Permit ,� "" � ��� OF TIGARD ELECTRICAL PERMIT
T �, O
PERMIT D : 10 7/2 ELC2008-00568
' -' COMMUNITY DEVELOPMENT DATE ISSUED: 10/7/2008
rtGAkq 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AB-00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 350 ZONING: l -L
SUBDIVISION: FANNO CREEK PLACE LOT : JURISDICTION: TIG
PROJECT: PROFESSIONAL LIABILITY FUND
Project Description: (7) branch circuits for reception area, conference room and hall.
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: SIGNAUPANEL:
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: 6 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:
AKERMAN, RICH/WATHEY, JAMES E BERGELECTRIC CORP
16075 SW UPPER BOONES FERRY RD 6026 NE 112TH AVE
TIGARD, OR 97224 PORTLAND, OR 97220
Phone: Contact #: PRI 503 - 255 - 1818
FAX 503 - 255 -1919
FEES
Description Date Amount Reg #: ELE 37 -682C
[ELPRMT] ELC Permit 10/7/2008 $86.75 LIC 110521
[TAX] 12% State Surchar 10/7/2008 $10.41 SUP 5121 S
Total $97.16 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 obtainese rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: = ` `` _ Permittee Signature: �X��/
— II
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.
OCT -06 -2008 10:36 From: 5032556633 To :5035981960 P.2'3
' Electrical .Permit Application O
PP � FOR OFFICE USE ONLY
City of Tigard Received
Welly: idA9 : v/ ! � /��t�� Perm t N Qp� �i r X)
City f ( L] U J/[� (J
i ~ 13125 SW Fall Blvd., Tigard 2 l 5 � J • Js Plan Review
PI lune: 503.639.4171 F . 60 d Date /By. Other Permit:
TiGAhD Inspection Line: 503.639. O� ( ♦O Date Ready /By: _ [d See Page 2 for
h1lCnlet Wy1 W
r �� : r� 1 tiga or.gov /' bI� ` C� t ` ' N oljGed /M l ethod: Supplemental Information
tllut)a NewGUn5tttictlon �� ( ���S'�0,: � : t t •� Ir . l Plensechecka lhUta[ a ,r l e >. '� ! t �E r „II�,' �'' �' r� i�
.,1,d,",+:
0 Addition /al fir! 1 < 1 , • � apply (submit ?r sets of plans w /items checked below):
• ` �, ❑ Service ur feeder 400 amps or more 13 Building over three stories
El Demolition • Other: n where the available fault cwmnl 9 M arinas and boatyards.
,.'.* tw $5 )1 ,, y )? :,'3 i4k 't.. 1 . : ` SiZ 9
C '. T - . {�+ ' t 9•t1C 4 to }.� ¢M C ; :,
exzetd:t 10.000 amps I.50 volts or ❑ Floating building,
less to ground, or exceeds 14.000 ❑ Co -use agricultural
❑ 1- and 2- family dwelling ► Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Mu1ti- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ in.Iallaln,n ar 75 KVA or
^l 4 t �
a;�'S I'{l,. � ;�ai 4'i , •IfvJ ., „p a bi � .` r : , + 1,, r 1 ,i s fi. , ❑ L•mer s larger separately "1- derived syate,n.
1�,� r r+ .1 , ❑Addition Ol' muter l o f
�s` � ��,+"�, .,.,, ra )t., #.�t , "�O ❑ .. A .... E .... 12 ., u
• 7 Job Site address: r 0(1111' or more, occupancy.
Job no.: //
nee/ ` 1 Uf ►F-c Oa . ❑ Six or more residcmial unit,. ❑ Recre:dinnal vehicle parks.
City/State/ZIP: Ti o, 0R q 7�7 Z I f ❑ Hcalth,ine I,cililies. ❑ Supply voltage for ohm! than
. ✓Ili Project C� p `Y l = • ' . . 4 p/ ❑ S or e a d e locations. nominal.
L• ( r / +P n . , •t.', I f "f !� rL�� 1 600 volt,.
Suite/bldg. /apt. no- name: ❑ Service or redr WO ,em or more. aa
CrOSs strcct/directions to job site (-a( r (1 stir <� '{ty I tee. t,t . ra
� / , Dncrfptinn I Qty. � 1'0191 1
New residential single- or multi - family dwelling unit
includes attached garage.
Subdivision: Lot no.: 1 ,( kK ) sq. ft. or less 145.15 4
Tux map /parcel no.:
E. udd'l SIX) sq. ft. or portion 33.40 I
r RI Ltlitited energy, residential
,^M.,: - ,r,, „ r , ,4 t'' T) , : ; 1'I �O w 'k h �, i 6 yi {{u i .
�'F �" "��:� A��.� �#.6�r.d1'.i 1�1f,1p.:t . ,��� � (withat,ovesg.R.) 75.00 2
1 / 1 , ,1.6 / r'1 /
Limited residential (with wi habove lumilft 75.00 2
d Q j � ,� M I � �� Services ur feeders initallation and/or relocation
�x
le I ' 1Lr ' i
200 amps or ICC$
,1 , i5.. ,V Q
• , . .. , lit2t r'F�'af, , 2, a4"i, I .lt `)' N .'0Fr ,, , ,. � ” t �lr � r s t'1;� 5k q 2 01 am Ps to 400 a mps
.✓tt� h „ �cx1 �k .. .'s. ( � �' p 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address;
_ 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 t
Owner installation: This installation is being muds 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 cxtension
Owner signature: Dale;
°�;{ s rr�Y dd y S e i d r xk :y� },, A. Fcc for branch cin:uits with
A A q• 5,i A ” µ . .. + I0.�� w 1 Sl �r'7 ?r3 1r' 0.1:K nC I .?L ,.:) : „ , 1 1 t� ^ above service or feeder fee, 6
.� +' i�, ..; •t,1� „�Sl. � . „. : , u�,ti C �., c , „ , � 65 2
each branch circuit
Business flume; Bergelectrie Corp. B. Pee for branch circuits ,
Contact name: PQ {� l MOSS lCf2, �^�� without service or feeder fee, 1 46.85 r �. 2
_ kirst branch circuit
Address: 6026 NE 112th Ave Each add'I branch circuit I le t.65 _ 9FIoI 2
Miscellaneous (ee vice or feeder not included)
City/State/ZIP: Portland OR 97220 Each manufactured or Modular
dwelling, service and/or fccder 90.90 2
Phone: (503) 255 -1818 Fax: ; (503) 255 -1919 Reconnect only 66.85 2
E -mail 017 I # / ,r/ . eC rri C 1 1'1 Pump or irrigation circle 53.40 2
V. ': ' r ;y'R f PA M, 'i . 11 a is tl : ° ti' ~< +, v # � � , : r ! . , � r) � r R
Ct y1� %'iS �:i,:, ,.�..� ta.xs, ,�et,:::� °I 7'3.,, Sign uriutlin el i ghting 53.40 2
Business name: Bergeleetrie Corp. Signal circuit(s) or limited-
energy panel, alteration, or
Address: 6026 NE I I2th Ave extension. Describe: Pagc 2 2
City/State/7,1P; Portland OR 97220 Each additional inspection over allowable in antof the above
Phone;
(503) Per inspection 62.50
( ) 2$$ -1818 Fox: (503) 255 1919 Investigation per hour (1 hr min) 62.51)
-
CCB Lic.: 110521 Electrical Lic.: 37 -682C Suprv. Lk.: 51215 industrial plant per y �' hour �l1 73.75
, :0 ;N rJt �:'�'iL R1 :.l �� FA!'It t��w +i
Suprv, Electrician signature. required: (�� 75
j' Subtotal:
Print name: Jeremy Richmond Date; Plan review (25% of permit fee)
State surcharge (12% of permit fee): 10, c/
Authorized signatu �,/,�.
��iLt�l TOTAL PERMIT IcE cy7. /(
Print flame: / f f Date ,l� !l' This permit appgcatlon expires if a permit b not oblaiaed within 180 of . ' J J (J CJ I days after It has heen accepted as complete.
s Nwnb of inspections allowed per permit,
: Luitdi •tnU'crmiwF.i.c- PermitApp. 05,23 +06 4401615171 hot +UUM /WLD