Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: E 8/2008 - 00518
DATE ISSUED: 9/8/2008
•TIGARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126 D B -02800
SITE ADDRESS: 09370 SW GREENBURG RD 202 ZONING: C - P
SUBDIVISION: PP1991 LOT : 001 JURISDICTION: TIG
PROJECT: AMERIPRISE FINANCIAL
Project Description: Reconnect mechanical unit.
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:
FRANKLIN COMMONS ASSOCIATES WILLAMETTE HVAC
BY NORRIS + STEVENS 3075 SW 234TH AVE. #206
520 SW 6TH STE 400 TIGARD, OR 97281
PORTLAND, OR 97204
Phone: Contact #: PRI 503 628 - 6841
FAX 503 - 848 -2597
FEES
Description Date Amount Reg #: ELE 34- 346LHR
[ELPRMT] ELC Permit 9/8/2008 $46.85 LIC 56951
ITAX1 12% State Surchar 9/8/2008 $5.62 SUP 4025LE13
Total $52.47 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 -0 hrough 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 B : - Permittee Signature:
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.
Electrical Permit Application ,fir g� `4,,,,i, k ri i l � , r ,,,,,,.,.,.1:,,,,..,. °` , � FOR °FH ICE, USE ONLYf r ,I s 2 altr_'4
>r . i,i4 City of Tiga � E'l.�l d E ��` DateBy D� kA 2,U0 -easi S
�It,v? P ermit No.:
'' ° 13125 SW Hall Blvd., Tigard, O 9 72 23 Plan Review
u • i: .. Other Permit:
n 1,, Phone: 503.639.4171 Fax: 503.598.19 Date /By:
* SEP — 8 2008 ® ^` Inspection Line: 503.639.4175 Date Ready /By: Juris See Page 2 for
aTIGA,RD' Int www.tigard - or.gov V Notified/Method: 11 Supplemental lnformation
TYPE OF WOR • • .--
❑ ® dtf1`JL`�hi�PitDIVISI�N PLAN REVIEW
New construction Addition /alterati a 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.
` less to ground, or exceeds 14,000 ❑Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: Job site address: 9370 SW Greenburg RD 1 or more. a
❑ Six x o or r more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ S nominal.
voltage for more than
❑ Hazardous locations.
g /a p t. no. D . 0 Project name (, m e / /v J .5 . � c M
Suite/bldg./apt. ile / � / ❑ Service or feeder 600 amps or more
°" Pro' "V // / ! / ( /(
FEE SCHEDULE'
Cross street/directions to job site: Description 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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi-family 75.00 2
Reconnect unit residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: 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, ■ 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 lu 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) ' Fax: : ( ) Reconnect only d 66.85 2
E -mail: Pump or irrigation circle 53.40 2
' . CONTRACTOR Sign or outline lighting 53.40 2
Signal panel, or limited-
Business name: Willamette HVAC
energy panel, alteration, or
Address: 3075 SW 234 Ave Ste 206 extension. Describe: Page 2 2
City /State /ZIP: Hillsboro, OR 97123 1 Each additional inspection over allowable in any of the above
Phone: 503 628.6841 Fax: 503 848.259, y g
Phone: ( 503) ( ) ' LH 11 I t t ' Per inspection 62.50 Investigation per hour(1 hr min) 62.50
CCB Lic.: 56951 Electrical Lic.: J . .1-00. Suprv. Lic.: 4025LEB Industrial plant per hour 73.75
/
ELECTRICAL PERMIT FEES / �(�
Suprv. Electrician signature, required: ' Subtotal: L-/ 6
Print name: Mike Sicard Date: 9/5/08 Plan review (25% of permit fee) 111 ��-
State surcharge (12% of permit fee): 5. le 7 ''
Authorized signature: TOTAL PERMIT FEE 5e2,.
This permit application expires if a permit is not obtained within 180
Print name: Date: q , days after it has been accepted as complete.
* Number of inspections allowed per permit
1: \ Build ing\Permits\ELC- PermitApp.doc 05/23/06 440- 46t5T(t 1/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00518
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 910/2008
Phone: (503) 639 -4171 F1
Inspection Requests (24 Hrs.): (503) 639 -4175 _��
INSPECTION WORKSHEET FOR DATE: 9/11/2008 TIME: 7:OOAM PAGE: 14
SITE ADDRESS: 09170 SW GREENBURG RD 202 CLASS OF WORK:
SUBDIVISION: PP1991 - 010 LOT #: 001 TYPE OF USE:
PROJECT NAME: AMERIPRISE FINANCIAL
DESCRIPTION: Reconnect mechanical unit.
OWNER: FRANKLIN COMMONS ASSOCIATES, PHONE #:
CONTRACTOR: WILLAML I 1 E HVAC PHONE #: 503
Inspection Request Scheduled For: Date: 9/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message ��
199 Electrical final 075367 -01 971- 998 -2908 Y /41144
OW Wi k.1yA14i` e
Corrections /Comments /Instructions:
0 01 #tt.1 0-9 u y Gvi 4 -- 4 -t-if
❑ PASS. ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION - ADDITIONAL FEES ASSESSED
Inspector: APO Date: 7-ii ` 4 Phone #: (503) 718-