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Permit CITY OF TIGARD ELECTRICAL PERMIT . ' PERMIT #: ELC2006 - 10015 .11"111,0, DEVELOPMENT SERVICES DATE ISSUED: 3/2/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135BB-00501 SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I - SUBDIVISION: CASCADE BUSINESS CENTER LOT : JURISDICTION: TIG Project Description: Lighting & power pole. (5) 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: 4 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: AMB PROPERTY L P BOONES FERRY ELECTRIC INC BY TRAMELL CROW NW INC PO BOX 628 8930 SW GEMINI DR WILSONVILLE, OR 97070 BEAVERTON, OR 97008 Phone: Contact #: PRI 503 - 682 -4936 FAX 503 - 682 -7946 FEES Description Date Amount Reg #: ELE 3 -223C [ELPRMT] ELC Permit 3/31/2006 $73.45 LIC 88482 [TAX] 8% State Surcharge 3/31/2006 $5.88 SUP 4918S Total $79.33 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 Signature: 4 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. CITY OF TIGARD 3/31/2006 III : a 13125 SW Hall Blvd. 3:03:03PM Tigard, Oregon 97223 TIGARD (503) 639 -4171 Receipt #: 27200600000000001038 Date: 03/31/2006 Line Items: Case No Tran Code Description Revenue Account No Amount Paid ELC2006 -10015 [ELPRMT] ELC Permit 220 - 0000 - 431510 73.45 ELC2006 -10015 [TAX] 8% State Surcharge 100 - 0000 - 207020 5.88 Line Item Total: $79.33 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard BOONES FERRY ELECTRIC DER/DLH 412060 In Person 79.33 Payment Total: $79.33 cReceipt rpt Page 1 of I CITY OF TIGARD • j ELECTRICAL PERMIT � ' ,� BUILDING SERVICES DIVISION ' �1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 www.ci.tigard.or.us PERMIT #: �[ ���� - �UQ /s DATE ISSUED: 2J:A SITE ADDRESS: I v S1 S S LLJ t'�jSC �Q12� vw-t At ./30 PARCEL #: BLDG /STE #: _ ZONING: SUBDIVISION: �� p ,� LOT: JURISDICTION: 11 c This is an interim permit issued during computer system maintenance. Construction work and inspections may proceed under this permit number. The actual permit will be issued and mailed to the applicant within one week of the date issued above. __ PROJECT DESCRIPTION: (_ � v_As p F RESIDENTIAL - i ( TEMP SRVC /FEEDERS I I — MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500 SF: 201 - 400 amp: SIGN/OUTLINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: - - - - -- - - - - - -- - MANF HM /SVC /FDR: 601+ amps _1000 volts: MINOR LABEL (10): — — SERVICE/FEEDER ______1 r BRANCH CIRCUITS ; - - ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1 W/O SRVC OR FDR: ) __ PER HOUR: 401 - 600 amp: EA ADD'L BRANCH CIR C: _ 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: i — OWNER 1 f —_ FEES Name: MC_4`r-- Permit Fee $ ?3. y. Address: _ Plan Review Fee $ __ City/State /Zip: _ _ _ _ State Surcharge (8 %) $ Phone: Other Fee: $ $ CONTRACTOR 1 Other Fee: -- - - -- - - -- Name: p[�g _f Ryl-,6\ Total Fees: $ t�� 33 Address: '4 O — $�Z� _ - City/State /Zip: l �� S 1�� 01_ _ g 1 0 7 O Phone: 612_ - it ?Y6 Fax: -0_� 9 CCB Lic #: yg Elect. Lic. #: Supr. Lic. #. '/ g /' s 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -1987 or 1-800- 332 -2344. / Issued By: `-L�, ,C,JS.:U.t ,L7-1 Permittee Signatun 01NNER 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. ELECTRICIAN: DATE: LICENSE NO.: Call 503 - 639 -4175 by 7:00 AM for an inspection that business day. Note: If you cannot schedule an inspection while the system is down, please call 503 - 718 -2433 for assistance. 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. I:\Building\Forms ManualPermitForms \ManualELCpermit.doc 12/05/05 Electrical Permit A ec,, �,. T • �, ' • FO R OFFICE USE OILY • • City of Tigard \IE.,. 13125SWHa Rcrvd Hall Bivd Tigard, Dat OR 972 e/B : PermitN .• g 97223 � o 3 . Phone: 503.639.4171 Fax: 503.598.1960 /i r � wl! Plan Revi 1 � �" `� - - 4 , / �Q Inspection Line: 503.639.4175 ��� 2UU 1 �` DateJB : Other Permit: - iternet: www.ci.tigard.or.us a Date edJMe S See Page Supplemental Information for i Notified/Method: ��iT� a rnr L ,,� Supplemental Information . ,4 L :€ & �. ? y z 1 a •Nik'�) �'srrn 1 7' `lictl ,rct��, pp { �7{y{�, y 3.s4r_ . ..r;n' c ? � f al t t6 , i:Y }'� � xt ° i r e . r 'nCsd 2d. 11St.d..7:1 u N M-415.- ). Il a� -'Tin° .. ..,..„'_.:::•„ El New construction i 3 , n ; °.:: ; 't:. , ; . [±r � � � sit o ' a l teratio n /repl'acem n ' Please check all that apply: • ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ['Hazardous location Ae„ t`''•� t {fi E' ��' �'v Y '� x ❑Service over 320 amps — rating ❑Buildn tie = 3 t Z. .i of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling St Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi-family ❑Master builder ❑Other: ['Building over three stones ['Feeders, 400 amps or more # "�4�1 ®sir �ki3 n r�� �� Iu '�—� " e ['Occupant load over 99 persons ❑Manufactured structures or 'r u � it t�,.'� +� t. ,�� ❑Egressllightingpian RV park Job no.: ��f 3 O Job site address: / 05 7 S 5 I- &Ls co. 0 C 114,.. Submit of plans ❑above. City /State /ZIP: / /� Submit 2 sets of plans with any of the above. ?�' O � " d / The above are not applicable to temporary construction service. Suite/bldg. /apt - Q. , c a _ ,r e , :"PA no.: oject name: �� 1� BEd • :r VILA �-• ,'-.,.._,,:,• Cross street/directions to job site: Description Qty. Pea Total New residential single- or multi- family dwelling unit. Includes attached garage. o 1,000 sq. ft. r less - Subdivision: 145.15 4 Lot no.: Ea. add'1500 sq. ft. or portion 1111 33.40 1 Tax map /parcel no y,r Limited energy, residential 75.00 2 i?u:4 r�T S ¢i var � ��3 ©,� ,�« ra ° Limited energy, non-residential 75.00 _ 4�, rF t.._ Each manufactured or modular 2 L �' / ' �� pd r✓er p�e r dwellin:, service and /or feeder III 2 Services or feeders installation, alteration, and/or relocation 200 amps or less y ' t'`itr '' dS 10 t 80.30 2 �ti . a.r l ....-+ . ,r> .- ,t , , ' . 51 ;v : t., • t.9 �t ,4. , , 1,- P 3 x, ,. " ice , 4,7„ \i "s� 401 amps to 600 a 201 amps to 400 amps 106.85 Name: ` s 2 amps 160 60 2 601 amps to 1,000 amps 240. �ddress: 60 2 Over 1,000 amps or volts 454.65 2 City/State /ZIP: Reconnect only 66.85 2 Phone: ( ) Temporary services or feeders installation, alteration, and /or Fax: ( ) relocation Owner installation: This installation is being made on property that I own which is nbt 200 amps or less 66.85 _ intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 2 m 100.30 1 Owner signature 1 401 amps to 600 amps in 133.75 2 Date :�i 3 }, c r G ,} r,i c a t { y? , r ,— P , I Branch circuits — new, alteration, or extension, per panel u..t_� e.-�: '.— ^1 x :: 3' � .l d" I t C . F r J r f r P I _ , ►. ._-= Ll. ° " A. Fee for branch circuits with Business name: service or feeder fee, each branch circuit B. Fee ■ . 6 65 2 Contact name: e for branch circuits Address: without service or feeder fee, each branch circuit 46.85 ■ 2 City/State/ZIP : Each add'1 branch circuit © 6.65 2.6,60 2 . Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) I Pump or irrigation circle - 53.40 E-mail: Sign or outline lighting 2 ' .., r, Z r: 53.40 2 ogsEk ci �n't Sy�rz �k Signal circuit(s) or limited - k4. .i`.li-'- °�^f rw s+. �K��1 41. ©, R$``,� d c iri ,. • r H. r energy Business name: �-- °� ���>€ ;• ,. gY Panel, alteration, or Boones Ferr Eleetr C extension. Describe. Paget 2 Address: P.O. Box X 6 2 8 Each additional inspection over allowable in any of the above City/State/ZIP: W i l s o n i1• i l i e OR 97070 Per inspection in 62 50 Phone: (5 0 3) 682-4936 Fax: Investigation per hour (1 hr min) mu 62.50 CCB Lic. 88482 4 8 2 (5 0 3) 682-7946 t Industrial plant per hour - S uprv. Lic.: n �I , ig*t Vii• 4. Suprv. Electrician signature, required: ` .1 =� Subtotal 7 3 , yt Plan review (25% of permit fee) tint name: 5 H e T S o n Date: I State surcharge (8% of permit fee) S' 8 7 Authorized signature: TOTAL PERMIT FEE 9 3 Z This permit application expires if a permit is not obtained within 180 Date: Fee methodology set by Tri -County Building Industry complete i tBuildingtPennits \ELC Pe, j1 don 12/03 f "" Number of inspections per permit allowed. Service Board 4404613T(10/07JCOM/WEB CITY OF TIGARD X-C• BUILDING DIVISION PERMIT #: 0.7o60 U � 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 zomp Inspection Requests (24 Hrs.): (503) 639 -4175 I � I INSPECTION WORKSHEET FOR DATE: TIME: PAGE: ITE ADDR : C J 7 CLASS OF WORK: ISION. LOT #: /30 TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3- 3- d Pour Time: Code # Inspection Descrip ion ' Confirm # Contact # Message / \ � 5l '1 77 Corrections /Comments /Instructions: 6 E0- 4 3 CO I ` r11Tc obtot A.__ . fo- 2cyzsis 3 38 - ► PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G1 19.4 Iv , ' o Date: 3• 3- 0 4 Phone #: (503) 718 -2)4