Permit •
CITY OF TIGARD • 3 - ELECTRICAL PERMIT
!PI COMMUNITY DEVELOPMENT PERMIT
ISSUED E 9/2007 00146
DATE ISSUED: 3/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 500 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT : 002 JURISDICTION: TIG
PROJECT: APOLLO /UNIVERSITY OF PHOENIX
Project Description: Install 5 boxes for retrofit power pole installation.
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: 5 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:
TIGARD TRIANGLE I LLC NEW TECH ELECTRIC
4650 SW MACADAM AVE STE 220 13970 SW 72ND AVE
PORTLAND, OR 97201 PORTLAND, OR 97224
Phone: Contact #: PRI 503- 648 -1900
FAX 503 - 670 -9572
FEES
Description Date Amount Reg #: ELE 26 -418c
[ELPRMT] ELC Permit 3/9/2007 $80.10 LIC 41868
[TAX] 8% State Surcharge 3/9/2007 $6.40 SUP 3849S
Total $86.50 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: &Ai /Wu)._ 6 m � Permittee Signature: _, alp 1 T 1
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.
03/05/2007 09:45 5036709571 NEW TECH ELECTRIC PAGE 01/02
...
., .
ElctricallPe Application F'OR OFFICE USE ON1N
City of Tigard Fclaksk'N-wv4biltcaudtersveyig/o7 dB Permit NoRL
" .. Ce Rile"
74 13125 SW Hall Blvd., Tigard. R 97 r ...., PInn Rev
i Other Permit:
Phone: 503.639.417 I Pax! 503.598. ! batc/Byt
Inspect Line:
ion 503.639.4175 Date Ready/By: Jana: Ea See Page 2 ror
'TIGARD , 1VotiAed/Methed! supplemental Tnrormation
internee www.tigard-or.gov NA A, R 0 9 2 00 ( . .. . .. . _ . .,., ...,_. .. , .. ..... . .
- 5. ,, , :14,,,o re , 04 .i.1;0 7 .ii , o w , te P 4;i1 1Vilk,Virbli, iii ; 0 1 qtt ISYNIVit i' 4 . , . . r '''' . ) - ■ 1 .
riiil9Rigggifglig P v ''t,i qt.i.rovoitko!.., ,AiN.,... ,„.„,1-,,, fi ., ko, .1 1,ditItotik,....,‘,6L591..NiudiAlritalb
.. . _. , .. ...." -..,- .,... . ..-,, ,, ..; . ,-. • • • • • • PkilSe check all &Kit apply (submit / nets of pking Whom! checked below):
0 New construction Cii Addition/alterag -1 ad
131MP-61'4'1MM 0 sorv or F ee d er dap amp or mom 0 Building over three stories,
El Demolition 0 Other: where the available fault current 0 tvfarinas and boatyards.
1W,
; or .141H '`,. J!T,M.t.k17,0 exceeds I0.000 amps at 150 volts a mindin building,
• . In. to grontal, (at exceeds 14,000 0 Commercial•ase anricultural
El 1- and 2-family dwelling„...EI-Cbmmercial/industrial 0 Accessory building :1111p4 for all other instalIntions. buildings,
•
0 Multi 0 Master builder 0 Other: El Isire pump. 0 Insailiation n175 KVA or
- .,, •,;,,,,.,..,,,.., 0 Emergency sysiem. toad of larger separately derived system
:', ^. ...khittg ; 0 Addition of Pew motor I:1"A",
V41;',-;;.il'iiiY,,! 4. i•'.1'.' f.; ; . . ....., • ... 0 . • •'i.., ••;,. ,.. • .. , ,.. .... - ' .• ••••••;. '% — ' • ' •• '..1.41;;X; ; ''";;•" ''"" ' ;"•''' ';" "t
Job no.1, ,V . Job site address: 22, ip e
.. ; I0, x or 011P or morc.
Si mote residential units. occupancy.
0 Recreational vehicle parks.
---......, 0 Health-cue facilities. EISupply voltage for more thnn
City/StaterZIP; .- / . Ct 2.7, n Hazardous locations. 600 volts nominal.
. • 0 service or %vier 600 nmpA or mow.
Suite/bldg/apt. no.: P-.. Project name: - 19.' 111 , "
ka WraigglilErrANRIPP.X.XP.0.40001EgililE VI
Cross street/directions to job site: s... \-t ingniglIPIMPA
• 1...... .....„, , .., %seri tlin Fee . Total •
AR il New residential single- or multi-family dwelling unit.
Includes attached garage,
Subdivision: Lot no.: 1,000 sq. ft. or less 145,15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
V.i?,:ir
'ti? ';P::,'i 74,`,'1 i ;. AtIototwoom,Rw.600.0,pn.‘aii!; iir 1 Irs:41 L imited (with above sq. ft.)
imited energy. multi-family 75.00 2
IM IMA 'MIMI residential (with above sco
? ' v Services or feeders Installation, alteration, and/or relocation
D\ - (461Ottifl 200 amps or less 80.30 2
Oir:R-Tiligatili'' :;.• ivimiglowirqiifi ,:,::* .$1)00:1;#ia pp . , . 41,1::.,) .4,1, 201 nmps to 400 amps 106.135 2
Name: . ...5 1 401 amps to 600 amps 160.60 2
Its4.0. , 6: ..ex I.. 6...‘•_L . .
. 601 amps to 1,000 amps 240.60 2
2-Z/ l A 1,5t- '87k,, , !,■I G Over 1,000 amps or volts 454.65 2
_
City/State/ZiP'r L_ C - )lt?_,... C r fr? - ''' ,Z ,....D Temporary services or feeders Installation, alteration, and/or
relocation ,
Phone: (5:0 L.2. -- 2_46-( Fax: ( ) 200 amps or less 66.135 I
i I •
Owner installation: This installaticn 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
Brandi &colts - new, alteration, or extension, per panel
Owner signature: Date: A. Pee for bninch circuits with.
iVariPiNger. 'cl ig . 1;AW I t v sg 1 1110,0091PIEMi!V,Pt above service or feeder fee,
6.65 • 2
; . each branch circuit
Business name: .
r- (-4 \- .-,rf— . '' toJi ch-■% B. Pc° for branch circuits
.
without service or feeder lee, II
Contact name: 12- ;.Z e .4 6 .1. 1_ 1 A lt,... \ . 46.85 Oil 2
Pa ).‘,... first branch eirtuit .
Address: VA Each arld'I branch circuit C-5 6.65 S.Z, 2
Miscellaneous (service or feeder not included)
City/State/ZiPt- 2 -- t 5 2 --- - Each manufactured or modular
90.90 2
, dwelling, service and/or feeder
Phone: (4 WO 54 _ ( Fax: : ( ) Reconnect only 66.85 2
E Pump or irrigation circle 53.40 2
i:?.: '.:.iM.i:!:.i;:i1;m:Rronitoexti.}0::;;,:owKini;o■iq;;; Sign Or Outline lighting 5340 2
Business name: i ___--•--... I 1 Signal circuit(S) or limited.
A • 1 1..._) energy panel, alteration, or
`--* ' IL
Address: • . . extension. Describe: Page 2 2
• .
City/State/ZIP: Vbc / I/1 t . r .-- i‘ . 2.-Z-- 3 Each additional inspection over allowable in any of the above
- • Per inspection 62.50
Phone: ( 5b) (ak.„LU61,3-6 Fax: 'Th • e -9S
.. investigation p hour (I hr min) 62.50 —
CCB Lic.: l...\ % 7
il Electrical Lic.: ...4..t a , Suprv. Lic.:3 6 t. s Industrial plant per hour 73
-- jall:ii.aili:i...:AtEPTA V
Suprv. Electrician signature, required; iga/M41'^--.
Print name; I) \.1 ; \ A___ cAN‘ , 0 Date ......i .._ 0, Plan review (25% of permit fcc):
_
State surcharge (8% of permit fee): ( -Lit)
Authorized signature: .
TOTAL PERM TT PEE;
Print name: i I • This permit application expires if n permit Is not obtained within 180
_ A
-v__ 54: -L y2z:urk , / tiny; Prior It hos peen necroted ps complete,
•
r)5,2.1/O6 40 i gisicomiwati Number of Impel:thins allowed per permit.
iAntiiichnoTarmaintu,C.PermicApp.une