Permit - r • -� 0,5 ELECTRICAL PERMIT
CITY OF TIGARD
•
PERMIT #: ELC2006 -00517
DEVELOPMENT SERVICES DATE ISSUED: 9/15/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136CD-00100
SITE ADDRESS: 11705 SW PACIFIC HWY * ** ZONING: C -G
SUBDIVISION: PACIFIC CROSSROADS LOT : JURISDICTION: TIG
Project Description: Crossroads Shopping Center. Clean up roof, (5) branch circuits. Job # 405.
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:
PACIFIC CROSSROADS PROPERTIES, I WILLAMETTE ELECTRIC INC
BY WYSE INVESTMENT SERVICES CO PO BOX 230547
200 SW MARKET ST STE 345 TIGARD, OR 97281
PORTLAND, OR 97201
Phone: Contact #: PRI 503 - 624 -3631
FAX 503- 624 -2938
FEES
Description Date Amount Reg #: ELE 34 - 283C
[ELPRMT] ELC Permit 9/15/2006 $80.10 LIC 75059
[TAX] 8% State Surcharge 9/15/2006 $6.41 SUP 19655
Total $86.51 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: Q Permittee Signature: 7,9 .e, p
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.
SEP 14 2006 7:05RM WILLAMETTE ELECTRIC 5036242938 p.2
•..
F oil I FI(•G USE ON1
Electrical Permit Applicatioil 1 __ _,4 6" D0'' 7
R 1p Penult No.:
City of Tigard oatelB : Q - rJ,
13125 SW Hall Blvd., Tigard, OR 97223 r Plan Review Other Permit:
- .
p 1 ::,,.1.1:..••
Phone: 503.639.4171 Fax: 503.598.1960 s 1 . I''� ?`f �I � Ready/By: Jur : See Pagei for
Inspection Line: 503.639.4175 r.,!1/414- �fi � 1 Suppteme
,-. Nodfied/Metbo J
Internet: vrww.ci.tigard.or.us _ �+,�; F, i;
e....:, C::--C71-'1•7' � ..,- e -sip ,•' rI "e«. � ' -cal ' i�;t5 -- - a - - r . - _ _ . ,._r. _ -
�. _.;= : �= 4 _ - � • �''_F� r„� - A � - _ . _ - - - Please check all that apply: ..- , -r
[] construction ®Addition/alterationheplacement OService over 225 amps, comm'I ['Hazardous location
0 Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. it.,
:i,._ 4:'q'_.:vct', "7: ' .' 4 is 17- FM !, `•��ls -n-r ... � `e -1 41- ' of 1- and 2- family dwellings 4 or more new residential
.... << ... t units in one structure
- . � 'r y - -" :` r ['System over 6 00 vo nominal
I - and 2- family dwelling G CommerciaVindustnal 0 Accessory building °Building over three stories ❑Feeders, 400 amps or more
Multi-family Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
Y r ��,uza �, ter f�1r F.•i ❑Egress/lightingplan RV park
_ . *= _ . ti _ ' _ , � �� .�' - :1 ✓,. . , ,� ,. _�, ��vrta� nt� r- - p*t. h ❑Health -care facility ❑Other:
Job no.: t--/ to J Job site address: 11 7 V S -' p„ .- • A, /4.4 f ".a,. Submit 2 sets of plans with any of the above.
c The above are not applicable to temporary construction service.
Cl /.State/ZIP: T d J �i t. J 7 =--7-407:1 :- . r. < ', 3 N 4`:1:; T,': - 'T` • '.
Suite/bldg. /apt. no.: I Project name: p ,a- a c.e., r naettpdoa Qtr. Fee. Torsi -
New residential single- or multi - family dwelling unit.
Cross street/directions to job site: Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.:. Ea. add' 1 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 _ 2
Tax map /parcel no.: _ Limited energy, non - residential 75.0 2
CY_•
- 71 " ` ` Each manufactured or modular
-;.. ;.' 1 ;t. :l -t . ia1?li � i fi. zr-' =1, t _ i T r +_ _i
_ - -' dwelling, service and/or feeder 90.90 - 2
C t /em. y A Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
•.� „� l 201 amps to 400 amps 106.85 2
:_ ,:,�.. -M rt i'' ''' '' `� 401 160.60 2
�. l= �i ��`_ ��_I �, T _i� °= amps to 600
; fie!= � -- ��= �T-,�r!'- i�,:�w..ii� -
Name: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
Cily /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 ►
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
r - +r."' A. Fee for branch cncuits with
• �� � - 't service or feeder fee, each 6.65 2
branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 Yd 2
first branch circuit
Address: '
Each add'l branch circuit S 6.65 .7 3 4. 2
Miscellaneous (service or feeder not included)
City/State/Z1P: pump or irrigation circle 53.40 2
Phone ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
�.t2' .�. -7r` _ energy panel, alteration, or
__w _x.�-r- .a.- I. � � extension. Describe: Page 2
Business name: (,J; I I a,M of t o E /'B c /'rr.. 1
) Each additional Inspection over allowable in any of the above
Address: P O a 0). 23 D P../ Per inspection r 62.50
City/State/ZIP: 7 i ' a cA 0 r
c; 7 2 ? ) Investigation per hour (I by min) 62.50
hour 73.75
62 Y - Z `f 3' ? Industrial plant per
Phone: ( ) 6 Z Y - 6 3/ Fax: (7%.7 ) n'f.: i !, VF71' 7. .1"-T r , .''1•. :-:; ' :' :-
CCB Lic.: 750$ ? I Electrical Lic.: 3`/-x.3 G I Suprv. Lic.: /Z Z 6 ••S Subtotal --=
-• -- - Plan review (25% of permit fee)
5upty. Electrician signature, require - - State surcharge (8% of permit fee) 6 V
0 a ( r
Print name: I Date: .� cif- id 6 TOTAL PERMIT FEE Ob S)
F
Authorized signature: This permit application expires if a permit Is nor obtained within ISO
days after it has been accepted as complete
1 Date: • Pee methodology set by Tri- County Building Industry Service Board
Print name: " Numberof inspections per permit allowed.
440 -461 ST(t0/OVCOMI WBB
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