Permit 71
CITY OF TIGARD
ELECTRICAL PERMIT
w . PERMIT #: ELC2007 -00258
COMMUNITY DEVELOPMENT DATE ISSUED: 4/26/2007
T . 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AD - 03450
SITE ADDRESS: 08777 SW BURNHAM ST ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: CITY OF TIGARD
Project Description: TI
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 HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 17 PER INSPECTION:
201 - 400 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CITY OF TIGARD ATLAS ELECTRICAL CONTRACTORS
13125 SW HALL BLVD 4403 SE ROETHE RD
TIGARD, OR 97223 MILWAUKIE, OR 97267
Phone: 503 - 639 - 4171 Contact #: FAX 659 - 4944
PRI 659 -2212
FEES
Description Date Amount Reg #: ELE 3 - 2C
[ELPRMT] ELC Permit 4/26/2007 $300.20 LIC 1532
[TAX] 8% State Surcharge 4/26/2007 $24.02 SUP 2581S
Total $324.22 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
•
Issued By: (_� I/ LQ , J Permittee Signature: N c p
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. •
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_ . Elec rical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Permit N.. IDate/By: y J / 13125 SW Hall Blvd., Tigard, OR a FCEIVED Plan Revie
C ' Phone: 503.639.4171 Fax: 503.598.1960 Other Pe ' ��j
DateBy: pY/� 7 — Dd13 0
TIGARD
Inspection Line: 503.639.4175 r F , iJ t. • 2007 Date Ready/By: Juris: See Page 2 for
Internet: www.tigard or.gov tt .. �O` , Notified/Method: Supplemental Information
TYPE OF 14 yy UOh f !GARO PLAN REVIEW
❑ New construction ® Addition /altera1l Y$CAM ION Please check all that apply (submit 2 sets of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ I -and 2-family dwelling Tess to ground, or exceeds 14,000 ❑ Commercial -use agricultural
y g ® Commercial /industrial ❑ Ac cessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: 15880 Job site address: 8777 SW Burnham Street IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, Oregon 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: TiGARD PUBLIC WORKS ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description J Descion 1 Qty. 1 Fee. 1 Total 1
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'l 500 sq. ft. or portion 33.40 _ I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi- family
Electrical for City of Tigard Public Works renovation. residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 1 80.30 80.30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps i 106.85 106.85 2
Name: City of Tigard Public Works 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 8777 SW Burnham Street Over 1,000 amps or volts 454.65 2
City /State /ZiP: Tigard, Oregon 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT ❑ CONTACT PERSON above service or feeder fee, 17 6.65 113.05 2
each branch circuit
Business name: Atlas Electrical Contractors, Inc. B. Fee for branch circuits
without service or feeder fee,
Contact name: Ronald J Gauger first branch circuit 46.85 2
Address: 4403 SE Roethe Road Each add'I branch circuit 6.65 1 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Milwaukie, Oregon 97267 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 659 - 2212 Fax: : (503) 659 - 4944 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Atlas Electrical Contractors, Inc. energy panel, alteration, or
Address: 4403 SE Roethe Road extension. Describe: Page 2 2
City /State /ZIP: Milwaukie, Oregon 97267 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 659 - 2212 Fax: (503) 659 - 4944
Investigation per hour (1 hr min) 62.50
CCB Lic.: 1532 Electrical Lic.: 3 -2C Supr . Lic.: 1091S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required:
� n Subtotal: 300.20
`
Print name: Ronald J Gauger Date: 4/16/ 7
Plan review (25% of permit fee):
State surcharge (8% of permit fee): 24.02
Authorized signature: TOTAL PERMIT FEE:
c.,-.2:-) This permit application expires if a permit is not obtained within 180
Print name: Ronald J Gauger Date: 4/16/07 days after it has been accepted as co lete.
* Number of inspections allowed per permit. 3� `�
1:\ Building \ Permits \ELC- Pem M/
ritApp.doc 05/23/06 440- 46I5T(II /05 /COWEB /
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 002138
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2&2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/18/2007 TIME: 7:04AM PAGE: 30
SITE ADDRESS: 011777 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CITY OF TIGARD
DESCRIPTION: TI
OWNER: CITY OF TIGARD, PHONE #: 503 -639 -4171
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659_
Inspection Request Scheduled For: Date: 6/18 /2007 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050388.01 503 -901 -9342 N
Corrections /Comments / Instructions:
/ P 7 /cc "
PASS I PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 7,PL"<? Date: -1 - Phone #: (503) 718-
CITY OF TIGARD .
BUILDING DIVISION A_ PERMIT #: ELC2007 -00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2007
Phone: (503) 639 -4171 Iii f
Inspection Requests (24 Hrs.): (503) 639-4175 - e:I
INSPECTION WORKSHEET FOR DATE: 6/1 /2007 TIME: 7:02AM PAGE: 29
SITE ADDRESS: 08777 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CITY OF TIGARD
DESCRIPTION: TI
OWNER: CITY OF TIGARD, PHONE #: 503. 639.41171
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659 - 2212
Inspection Request Scheduled For: Date: 6/1 /2007 Pour Time:
Code # Inspection Description — Confirm_# Contact # Message
130 Ceiling cover 049413-01 \ 503 - 901 -9342 N
. ;\ 1
Corrections /Comments /Instructions: ,\ J
1-..i c*11 V oa t cE VU l,r 4
c- ( Pis •
O `aPZiki )4w4 , Val f G :Cu 15 ANO '1 psSiNL
WO Eoci.E c0 utA. i iN I Lit V.
)4PASS 1 1 PARTIAL APPROVAL ❑ CANCEL 1 NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
��`` .../ �
Inspector: �' Nt L.; Date: ' I t-) Phone #: (503) 718 '
CITY OF TIGARD
BUILDING DIVISION A, PERMIT #: ELC2007 -00258
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2612007
Phone: (503) 639 -4171 A 1 ,I ,
Inspection Requests (24 Hrs.): (503) 639 -4175 .,. ..... l'I
INSPECTION WORKSHEET FOR DATE: 4/2712007 TIME: 7:00AM PAGE: 74
SITE ADDRESS: 013777 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CITY OF TIGARD
DESCRIPTION: TI
OWNER: CITY OF TIGARD, PHONE #: 503- 639.4171
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659 - 2212
Inspection Request Scheduled For: Date: 4/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cove
c 503-901-9342 N
Corrections /Comments/ Instructions:
PASS RTI APPR AL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: ^ r ( (_E Date: 2101 Phone #: (503) 718 -1 b