Permit OI TY OF TIGARD 70 - 0 g ELECTRICAL PERMIT
PERMIT #: ELC2006 -00585
A A , X11 DEVELOPMENT SERVICES DATE ISSUED: 10/16/2006
' '` �--- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 112 DA -01200
SITE ADDRESS: 15060 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : 003 JURISDICTION: TIG
Project Description: Relocating (21) 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: 20 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:
PACIFIC REALTY ASSOCIATES KEIZER ELECTRIC INC.
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 12426
PORTLAND, OR 97224 SALEM, OR 97303 -0426
Phone: Contact #: PRI 503 - 378 -0267
FAX 503- 378 -1861
FEES
Description Date Amount Reg #: ELE 24 - 68C
[ELPRMT] ELC Permit 10/16/200( $179.85 LIC 25359
[TAX] 8% State Surcharge I0/I6/200r $14.39 SUP 28435
Total $194.24 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
suspen for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules re set forth in OAR• -1 i p10 through OAR 952- 001 -0100. You may obtain copies of these r -s or direct questions to OUNC at
503 46 6699 or 1- 800 -3 fl 2 I
Iss ed By: L � -/� Permittee Signat OWN iWWI/ / d—(----
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:
„ — e RACTOR INSTALLATION ONLY // ININWI
SIGNATURE OF SUPR. ELEC'N ' -.: 01 " DATE: 7 /A4
LICENSE NO: - aefi S
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.
16/12/2006 10:20 FAX 5035981960 CITY OF TIGARD I) 002
,,-- - :, -. -\ -'\
Electrical Permit Application U u- FUN l 1 F l l c I I l' I. U\ I.1
City of Tigard Q;;T r 200 Received 41�olv / � Pam' 14 °.: . ,G( P -o :�
IN 13125 SW Hall Blvd., Tigard. OR 97223 ..,� 1 { ,r ' Ran Review Other Permit
R Phone: 503.639.417 Fate 503.598.1960 -A ' 0 paws .
Inspection Line; 503.639.4175 B'UiLCIN2: DIVIS Deft Rem B See Paae2for
i i „A I: l? Internet: www.tiprd-or.gov Notified'Mcthod: SupplemoW (ofov adoa
. ..,.. .., ; .. . ..' , ,.. l 11 �,�.WA�; , H�. _ .1C, r p \ . .i �•7�: '` . . a:`. ?�'�:J : '�
Q New construe o Addi
• ... : :. .. .:... . . : =
• ,.. . n dan/altecatioo/teplatxment Fiesta cheek all that apply (submit 2 secs elitism wfitahu CberJmdbdow):
❑ Sem. or feeder 400 amts or mote 0 B ulding over three stones.
❑ Demolition 0 - . Other. what able 0 Morin yards.
. . ;� mraaM 000 em ®•
r
... ; t . ia jX.. - i :s r O Commercial r the avm
., .. - �.�. =4. ;: 10. DzellSOvolteo Flouring ..... ' :��� `' lass w ground or aeeeeds 14 000 e{7i eel tural
Q 1- and 2- family dwelling , Commercialrtndustrial 0 Accessary building mnps ror all other installations. buildings Q Multi- family 0 Master builder ❑ Otter. Orin pump. D lnsstaileam of 75 KVA ar
D Emerpmcy system. larger separately derived system
': IJ ; Bi�u7�ta U O ; a :' a .' :: ., .: � I] Addition of new mover load D "E', 1 -2" °1-3"
" Job site address: lot►IlP damo�
occupancy.
Job no.:
�� O�p s(•'J Se/ (AG t n Pk� ❑ $e a more residential units. D Reaeadonal vehide parks.
ll D Healtb•eme facilities. D Supply voltage for more t6sa
- City/State/ZIP: �, 5 a r � o A 97 Z. Z � 0 Hazardous locations. 600 volts nominal.
t
D Savior o r feeder Eta am or mote
Suitdbldg /apt no.: l Project name: : « 10 s4 ; t:
..Ili tadDIF '
Cross street/directions to job site: 7.. Nan 4,..›4E.. S c �}- i n s�r t a t e a i on- 1 gm j row l •
New residential single- or multi -family dwelling unit.
�� 4. .5� l �p 1 ad, smelted aelted garage.
Subdivision: ` l Lot no.: 1,000 sq. S or less 145.15 4 1
Ea. addi 500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
e ° :T- .:,!".;,,.7 -a � F,--; with above sot. R.) 75.00 2
'; ' �:: �.,• : • ?l; ' ; : - „re-;,. 'D�;B'iID1�T' =b>E�W9�`? .: t �`� :. .. n . , ..:. .
Limited energy. multi- family
(Z' pe'-'k :kJ.) PDc.Je r- C._ . 1/4 P • residential (with above ay. ft)
75.00 2
J Service or feeders iostallatioo and/or relocatioo
200 amps or less 8030 2
Pg a .. 'M : OWi t ,:\; �_ -' ' :ti l °:::,;; ;:: 201 amps to 400 amps 106.85 2
• Name: Orel G4 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: / sot !oo . - �� o ; - p ki i i Over 1.000 amps or vnks 454.65 2
City/State/ZIP: • o „ rod ° (t 9 Z - L 41 Temporary services or feeders i stillatloo, situation. and/or
relocation
Phone: (o3) (03 ? - 3 ?go 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, ear. panel
Owner signature: A. Fee for branch circuits with
n v ':r13.( T : u' , c ( e. above service or feeder fee,
6.65 2
each branch circuit
Business name: $AAA E B. Fee for branch circuits
• Contact name: without service or feeder fee, 1 46.85 y 6e,s 2
first branch circuit
Address: Each add'' branch circuit Z.e> 6.65 /33,x: 2
Miscellaneous (service or feeder not Inc luded)
City /State/ZIP: Each menu factured or modular 90.90 2
dwelling. service and/or feeder
Phone: ( ) I Fax:: ( ) Reconnect only 66.85 2
E Pump or irrigation circle 53.40 2
1!.. . ' .i': . �L'0 `�` ,' +;: ;
'....'.. -.`rt "' ,. ' .', Sign Or outline 53.40 2
Business n ame: 1 <e ■ ta-c (( c4 r ie. Signal circuit(s) or limited-
energy panel, alteration, or
Address: I'D he, IC 1949.4.p extension Desaibd:. Page 2 2
City /State/ZIP: p Z ? G q - G C /,, 4 Each additional iwpeettoe over allowable io ao of the above
d••M -�i (� Ct 7} / Per inspection 6250
• Phone: (5 b3 ) 3.7 p 7 02,6 Fax: ( 5013) 3 78 / g (P f Investigation per hour (1 hr min) 62.50 ,
CCB Lie.: - 3 c' ? 1 Electrical Lic.:p? p4 Suprv. Lic.: 2.43‘7 S Industrial plant per hour _ 73.75
t /2 sic 8
Suprv. Electrician signatu re, required ��� / iO /• / Subtotal: / -77. fS
�U & LpcS r"t W , 0 6 Plan review (2596 of permit fee):
• print tuamc• D, 0) to - / 3 - /,
State surcharge (896 of permit fee): /e/3 9
• Authorized signature: TOTAL PERMIT FEE: /9t, 2e-/
Print name: i Date: Tab permit appheadass eapirn Ifs permit is not obtained within 580
days air it has been accepted as complete-
• Number of inspections allowed per permit
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