Permit 71 CITY OF TIGARD ELECTRICAL PERMIT
ii
PERMIT #: ELC2007 -00334
COMMUNITY DEVELOPMENT DATE ISSUED: 5/16/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S115BA-02500
SITE ADDRESS: 16200 SW PACIFIC HWY W2 ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT : 001 JURISDICTION: TIG
PROJECT: RAINBOW WEST BOOKSTORE
Project Description: Replace the 100 amp meter section to this suite.
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: 1 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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
HARSCH INVESTMENT PROPERTIES CAPITOL ELECTRIC CO INC
851 SW 6TH AVE SUITE 550 11401 NE MARX ST
PORTLAND, OR 97204 PORTLAND, OR 97220 -1041
Phone: 503 - 228 -3317 Contact #: PRI 503 - 255 -9488
FAX 503 - 257 -7121
FEES
Description Date Amount Reg #: ELE 26 -496C
[ELPRMT] ELC Permit 5/16/2007 $80.30 LIC 48748
[TAX] 8% State Surcharge 5/16/2007 $6.42 SUP 31325
Total $86.72 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.
// Permittee Signature: SjeLL /; G .G� ' n-Y)
Issued ii. /� / ,� ,_ � �„ /
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.
J ::' i - FOR OFFICE USE ONLY
E lectrical Permit A I .- _' _ �l Received `
Y �t 1 Date/By:
Permit no.:
City of Tigard tt Plan Review
w ��� ELG2 _00334
13125 SW HALL BLVD., TIGARD, OR 97223 AI, -4' 11 r. Date/By: Other Permit:
Phone: (503) 639 -4171 Fax (503) 598 -1960 MAY 1 V 2g 1 OF TIGA Date Ready/By: Juris: T i U See Page 2 for
Inspection Line: 503- 639 -4175 Notified/Method: l Ili Supplemental Information
Internet: www.ci.tigard.or.us ' / ;. }i�' j j� {l
TYPV7_ T, �-�� , � �� � � � PLAN REVIEW '
U New construction L A b altera m Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ otter:: ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards
U 1- and 2- family dwelling L Commercial/industrial U Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi- family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. ❑ buildings
Job no.: 270750 Job site address: 16200 SW Hwy 99 Cl Fire Pump CI Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State/ZIP: Tigard, Ore 97223 ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
100HP or more. ❑ occupancy
Suite/bldg. /apt. no.: Project name: Rainbow West Bookstore
El six or more residential units ❑ Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Sen"ice or feeder 600 amps or more
Subdivision: Lot no.: FEE SCHEDULE
Description I Qty. I Fee. ' Total '
Tax map /parcel no.: New residential - single or multi - family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
Replace the 100amp Meter section to this suite. 1000 sq. ft. or less $ 145.15 4
Ea. Add! 500 sq. ft or portion $ 33.40 1
11 PROPERTY OWNER I U TENANT Limited energy residential
Name: (with above sq. ft.) $ 75.00 2
Harsch Investment Properties Limited energy, multi- family
Address: 851 SW 6th Ave, Suite 550 residential (with above sq. ft.) $ 75.00 2
Service or feeders installation, alteration, and/or relocation
City/State /ZIP: Portland, Ore 97204 200 amps or less 1 $ 80.30 80.30 2
201 amps to 400 amps $ 106.85 2
Phone: Fax: 401 amps to 600 amps $ 160.60 2
503- 228 -3317 601 amps to 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 454.65 _ 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and /or
Owner signature: Date: relocation
200 amps or less $ 66.85 I
U APPLICANT I U CONTACT PERSON 201 amps to 400 amps $ 100.30 2
Business Name: 401 amps to 600 amps $ 133.75 2
Branch circuits - new, alteration, or extension, per panel
Contact name:
A. Fee fut brdncit circuits with t I
service or feeder fee, each
Address: branch circuit $ 6.65 2
B. Fee for branch circuits
City/State/ZIP: without service or feeder fee,
first branch circuit $ 46.85 2
Phone: Fax: Each additional branch circuit: $ 6.65 2
Miscellaneous (service or feeder not included)
E -mail: Each manufactured or modular
CONTRACTOR dwelling, service and or feeder $ 90.90 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 66.85 2
Pump or irrigation circle $ 53.40 2
Contact name: Gary Stelert Sign or outline lighting $ 53.40 2
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: Page 2 2
City/State/ZIP: PORTLAND, OR 97220 -1041
Each additional inspection over allowable in any of the above
Phone: 503 - 255 -9488 Fax: 503 - 257 -7121 Per inspection $ 62.50
Investigation per hour (I hr min) $ 62.50
CCB Lic.: 48748 'Electrical Lic.: 26-496C ISuprv. Lic.: 3132 -S Industrial plant per hour $ 73.75
Suprv. Electrician signature, required: �q �v ELECTRICAL PERMIT FEES*
e4 ... , f p r- Subtotal $ 80.30
Print Name: DARRELL MCNE Date: 05/14/07 Plan review (25% of permit fee)
Authorized signature: /^ State surcharge ( 8% of permit fee) $ 6.42
N 1/41t— s/ _— TOTAL PERMIT FEE _ $ 86.72
Print Name: DARK CNEEL This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
• Number of inspections per permit allowed.
CITY OF TIGARD
DIVISION PERMIT #: ELG2007 -00334
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/16/2007
Phone: (503) 639 -4171 ,,jil
Inspection Requests (24 Hrs.): (503) 639 -4175 �__..
INSPECTION WORKSHEET FOR DATE: 6/21/2007 TIME: 7:03AM PAGE: 45
SITE ADDRESS: 16200 SW PACIFIC HWY W2 CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: RAINBOW WEST BOOKSTORE
DESCRIPTION: Replace the 100 amp meter section to this suite.
OWNER: HARSCH INVESTMENT PROPERTIES. PHONE #: 503- 226 -3317
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503-255-9488
Inspection Request Scheduled For: Date: 6/21 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1- q art i I service 050649.01 971 - 505 -3089 Y
■ of ectibns /ComrrReet `/Instru ions:
`I' 10 ,
01
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �' N Qie t- E Date: 6.14 01 Phone #: (503) 718- 1t
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