Permit 4 84/(9 `^ _ ' "` ELECTRICAL PERMIT
111 - C 600syt Aa PERMIT #: ELC2008 -00630
COMMUNITY DEVELOPMENT DATE ISSUED: 11/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101 DA 01500
SITE ADDRESS: 07150 SW FIR LP 205 ZONING: C -P
SUBDIVISION: 72ND BUSINESS CTR-VARNS PARK LOT : 005 JURISDICTION: TIG
PROJECT: DHS /HALSTEAD
Project Description: TI - (5) branch circuits. Job No. M- 074508. 11/21/2008 ADDED low voltage for data cabling.
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: 1
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: 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:
BTE LEASING, INC DND ELECTRICAL CONTRACTORS INC
c/o MASON, H CARL + 2019 NE COLVIN COURT
HAFNER, ROBERT E PARTNERSHIP MCMINNVILLE, OR 97128
TIGARD, OR 97281
Phone: Contact #: PRI 503 - 472 -4003
FAX 503 - 472 -3668
FEES
Description Date Amount Reg #: ELE 36 -35C
[ELPRMT] ELC Permit 11/10/2001 $73.45 LIC 53986
[TAX] 12% State 11/10/20W $8.81 SUP 38185
[ELPRMT] ELC Permit 11/21/2001 $75.00
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $166.26
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 - • h in OAR 952 - 001 -0010 through OAR 952 -001 -0100 You may obtain copies ese rules or direct questions to OUNC at
503 246,669: or 1 800 3 2
Issued By: . y Permittee Signat
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: s" e �� - 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.
/1. 1/ i,42& 4/,k /r. cwoce / /0.4) af! / ELECTRICAL PERMIT
CITY OF TIGARD (�
ef� PERMIT #: ELC2008 -00630
COMMUNITY DEVELOPMENT DATE ISSUED: 11/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DA -01500
SITE ADDRESS: 07150 SW FIR LP 202 ZONING: C -P
SUBDIVISION: 72ND BUSINESS CTR -VARNS PARK LOT : 005 JURISDICTION: TIG
PROJECT: DHS /HALSTEAD
Project Description: TI - (5) branch circuits Job No. M- 074508 11/21/2008 ADDED low voltage for data cabling.
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: 1
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: 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:
BTE LEASING, INC DND ELECTRICAL CONTRACTORS INC
c/o MASON, H CARL + 2019 NE COLVIN COURT
HAFNER, ROBERT E PARTNERSHIP MCMINNVILLE, OR 97128
TIGARD, OR 97281
Phone: Contact #: PRI 503- 472 -4003
FAX 503 - 472 -3668
FEES
Description Date Amount Reg #: ELE 36 -35C
[ELPRMT] ELC Permit 11/10/200} $73.45 LIC 53986
[TAX] 12% State Surchar 11/10/200} $8 81 SUP 3818S
[ELPRMT] ELC Permit 11/21/200} $75.00
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $166.26
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: i �' 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.
s.
CITY O F TIGARD ELECTRICAL PERMIT
II
1 1 11 /1
PERMIT #: ELC2008 00630
COMMUNITY DEVELOPMENT DATE ISSUED: 11/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DA -01500
SITE ADDRESS: 07150 SW FIR LP 202 ZONING: C -P
SUBDIVISION: 72ND BUSINESS CTR-VARNS PARK LOT : 005 JURISDICTION: TIG
PROJECT: DHS /HALSTEAD
Project Description: TI - (5) branch circuits. Job No. M- 074508
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: 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:
BTE LEASING, INC DND ELECTRICAL CONTRACTORS INC
c/o MASON, H CARL + 2019 NE COLVIN COURT
HAFNER, ROBERT E PARTNERSHIP MCMINNVILLE, OR 97128
TIGARD, OR 97281
Phone: Contact #: PRI 503 - 472 - 4003
FAX 503 - 472 - 3668
FEES
Description Date Amount Reg #: ELE 36 -35C
[ELPRT] ELC Permit 11/10/2007 $73.45
LIC 53986
M
[TAX] 12% State 11/10/2007 $8 81 SUP 3818S
Total $82.26 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Muniopal 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 66" or 1.80' - = , .
Issued :y: J 12 �,,/ n
�, Permittee Sig. ure:`, , <In
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:
- 'NTRACTOR 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.
02/24/2009 TUE 14:28 FAX 5034723668 DND ELECTRICAL [ 001 /00l.
Electrical Permit Application ' - y , FOB off FILE USE ONLY .
' ''o_ �9 - ceived C (�
c
City of Tigard �" Date /By Permit No.' �. _ Lc OTC ok,3o
• 13125 SW Hall Blvd., Tigard, OR 97223 FEB 2 4 2009 Plan Review Other Permit
11
Phone. 503.639.4171 Fax: 503.598 1960 Date /By:
'T[GAItD; Inspection Line. 503.639.4175 Date Ready /By, Jam 10 See Page 2 for
Internet. www.tigard -or gov CITY OF TIGARD Notified /Method. Supplemental Information
TYPE OF W ILDING DIVISION PLAN REVIEW
New construction Addition /alteration/re ace[ pent 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: a 1 where the available fault current ❑ Marinas and boatyards
CATEGORY OF COF /' TRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Icss to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ hire pump ❑ Installation of75 KVA or
__
JOB SITE INFORMATION AND LOCATION Additi
❑ Emergency system larger separately derived system
Q Addition of new motor load of ❑ "A ", "E ", "I -2 ", "l -3 ",
11 v t 001(P or more occupancy
Job no.: Job site address: ` t� � i � S � N ��VY /ml) r ❑ Six or more residential units, ❑ Recreational vehicle parks
try /State/ZIP: 3 , - -\� aU a), `1\ 0 ❑ Health -care facilities, ❑ Supply voltage for more than
'� ❑ Hazardous locations 600 volts nominal
Suite/ bldg. /apt. no.'. & n tne
1 Project : _
t \ �d
❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtr. I Foe. I Total 1
( New residential single- or multi - family dwelling unit.
Includes attached garage.
I -----
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
i Tax map /parcel no Ea add'I 500 sq. ft. or portion 33.40 1
_ _ Limited energy, residential 75 00 2 - \ DESCRIPTION OF WORK (with above sq ft.)
Limited energy, multi- family 75 00 2
*neLtic__C ,^ t_ Q V` s,.,\,_ aV - k C h � 0 residential (with above sq ft )
` O c Services or feeders installation, alteration, and /or relocation 2
r� O � 200 amps or less 80.30
❑ 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
Owner signature' Date: Branch circuits - new, alteration, or extension, per panel
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 i
Contact name: wuhout service or feeder fee, 46.85 2
_ first branch circuit
Address: Each add'1 branch circuit 6.65 2
Fax..( ) - Miscellaneous (service or feeder not included) i
City /State /ZIP' Each manufactured or modular
- dwelling, service and/or feeder 90.90 2
Phone:( ) -
Reconnect only 66 85 2
E -mail:
-- Pump or irrigation circle 53.40 2
i CONTRACTOR Sign or outline lighting 53.40 2
v" Business name: l Signal circuit(s) or limited -
Q f �� L-1 e�� ,l G (J tdv cv S ` energy panel, alteration, or
Address. C3-0\ Ck I . J ' C-0 tv Co J o extension Describe Page 2 2
City /State /ZIP: n .,- \ f (y\,,'\,-.i. 0 1\ LQ C � C.(� \ " Each additional inspection over allowable in any of the above
u Per inspection 62.50
d) Phone: (5) 3) S 1 __ _, J--. Fax: (3)3) 1- n � -- r 73 4_ Investigation per hour (I hr nun) 62.50
A CCB Lie.: 5 3 C l Io El ectrical Lie,. 5(a, y c. Suprv. Lie.: '3 l& `-� Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES
Supry Electrician signature, required: i ,
n << ! ., }n ,, Subtotal: —
Print name: �"N � (� .," Date: ��j 0 Plan review (25% of permit fee)
4 u� State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
' Number of inspections allowed per permit
I \Budding \Prnnits \Ei.c- Pe,ulApp doe 05,23/06 440- 4615T(t I /05 /COM/WED
11/21/2008 FRI 9:26 FAX 5034723668 DND ELECTRICAL 0002/003
• ,
'h
Electrical Permit Application EoR orFicE USE ONLI 1 Received n City of Tigard Plan R y: 7 ‘ 2. 4 J s_ Permit No. L( Qb ( 0
13125 S W Hall Blvd , TigarR
1 Plan Review
, 14 ; . - Phone: 503.639.4171 Fax• 503 598 196 !d 0 c,, tC t 1) Date /By: Oilier Permit:
T.IGARD Inspection Line: 503.639.4175 NOV Date Ready /By Turn ® See Page 2 for
Internet. www.tigard or.gov ((�� �� Notified /Method: e r Supplemental information
TYPE a. `` R
N. �� . ,,,(((
to Q�� p�a101 P LAN REVIEW
Ik1 t o r YfC . ;Ft t I%5' Please check all that apply (submit 2 sets of plans w /uems checked below):
❑ New construction A ddltt A� r tI0 placement 0 Service or feeder 400 amps or more 0 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
❑ I - and 2- family dwelling ;Commercial /industrial 111 Accessory building amps for all other installations buildings.
❑ Multi- family / ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
0 Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1.3 ",
Job no : (y\_ v Job site address: ( C 1001W or more occupancy
!w �� `l O �t i � — / c 0 Six or more residential units ❑ Recreational vehicle parks.
City /State /ZIP: T / Cr S 0 1� { �� 3 Q Health - care t iies. 0 Supply voltage for more than
1 , . " f `— ❑ Hazardous locations. 600 volts nominal
Suite/bldg /apt. no.: Project name' ❑ Service or feeder 600 amps or mole.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I FM I Total — i - "
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Tax map /parcel no,: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq. ft.)
A
` , Limited energy, multi- family 75.00 2
A ,,k_ k t ,c, •,. � J L. �/ O, �- (p � residential (with above sq ft.)
/� o t f �� Services or feeders installation, alteration, and/or relocation
l
Y r .. 1 ,� 1 t- C__ 6 3 0 200 amps or less 80.30 2
—_
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 am 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
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, 46.85 2
first branch circuit
Address: Each add'l 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 66.85 2
-
E -mail: Pump or irrigation circle 53.40 2
CON TRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
Business name: t_ n (,, U
QN 1? S .IF c .Y'; ,_,,..&, CO. ! -G.i �--s t c.- • energy panel, alteration, or ����
Address: t \ NE C J � C OU ,•- extension Descri13e �r I Page 2 /� 2
City /State /ZIP: \ Cr-) J Each additional inspection over allowable in any of the above
I� G ^� V 1 \ 1 ()V-- � �tl Per inspection 62.50
Phone: ( ) Fa ( ' ( ) _ (
j 3 Investigation per hour (l hr min) 62 50
CCB Lic.:S C ( ,,s Electrical Lic . 3 C - 3 j (,_ Supry Lie.: 3 (, - Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required. Subtotal 1 - 757�-
Print name. m ( !J� )0 , v_L.- Date: (12% Plan review (25% of permit fee). 1V------ �
_,v State surcharge (12 of permit fee).
Authorized signature: TOTAL PERMIT FEE: -
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Bu lding\Penniis\LLC- Permanpp dos 05/23/06 440 4615T(I 1 /05 /COM/WEB
11/21/2008 FRI 9:26 FAX 5034723668 DND ELECTRICAL 0003/003
4
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems"
❑ Burglar Alann
❑ Garage Door Opener*
E Heating, Ventilation and Air Conditioning System
❑ Vacuum Systems"
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 - 309 -0000)
Check Type of Work Involved:
(l Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
Data Telecommunication Installation
(l Fire Alarm Installation
L{ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control"
7 M edical
❑ Nurse Calls
❑ O utdoor Landscape Lighting
❑ Protective Signaling
Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
,1./10/2008 MON 14:30 FAX 5034723668 DND ELECTRICAL 0001/002
r
Electrical Permit Application RECEIVE :, . . " FOR`OFFICE USEO l ° .. ' " . t
City of Tigard NOV p DateB Permit No i��5 � d).30
U PI tl 13125 SW W Hall Blvd ,Tigard, OR 972 0 2008 Plan Rc vrcw
Other Pemut.
Phone. 503.639.4171 Fax: 503.598.19 Date /By
Inspection Line: 503.639.4175 C ITY OF TIGARD Date Ready /By T uns / 0 See Page 2 for
TlGp►ZD Internet www.tigard -or gov BUILDING DIVISID Notified /Method I a Supplemental Information
TYPE OF WORK PLAN REVIEW
(:j New construction .ddition /alteration /replacement Please check all that apply (submit 2 sets of plans whtems 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 0 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
_ ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: r ,.....0 14 4 Job site address: — t 5� 5 � r r ^ Lpof' 5v114.-- o�C�� h00HP or more occupancy.
r ❑ Six or more residential units ❑ Recreational vehicle parks
City/State/ZIP: , 'r o Health -care facilities. ❑ Supply voltage for more than
012. I ? da3 ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no : Project name: f ❑ Service or feeder 600 amps or more
�� 5 J }5 FEE SCHEDULE
Cross street/directions to Job site: Description Qty. Fee. Total r'` m
C( New residential single- or multi - family dwelling unit.
Includes attached garage.
�
1,000 sq. ft. or less 145 15 4
til Subdivision: Lot no.: Fa add'l 500 sq ft or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. IL)
Limited oq ft 75.00 2
�e, (,�h'\` �� / �yN,,� � i �rS residential (with w above ve a sq ft.)
JU , � � Services or feeders installation, alteration, and/or relocatio
_ _ �.' 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
v 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 I
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, . er panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above source or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits I
without service or feeder fee, t/ / b' J Er l' -
Contact name 46.85 { 2
,ti
first branch circuit
Address: Each add'l branch circuit t1 6.65 t)(°' 6C 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
9090 2
dwelling, service and/or feeder
Phone: ( ) Fax. ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53 40 2
_CONTRACTOR
Sign or outline lighting 53 40 2
l Business name; M vAj 0 l .�,,1 c_ Signal circuit(s) or limited-
2C C�� - �i" S I C energy panel, alteration, or
Tess: q _ ( �• �+ extension Describe • Page 2 2
\ City /State /ZIP• t `` O c 1 1 � y r Each additional inspection over allowable in any of the above
`v \ f M t ,.s.„.. U C 3 V Per inspection 62.50
Phone: (5p3) L \ .. _ I„ .3 lit /, + ax: (9)3) 4 3“-.)r Investigation per hour(i hr Iran) 62.50
% CO3 Lie.: b3 l Electrical Lie., 3e0. -3S( Suprv. Lie.: 3c I X —S Industnal plant per hour 73.75 i
ZatAie '� �G ELECTRICA PE R MIT FEES
4
V
Suprv. Electrician sig required: V , � � o,ci ji Subtotal: — 17? , L I S
Print name 'r \ E &W� oe . I Date \ 1' 10 } 0 Plan review (25% of per,uit fee)
J State surcharge (12% of permit fee): 6
Authorized signature: TOTAL PERMIT FEE: 8 a , a. C,
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
' Number of inspections allowed per permit
I \ Budding \Pcrnuts \ELC- PcnnttApp doe 05/23/06 440.4615T(11 /05 /COSVWEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 0LC2008.00630
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/20013
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: ' 2/25/2003 TIME: 7 :0OAM PAGE: 10
SITE ADDRESS: 07150 SW FIR LP 205 CLASS OF WORK:
SUBDIVISION: 72ND BUSINFSS CTR - VARNS PARK LOT #: 005 TYPE OF USE:
PROJECT NAME: [)HS /FIALSTEA[)
DESCRIPTION: 11 - (5) branch circuit:,. Job No. M- 074508. 11/2.1/2008 ADDED leer volta e for data cabling.
OWNER: ETE LEASING, INC, PHONE #:
CONTRACTOR: DND ELECTRICAL CONTRACTORS INC CN PHONE #: 503. 472 -4003
Inspection Request Scheduled For: D e: Pour Time:
Code # Inspection Description Confirm # Contact # ,essage
199 Electrical final 080828.01 503.472 -4003
Corrections /Comments /Instructions:
I!
0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 66 L' Date: V 2.61 Phone #: (503) 718- 10
CITY OF TIGAD
•
BUILDING DIVISION PERMIT #: F1 :20013 00€30
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1012000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2124/2009 TIME: 7 :00AM PAGE: 11
SITE ADDRESS: 07150 SW FIR LP MR 2015 CLASS OF WORK:
SUBDIVISION: 72N1) BUSINESS CI'R - VARNS PARK LOT #: 005 TYPE OF USE:
PROJECT NAME: DHS /HALSTEAD
DESCRIPTION: 11 - (5) branch circuits. Job No. M- 074508. 11/21/2008 ADDED low voltage for data cabling.
OWNER: BTE LEASING, INC. PHONE #:
CONTRACTOR: DNL.) ELECTRICAL CONTRACTORS INC PHONE #: 503- 472 -4003
Inspection Request Scheduled For: Date: 7124/2009 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 080785 -01 800.927 -9324 N
Corrections /Comments /Instructions:
c,o M ` !Al. 6 NAI. N u yvtib•Ek. I u ` 1k cAt
Pco.,040 a PhSi3`(t";■'9 -v6L'Q :
^� N 3 \ 1 0;y0 - V of cx� DK
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL T CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� �� LE"
Date: o Phone #: (503) 718 - 3-4th
CITY OF TIGARD
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BUILDING DIVISION PERMIT #: FLC20013,00630
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11i1012008
Phone: (503) 639-4171
Inspection Requests (24 Hrs): (503) 639-4175 4J.. ii.
INSPECTION WORKSHEET FOR DATE: 11/1912008 TIME: 7:02AM PAGE: 26
SITE ADDRESS: 07150 SW HR 12 202 CLASS OF WORK:
SUBDIVISION: 71ND BUSINESS CTR PARK LOT #: gOS TYPE OF USE:
PROJECT NAME: DHSIHALSTEAD
DESCRIPTION: 'n - (5) branch circuits. Job No. M-074508
OWNER: ffIE LEASING, INC, PHONE #:
CONTRACTOR: DND ELECTRICAL CONTRACTORS INC 3c4,1 PHONE #: 503-472-4003
Inspection Request Scheduled For: Date: 11/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough-in R 078237-01 503-472-4003 Y c...„..7
Corrections/Comments/Instructions: .
' .
•
-c=1-13trSS r] PARTIAL APPROVAL D CANCEL 0 NO ACCESS
fl FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector:
/4 Date: /1 i C) / - '4 3 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00630
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 1/ 'moos
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Phone: (503) 639-4171 04,44
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11118/2008 TIME: 7:01AM PAGE: 29
SITE ADDRESS: 07150 SW FIR LP 202 CLASS OF WORK:
• SUBDIVISION: 72ND BUSINESS CTR-VARNS PARK LOT #: 00E, TYPE OF USE:
PROJECT NAME: DNS/HALSTEAD
DESCRIPTION: 11 - (6) branch circuits. Job No. M-074508
OWNER: BIF LEASING, INC, PHONE #:
CONTRACTOR:
PHONE #: / —503-472-4003
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DND ELECTRICAL CONTRACTORS INC 7p4 \ A
F)f 1- - - %C
Inspection Request Scheduled For: Date: 11/18/2008 Pour Time:
•
Code # Inspection Description Confirm # • Contact # (/ Message
\
120 Electrical rough-in 078173-01 W3.472-4003 Y
Corrections/Comments/Instructions:
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fl PASS fl PARTIAL APPROVAL El CANCEL fl NO ACCESS
*1
fl CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: 7 1 : 1
• 4 Date: Itilifit Phone #: (503) 718- *ft