Permit •
T -,) CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007-00255
•
COMMUNITY DEVELOPMENT
DATE ISSUED: 4/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AB-00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD ZONING: I -
SUBDIVISION: FANNO CREEK PLACE LOT : JURISDICTION: TIG
PROJECT: FANNO CREEK PLACE
Project Description: Temporary power.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
OPUS NORTHWEST LLC BERGELECTRIC CORP
1500 SW FIRST AVE. STE. 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
[ELPRMT] ELC Permit 4/19/2007 $66.85 LIC 110521
[TAX] 8% State Surcharge 4/19/2007 $5.35 SUP 5121 S
Total $72.20 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: ,/ x y 1 / // Permittee Signature: 362_, piO/r i
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.
Jecti cal Permit A "' ' iVEL FOR OFFICE USE ONLY •
__ _
City of Tigard Received
Re Re eiv : Permit No : ELL_2009 . -002S5 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
A P 1 3 � � � I Date/B
Phone: 503.639.4171 Fax: 503.598 1960 3 2001 d A Other Permit
Inspection Line. 503.639.4175 --11 - 64 1' Date ReadyBy: tuns el See Page 2 for
I www.ci.tigard.or.us (/IT 1 v 01- I l( - - Notified/Method: Supplemental Information
.. Y ^ ' " ' PE F° `'bRIC 18 1�� . .Fre_ :• -3 "Y , r a > - ' ;PLAN REVIE. - '''' - • !"
K New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
, , �" 2 , CATEGORY .,OF,',CONSTRUCTIOI;._ ,'i' {;r -,• ' ; •0 of I- and 2- family dwellings 4 or more new residential •
❑ I- and 2- family dwelling C ommercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family 0 Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
• li. : - •' !:''' i JOB, SITE, INFORMATION. AND ',LOCATION " . _ - _ _ ❑Egress/lighting plan RV park
Job no.: 6O Job /03 T /� Job site address: ■ Health -care facility ❑Other
• - �� Submit 2 sets of plans with any of the above.
City/State/ZIP: Q(2r4 / Q ' t 7 7 /� The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name: �� / A £ �/ ° ^�` �^� FEE*, SCHEDULE :; _ _ _ 19 " :
C C� t
/1 n V rrL `
L/C. �l� Description I Qty. I Fee. I Total '
Cross street/directions to job site: / j , /. 5 �� ori e 1-Pri New residential single - or multi - family dwelling unit.
Includes attached garage.
■ 1,000 sq. ft or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40
Tax map /parcel no.: Limited energy, residential 75.00 2
.-�, ' ", ''-':-;?'";[',...7'1.1'''::' r';' ' WORK�h`-`:` : . z �T� : :
Limited energy, non - residential 75.00 • 2
_ . � -` . - :. .•• ' �• •+..�_ a� { �`- `%�•.>}• Each manufactured or modular
—7-631,61/(al /d P J � , ! dwelling, service and/or a eeder 90.90 2
�/ Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ s ' ,..: 1-.: ':r L NN
TEAT4` •r ` - : 201 amps to 400 amps 106.85 2
- 'PRUPERTYi DOWNER• 7 =`,� _ - i _. -
''` 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: ( ) Fax: ( ) relocation
200 amps or less / 66.85 (A, -R S 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
^U `,®- , APPLICANT;,, -,, ;- ai r , i'' •:, <U CONTACT PER -s s:`';;, ; A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Bergelectric Corporation branch circuit
Contact name: / / B. Fee for branch circuits
P.1 �(� without service or feeder fee,' 46.85 2
Address: 6026 NE 112th e first branch circuit
Each add'I branch circuit 6.65 2
City/State /ZIP: Portland, OR 97220 Miscellaneous (service or feeder not included)
Phone: (503) 255 -1818 I Fax: : (503) 255 -1919 Pump or irrigation circle 53.40 2
P n// (' �T /� Gi E-mail: ea��� /,yrz P £ Sign or outline lighting 53.40 2
G ( (/)
' ' "i "i a - "=� r t: , ' - [ ',.,t,,- Signal circuit(s) or limited-
•- , energy panel, alteration, or
- �: - ?` +�:��,. < - .:` "�;,•CONTRA aye-ha('
••�� = •�����a =? ".' .,:G�:";'��', .. ,'
extension. Describe: Page 2 2 •
Business name: Bergelectric Corporation
Address: 6026 NE 112th Ave Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Portland, OR 97220 Investigation per hour (1 hr min) 62.50
Phone: (503) 255 -1818 I Fax: (503) 255 -1919 Industrial p lant per hour 73.75
_ -
",s1P - ; sir-;,; _ 'ELECfRICA , PERMIT FEES *. `' ,• _ ', , •,;
• CCB Lic.: 110521 Electrical Lic.: 37 -682C S Lic . .1S Subtotal (1' gS
S uprv. Electrician signature, required: ' Plan review (25 %ofpermit fee) ,e,
Print name- F a .. D ate: L- � -/ -� 7 State surcharge (8% of permit fee)
�C TOTAL PERMIT FEE 7 . .1:2(--)
Authorized signature: ,4±....., .� / , / i ` This permit application expires if a permit is not obtained within I80
�
/ days after it has been accepted as complete
Print name: , I Date: `7 — L) • Fee methodology set by Tri -County Building Industry Service Board
�� / A./7 A./7
•• Number of inspections per permit allowed
i \Building\P- :mits\ELC- Permit doe 12/03 440- 4615T(10/02/COM/WEB ' •
1 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00265
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007
Phone: (503) 639 -4171 l
Inspection Requests (24 Hrs.): (503) 639 -4175 .�.' I I..
INSPECTION WORKSHEET FOR DATE: 5/1/2007 TIME: 7:00AM PAGE: 4
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: FANNO CREEK PLACE
DESCRIPTION: Temporary power.
OWNER: OPUS NORTHWEST LLC, PHONE #: 503-916-8963
CONTRACTOR: BERGELECTRIC CORP PHONE #: 503 - 255.1618
Inspection Request Scheduled For: Date: 5/1 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical service 047428 -01 503 - 849-3289 N
Corrections /Comments /Instructions:
/ '
0 ,X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION Li ADDITIONAL FEES ASSESSED
Inspector: �- 1v 03 U ` � Date: sl I J Phone #: (503) 718- 21 1 L lk -