Permit '' ' CiTY OF TIGARD ELECTRICAL PERMIT
11111 ° PERMIT #: ELC2009 -00045
COMMUNITY DEVELOPMENT DATE ISSUED: 1/30/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112BA -05900
SITE ADDRESS: 14058 SW MILTON CT ZONING: I -
SUBDIVISION: BONITA INDUSTRIAL PARK LOT : 007 JURISDICTION: TIG
PROJECT: WESTCON INC
Project Description: (4) branch circuits. Job No. 321470
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: 3 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:
DAVID & JAN GOODHEAD ROSENDIN ELECTRIC INC
14058 SW MILTON CT 2925 NW ALOCLEK DR #170
PORTLAND, OR 97224 HILLSBORO, OR 97124
Phone: Contact #: PRI 503 - 615 - 8189
FAX 503 - 615 -0689
FEES
Description Date Amount Reg #: ELE 37 -692C
[ELPRMT] ELC Permit 1/30/2009 $66.80 LIC 103939
[TAX] 12% State Surchar 1/30/2009 $8.02 SUP 3991S
Total $74.82 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 tha days. • -" ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952-001-0010 throug • • - • 5 - 001 -0100. You may obtain copies of these rules or direct question - to•OUNC at 503.246.6699 or 1.800.332.234.4.
I
Iss � >d By: i I # i Permittee Signa • re: -4 . � % �)•-/,
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 INSTAL • . ION ONLY
.. SIGNATURE OF SUPR. ELEC'N: 17 / - iiiiiire.ir 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.
Electri+ca1'P rmit Application FOR OFFICE USE ONLY
City of Tigard Received V /t) dy Permit No.: eGe 9-.etvc/
• = y:
° 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 p Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/Ely: luny/ H See Page 2 for
Internet: www.tigard or.gov Notified/Method: / ��� Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
El New construction ® Addition/alteration/replacement
❑ 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
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.: 321470 Job site address: 14058 SW Milton Ct. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97224 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Westcon Inc. - Lab Power ❑ Service or feeder 600 amps or more.
FEE SCREDULE
i Cross street/directions to job site: Description I Qty. L Fee. 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
Ea. 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. R)
Install power pole and 4 new 120v circuits Limited energy, multi- family 75.00 2
P P 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: WestCon, Inc. 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 14058 SW Milton Ct. Over 1,000 amps or volts 454.65 2
City/State/ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)598 -8700 Fax: (503)598 -4545 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 I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Rosendin Electric B. Fee for branch circuits
without service or feeder fee, 1 46.85 46.85 2
Contact name: Steve Hogberg first branch circuit
Address: 2925 NW Aloclek Dr. #170 Each add'I branch circuit 3 6.65 19.95 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Hillsboro, OR 97124 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 615 -8189 Fax: : (503) 615 -0689 Reconnect only 66.85 2
E -mail: shogberg @rosendin.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal panel, or limited -
Business name: SAME AS APPLICANT
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/ State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: 103939 11It? Electrical Lie.: 37- 692C , Suprv. ' .. 3991S /p' I i0 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 66.80
Print name: Stephen Lawhead Date: 1/29/09 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 8.02
Authorized signature: TOTAL PERMIT FEE: 1 74.82
1
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.
I:\ Building \Pamirs \ELC- PcmiiApp.doc 05/23/06 440 -46I 5T(I I /05 /COM/WEB
CITY
BOIL` :.,AVISION PERMIT #: ELC2009••00045
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/30124109
Phone: (503) 639 -4171 V'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 �'.� _. .
INSPECTION WORKSHEET FOR DATE: 214/2009 TIME: 7:OOAM PAGE: 25
SITE ADDRESS: 140513 SW MILTON CT CLASS OF WORK:
SUBDIVISION: • BONITA INDUSTRIAL PARK LOT #: 007 TYPE OF USE:
PROJECT NAME: WESTCON Itic:
DESCRIPTION: (4) branch circuits. Job No. 321470
OWNER: C3OODHEAD, DAVID & JAN PHONE #:
CONTRACTOR: ROSENDIN ELECTRIC INC PHONE #: 503 615.81t39
Inspection Request Scheduled For: Date: 2/412009 Pour Time:
Code # Inspection Description. Con" Contact # Message
199 Electrical final 06247-01 503-598-8700 \ Y
Corrections /Comments /Instructions:
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0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 1 NOO Date: 27. Phone #: (503) 718- ill ?
CITY , _ TIGARD °
' -
��UUU�1m����� DIVISION PERMIT #: El .C2009-00016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1[30y2089
Phone: (503) 639-4171 A w
|nnpe��ionReque�a(24Hmj:(6O3)83A-4176 ,K.41,1,1- "���
INSPECTION WORKSHEET FOR DATE: 2120009 TIME: 7:O0AKd PAGE: 11
SITE ADDRESS: 14O5R3VV MILTON CT CLASS OF WORK:
SUBDIVISION: E3CNITA INDUSTRIAL PARK LOT #: ow TYPE OF USE:
PROJECT NAME: VV[STC()M|NC
DESCRIPTION: VI) branch circuits. Job No 321470
OWNER: GOODHEAD, DAVID & JAN PHONE #:
CONTRACTOR: R03END|N ELECTRIC INC PHONE #: 503-61S'8109
Inspection Request Scheduled For: Date: Jy212009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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199 i]edrmN�noU 000173-01 , 503-690-8700 ^` Y
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Inspector: �� v ������ L�� Date: '� Phone #: (503) 718- ` .