Permit :!: n
•
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00794
COMMUNITY DEVELOPMENT DATE ISSUED: 11/27/2007
rT,I;GdRD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102AA - 04100
SITE ADDRESS: 12230 SW MAIN ST ZONING: CBD
SUBDIVISION: MORINS ADDITION LOT : JURISDICTION: TIG
PROJECT: CROWN CARPET
Project Description: (5) branch circuits. Wire HVAC and relocate lighting.
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: 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: 4 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:
INTEGRITY INVESTMENTS INC WILLAMETTE ELECTRIC INC
2229 NE BURNSIDE SUITE 86 PO BOX 230547
GRESHAM, OR 97030 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
IELPRMTI LC Permit 1 1/27/200" $73.45 LIC 75059
II
ITAXI8 % State Surcharge 1 1/27/200' $5.88 SUP 4226S
Total $79.33 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: C%t /t�G.�c_ /G Permittee Signature: &' '7
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.
N0) 27 2007 8:49RM WILLAMETTE ELECTRIC INC. 5555555555 p.2
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.- Electrical Permit Applicatio _.: ,.� ... ....:... . _..
Received Permit No.: � ��
City of Tigard Date/By `I / `27/0 / 13 7 79
t a /
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review Other permit:
140V 2 t 2001
. y q it Phone: 503.639.4171 Fax: 503.598.1960 Date/By: tar . ® See page 2 for
ry h'? Inspection Line: 503.639.4175 r ?V ' Dat h eady /By:
f 16 A It l� , F TI G AR Supplemental Information p CITY D O Notifted/Method: pP
,, .,,:c x�. Internet: www.tigard- or.gav
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Ip. 1 ,. ... 111 7 9 t431 P l 1, 1q' tt # i t l 1 fil a 4 2 f a I idol:. ��• �f�,llll t _I i ii ¢R t.Ilt7t A'f'�11f1fl'rCiUliati ibi aI.1 1ifi
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l j Ne U c cj n Sl n i c t li on " 9 4 td�al iilr7ri` Ad % iim� �i Ofl/ r eP ga m tJk 1�Iw Please check all that apply (submit 2 acts of plans w/dems checked below)
ID New construction ❑ Addition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marina and boatyards.
WIN-, � 1,(�N ,„ � m I t u qq P p cpx J!°'HG�� rgunurin, nr � s + n,,� t�i��j� '�. til8uyI 1�p exceeds 10,000 amps at 150 volts or ❑ Floating buildings
1 111, pp}}��i t in t 1 li t, I a 1 , } Illtdfl',1t llti111d?t 111 l((>I
q�, 111111JY 2i >iU,flllllilif li dfudat aids hq,et, tut ¢ less to ground, or exceeds 14,000 ❑ Commercial use agricultural
❑ 1- and 2- family dwelling 0 ❑ Accessory building amps for all other installations. buildings.
❑ iin Installation of 75 KVA or
Master builder ❑ Other: ❑ Fire pump'
❑ Multi-family ❑ ild ❑ Emergency system. Larger separately derived system.
a 8` A 7r 1rl a ^nul pt bu¢ o' unQ yn li n r r r ilFR¢t p e ?ik tin! y�, 111 i ' a. ° ?l �� �9`1�� 1 Addition o bad of ❑ "A ", "E" "1 -2" "1.3"
I I,I�} ,(� " i 4 a • t ' a I . - iii t ,, {, , lid ( ' (iii ❑ f new motor
UL`' 7111;" ilI�IIIIItU10�:,; 4Tl taubsait' cYqi a l ad5tdm t4g�cxtftf ¢i¢1ot1w n11RNt lla g116ia1(�Ill nl, � •
100HP or more. occupancy.
Job no.: -79G, Job site address: } 22 3D St3 M, ..c..7
❑ Six or more residential mots. ❑ Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for more then
City /State/ZIP: -[► /LRr? CIL CI Hazardous locations. 600 volts nominal.
❑ Service or feeder 600 amps or more. � �
Suite/bldg./apt. no.: ,Project name: Gl xa�1 L p INEEME f;,•.
G/+,t puTS t } 1 r q aka , r. r 'e ai r
daiu 'III �t+S6���N�I',� ��,�a u�dr,L r,.
Cross street/directions to job site: N/p Description Qty. roc. Total New residential single- or multi- family dwelling unit.
Includes attached garage. _
Lot no.: h..1(A 1,000 sq. ft. or less 145.15 4
Subdivision: i„..1/4 Ea. add'I 500 sq. ft. or portion 33.40 I
}[ Taax Q m ,� a g p/pa t r � cel �l� no ' .: �F� o /p Limited energy, residential 75.00 2
EATER r . ��'Ofaaai�lYetg EMail a l ae .VtmiWic it 1 1 v g lI lit..- 11 i hil rlAle il (w ith above sq. ft.)
Limited energy, mult - family 7500 2
L) . _ s 11=13' a j - to WTI. 11 residential (with above sq. fl.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
n la, t m,lq cr 2ea. ��; i 1 lI rr l n! i P°�1; . ��! !. I 9� 1. 201 am s to 400 amps 106.85 2
l tilij� ..l, I � ixn''''.e� i E witilit iii' , J ii 1111 1 I' 1 1 11 11 11 E . gt u 73r t;it@ i lli if A p
401 amps to 600 amps 160.60 2
Name: 3AV U d 601 amps to 1,000 amps 24D.6D 2
Address: Over 1,000 amps Of volts 454.65 2
Temporary services or feeders inetalladon, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) 1 Fax: ( ) 200 amps or less 1
166.8 _ 1
201 amps to 400 amps 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2 _
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new alteration or extension, , r panel
Owner signature: Date: A. Fee for branch circuits with
apt I ,. q i xr ,s, ,)< , �,'. ()�g� � {�i r , ,,, t� � :�'^7att atmlai;; ;flq. �' 2
VPrl f�1111 9zJ '�%!' nini Mbi ".1(lif�}l1 ,II 11 t6ff r6 :m reef IJi ;�: v"C "s lain hbranchccucuiteder fee, 6.65
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 yi Q 2 l
Contact name: first branch circuit
Each add'I branch circuit ti 6.65 a, 2
Address: Miscellaaeous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling. service and /or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
Pump or irrigation circle 53.40 2
��� g _,�y �� } gp�gip �p�p , �p��p
?kB iilfl�U'fll[ Itfsl"0tc'a tilUlBllt,`E ��d r t "> igi I il ' I ng I ` ai _Sign or outline lighting 53.40 2
Signal circuit(s) or Ihnited-
Business name: Willamette Electric Inc energy panel, alteration, or
extension. Describe: Page 2 2
Address: PO Box 230547
OR 97281 Each additional inspection over allowabk in any of the above
Per inspection
City/State /ZIP: Tigard, 62.50
Phone: (503) 624 - 3631 I Fax: (503) 624 -2938 Investigation per hour(1 hr min) 62.50
Suprv. Li 4226S Industrial plant per hour 73.75
CCB Lic.: 75059 Electrical Lic.: 34 283C I ra3 iS s 1tli', g i • s '� 7nlh 1
���4��i��iIII�IlI1.��la �..,;�1.,�;�.���.Cl�°�:���:;. � �'�I1�3�1111�
Suprv. Electrician signature, re ui ~` �- -- . -,_... Subtotal: -t3 .•_
Plan review (25% of permit fee)
Print name: David Fife Date: )y�a( G,?
State surcharge (8% of permit fee): c 5D
Authorized signature: TOTAL PERMIT FEE: 741 f
This permit application expires if a permit is not obtained within 180
Print name: Dale: days after it has been accepted as complete.
• Number of inspections allowed per penult.
i 'tBuildinePermita\ELGPermitApp .tine OS/23'06
440 -461 5T(11/05rcoM/WEe