Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -10047
c.J � l n, DEVELOPMENT SERVICES DATE ISSUED: 3/15/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S113AD -01900
SITE ADDRESS: 16600 SW 72ND AVE B10 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT : 009 JURISDICTION: TIG
Project Description: Replace transformer & disconnect. Job # 91557.
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: 2 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES OREGON ELECTRIC GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 -2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 4/3/2006 $160.60 LIC 203
[TAX] 8% State Surcharge 4/3/2006 $12.85 SUP 44605
[ELPRMT] ELC Permit 4/4/2006 $160.60
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $346.90
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: e� Permittee Signature: _s -e C31
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.
s� _ ._ r,
MAR -14 -2006 10:03AM FROM -OR ELECTRIC SERVICE 5035352763 T -425 P.001 /002 F -833
Electrical rerr1L AppncanOil ��'n �� c,,.rr lE rwAA..,�:''Ft. t lt, ; R s t, ' % .
City of TI RIv&T i OR 97 .( �� @��® ▪ a , ny - /Y eG � Permit No. :�L.Z.. 4) 6 yogi?
13125 SW Hall Blvd, T. Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 I,�� t Date/By Other Permit:
Inspection Line 503.639A175 , p () E / ) � � ) pq y , - i � Doe ed/M /t o tuff ) So Page2 for
Internet: www.atigard.or.us i °IHi� U Notified/Method y
Supplemental informadon
• 41 a ' ' ti 2.:.e a PLAN REVIEW
❑ New construction ® < Vien,�e>lRcement Please check all that apply:
1:1 Demolition ❑Other. ❑Service over 225 amps, comm'I ['Hazardous location
❑ Service over 320 amps- rating ['Bullring over 10,000 sq. fl,
CATEGORY OF CONSTRUCTION oft- and 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling IN Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
ID Multi - family ❑Master builder ID Other: ❑Building over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION • ['Egress/lighting plan RV park
Job no.: 91557 I Job site address: 16600 SW 72 AVE ['Health facility ❑gym'
Submit 2 seta of plans with imy of the above.
City /State/ZIP: TIGARD, OR 97224 The above are not applicable to temporary construction service.
Suite6da pt. no 2 - f 0 I Project name: FLIGHT DYNAMICS FEE* SCHEDULE
1 /a Daaipa® 1 Qty. 1 tree I 'raw I "
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
+
Subdivision: I Lot no Fa add'I 500 sq. fL or portion 33.40 1
Tax map /parCCl no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION .OF WORK Each manufactured or modular
REPLACE TRANSFORMER AND DISCONNECT dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less ' p. 80.30 flap (no 2
❑ .PROPERTY OWNER i ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: ROCKWELL COLLINS 601 amps to 1,000 amps 240.60 2
Address: 16600 SW 72 AVE Ova' 1,000 amps or volts 454.65 2
- Reconnect only 66.85 2
Ciry/ State%ZIP: TIGARD, OR 97224 . Temporary services or feeders installation, alteration, and/or
Phone; (503)443 -3298 Fax; ( ) relocation
200 amps or Im 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 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
❑ APPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
a Fee for branch circuits
Contact name: without service or feeder fee,
Address:
each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/ Statc/Z1P: Mlecellaneo!s (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53,40 2
E -mail: Signal circuits) or limited -
• CONTRACTOR energy panel. alteration. or
extension Describe: Paget 2
Business name: Oregon Electric Group
Address: 1010 SE 11th Ave Each additional inspection over allowable in any of the above
- Per inspection 62.50
City/State/ZIP: Portland, OR 97214 Investigation per hots (I hr min) 62.50
Phone: (503) 234 -9900 - I Fax: (503) S35 -2763 Industrial plant per hour _ 73.75
ELECFRICAL PERMIT FEES*
CCl3 Lie.: 203 Electrical Li 5 , _ ' ■ prv. Lie.: 4460S Subtotal i 100 , L,00
.-- Suprv. Electrician signature, required: '. • ! J - • Plan review (25 %ofpermit fee)
Print name: M ' I / /, ` �� Stato surcharge (8% of permit fcc) 1 a _ gc
M v.. �• K eln✓le� •at /
TOTAL PERMIT FEE 1 1 '� . 45
Authorized signature: / This permit appncatiou expires It a permit Is not obtutned within 180
days after it has been accepted as complete
Print name: M 6 , - C Key\ n e, P D' O D ( , • Feo methodology set by Tri-County Banding tnduat y Service Board
•• Number of inspections per permit allowed.
istBuildiaa? iteo.C- permaapp.dnc 12/03 4404615T(IIY02/COstAVE1i
CITY OF TIGARD
BUILDING DIVISION PERMIT #:0G20D6 — /o o # / �7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
•
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: (n(,00 7. e— CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:b3 -4 .9- .6/D
CONTRACTOR: L) 01". PHONE #:
Inspection Request Scheduled For: Date: � j — � Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments/ Instructions:
` \k w 200
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PAS • ❑ PARTIAL APPROVAL PI CANCEL ❑ NO ACCESS
!,��• '4I CALL FOR INSPEC IO■ ❑ ADDITIONAL FEES ASSESSED
/
Inspector: �� Date: 3 1 ' 2 1 Phone #: (503) 718 - 'Mt