Permit - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00725
�i� DEVELOPMENT SERVICES DATE ISSUED: 9/27/2005
"- 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: (1) branch circuit, power to office cubicle. Job No. 87869
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: 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 CONST /GROUP
15350 SW SEQUOIA PKWY #300 -1MWI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: 503 - 624 -6300 Phone: 503 - 234 -9900
FEES Reg #: LIC 203
SUP 4460S
Description Date Amount ELE 26 - 95C
[ELPRMT] ELC Permit 9/27/2005 $46.85
[TAX] 8% State Surcharge 9/27/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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 • ••• - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a - set forth in O. • 952 - 081 -0810 through OAR 952 - 001 -0100. You may obtain copies of thes- .les or direct questiobs to OUNC at
503 -2 6 -6699 or 1- 800 -33 -i 34 .
Issued By: I l �g 4 P ermittee • S if 000/ .
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:
ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' _ .��ft�. ��'� DATE:
LICENSE NO: to a 5
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.
•
SCL' -26 -2005 12:26PM FROM -OR ELECTRIC SERVICE 5035352763 T -110 P.001 /002 F -397
• --"- rileCITataA efiutit. ii i
City of Tigard R ""`d ��� 7�
Dawns 9 .' Peru' No Ere -,PeK - oo S
13125 SW Hatll Blvd, Tigard, OR 27223 Platy Review �:+daerpertn�t
Phone: 503.639.4171 Fax 503.598.1960 ' h tt I '; Dbw>31.
Inspection Line_ 503.639.4175 SEP . 2 6 20 0 ds I { D°teRe Ready/By h RI see Page 2 for
Internet www.citigard.or.us Notifed/Mcthed: / i e. sapplernentnr lnrorm:Mon
_ CZ o�'o R GA PLAN REVIEW
❑ New construction 13 D `IU'i ISICIN Please check all that apply:
['Service over 225 amps, comm'1 ['Hazardous location
❑ Demolition ❑ Other. . ❑service over 320 amps -rating ['Haft over 10,000 sq, it.,
CATEGORY OF CONSTRDCr1ON of 1- and 2- family dwellings 4 ur more new residential
❑ 1 - and 2 family dwelling ® Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi- fatmly 0 Master builder 0 Other: ❑Occupant load over 99 persons ❑Manttfaclured structures or
JOB SITE INFORMATIOly AND LOCATION ❑Egress/lightingplan RV park
oa ❑Health - core facility ['Other: Job no.: 57869 l Job site address: 16600 SW 72 AVE
Submit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OR The above arc not applicable to temporary construction service.
�./ t no.: B LDG 10 P roject name: FLIGHT DYNAMICS -
FEE' S j Ci 1 LE
Suite/bld
b aP Description J Qty- I Fat I coral i .•
Cross street/directions to job site: New residcadal single- or multi- family dwelling trait.
Includes attached garage.
V
1,000 sq. ft. or less. 145.15 4
SubdiViSlOIa: Lot no.: a Ea. add'I 500 sq. R or portion _ 33.40 1
Limited energy, residential 75.00 2 - • Tax map /parcel no.: T Limited energy, non - resident 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
INSTALL POWER TO OFFICE CUBICLE
dwelling, service and/or feeder _ 90,90 2
Services or feeders installation, alteration, ad/or relocation
n
200 amps or less 80.3 2
201 amps to 400 amps - 106.85 2
123 PROPERTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2
Name: FLIGHT DYNAMICS/ROCKWELL COLUNS 601 amps to 1,000 amps _ 240.60 2
Address: 400 COLLINS RD. NE Over 1,000 amps or volts • 454.65 2
Reconnect only 66.85 2
City/State/ZIP: CEDAR RAPIDS, IA 52498 Temporary services or feeders installation, alteration, and/or
503 43 -3288 Fax relocation
Phone: amps
( � _ ( ) 200 amps or 1en 66.85 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to400,cups 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 pamcl
❑ APPLICA•T 1 0 CONTACT PERSON a. Fce for branch circuits tivih
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without sesvice feeder lea, 1 46.85 I}Ip -S5 2
each branch circuit
Addre . Each add'l branch circuit 6.65 2
City/State/ZIP: Misccllaneoaa (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fa, ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limhcd-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Oregon Electric Group
Address: 1010 SE l lth Ave Each additional inapecdon over allowable In any of the above _
- Per inspection 62.50
City/State/ZIP: Portland, OR 97214 Investigation per luau (1 hr min) 62.50
Phone: (503) 234 -9900 I Fax: (503) 535 -2763 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 203 , Electrical Lic.: 26 C Su.. - Lic.: 4460S • Subtotal 1 - 110. $5
Suprv. Electrician signature, required:i < ��A '' , ' ;. "" ` , ` ' ,' - 17 ; Plan review (25% of permit fcc)
Lam` J
State :surcharge (8% of permit fcc) ,3 . 1 5
Print name: M v AR1{ - Ki p te: 4 PERMIT FEE TOTAL. SO. to n
Authorized signature: f,... �. '.✓' .0 . .i .. rtsr x: ^ Ti , i l This permit application expo era posit is am obtained within 180
i .- , t .1:. . _ '; j e.nC,r, , = i Vii. days altar tt has been nccepaed as complete
Print name' r)1/\ p, RV, A K F TDate: 09/26/05 • Fels methodology set by Tri•Cotmty Building Industry service Boar/
+• Number of inspections per permit allowed