: YARNS ACRES LOT #: p03 TYPE OF USE:
PROJECT NAME: TRI STAR
DESCRIPTION: (5) branch ciruits, (1) low voltage For dataltelecommunications.
OWNER: HEALTH RESOURCES, INC, PHONE #:
CONTRACTOR: ALL PRO ELECTRIC INC PHONE #: 503 - 216 - 0361
Inspection Request Scheduled For: Date: 12/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040608 -01 5035'16 -7635 N
Corrections /Comments/ Instructions:
11r�1 S ■h1 fi '(ZEta)vI fri3
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918- 271 -0030
• 23 r 0
•
•
•
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: W66 L i Date: I a,--4-at Phone #: (503) 718 - 1.-141417-
CITY OF TIGARD
BUILDING DIVISION. PERMIT #: ELC200G-00641
13125 SW Hall Blvd., Tigard, OR 97223 _ DATE ISSUED: 11/912006
Phone: (503) 639 -4171 Ayi�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/22/2007 TIME: 7:01AM PAGE: 12
SITE ADDRESS: 06960 SW YARNS ST CLASS OF WORK:
SUBDIVISION: VARNS ACRES LOT #: 003 TYPE OF USE:
PROJECT NAME: TRI STAR
DESCRIPTION: (5) branch ciruits, (1) low voltage for data/telecommunications.
OWNER: HEALTH RESOURCES, INC, PHONE #:
CONTRACTOR: ALL PRO ELECTRIC INC PHONE #: 503- 246 -0361
Inspection Request Scheduled For: Date: 8/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054478 -01 503- 516-7635 N
Corrections/Comments/Instructions:
•
" A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector • ; C s - -, - Date: lb Z c Phone #: (503) 718-