Permit CITY OF TIGARD ELECTRICAL PERMIT
2: . COMMUNITY DEVELOPMENT Permit #: ELC2009 -00074
Date Issued: 03/26/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101CB00500
Jurisdiction: TIG
Site address: 12670 SW HALL BLVD BLDG 1
Subdivision: Lot:
Project: APEX INDUSTRIES
Project Description: Install (13) 200 amp panels, (2) 201 -400 amp panel, (1) 1000 amp panel, and (60) branch circuits.
Job No. 20 -660
Owner: FEES
GAZELEY, H WILLIAM Quantity Description Date Amount
PO BOX 230414
TIGARD, OR 97281 13 ea Services or Feeders - 200 03/26/2009 $1,043.90
PHONE: amps or less
2 ea Services or Feeders - 201 03/26/2009 $213.70
to 400 amps
Contractor: 1 ea Services or Feeders - 601 03/26/2009 $240.60
ACCURATE ELECTRIC to 1000 amps
P.O. BOX 873425 60 crt Branch Circuits w /Purchase 03/26/2009 $399.00
VANCOUVER, WA 98687 Service or Feeder
PHONE: 360 - 944 -7001 1 ea 12% State Surcharge - 03/26/2009 $227.66
FAX: 360- 944 -7013 Electrical
1 ea Plan Review Electricial 03/26/2009 $474.30
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $2,599.16
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done i ccordance th appro • plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the
180 da . ATTENTION: Ore•.•n -w -. ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 1 -0010 thro gh OAR 95 '101-0 r ou may obtain a •py of the rules or direct questions to OUNC by calling 546.669 or 1.800.332.2344.
Is ed By: _ . /i .L�I . Permittee Signature: Y
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: e g/i 4
LICENSE NO. 5 9q
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 ApplicationR FOR OFFICE USE ONLY. L •
6- Lill V li
• City of Tigard Received B : _ - . p � Permit No.: ' ��� r �,„ l
IN ° 13125 SW Hall Blvd., Tigard, OR 97223 DEB 2 5 2009 Plan Review
L ? ' Phone: 503.639.4171 Fax: 503.598.196 FEB e9 '.i . Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /B : // ! J n s: ® See Page 2 for
Internet: wwwrigard -ocgov CITY OFTI Notif /Method. a _ _ Supplemental Information
. TYPE OF ?� �' a / d. 00. � j�� -c . PLAN REVIEW
�,
❑ New construction Addition /alteration /replacement Pl ase check all that apply (submit 2 sets of plans w /items checked below):
Service or feeder 400 amps or more El 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 2 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 ",
I OOHP or more. occupancy.
Job no.: 0 20 _ (� ( Job site address: (.6.70 5� l I ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: .i. ',,, h ..�� ❑ Health -care facilities. ❑ Supply voltage for more than
rI J ..��
1 li ly. 9-7213 ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: (� g ' ervice or feeder 600 amps or more.
!7 �)( IlncllzS�f 12S v .FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I 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
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.)
n Limited energy, multi- family 75.00 2
h em) sesvae . cA.tX 11 SV()P w I lry, residential (with above sq. ft.)
1 Services or feeders installation, alteration, and/or relocation
200 amps or less \ 3 A 80.30 1 o43.gp 2
- ❑ PROPERTY OWNER , ❑ TENANT 201 amps to 400 amps 2, 106.85 e13•10 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 1 240.60 elo.bo 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 I ❑ CONTACT PERSON above service or feeder fee, (00 6.65 3 1p
q -�2
/� each branch circuit
Business name: Accofii E IeCA-1`i L B. Fee for branch circuits
C without service or feeder fee,
Contact name:
Q.Y\ S we; first branch circuit 46.85 2
Address: Po B c . 7 3 Li as Each add'► branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: VuiAcoV t 606 Gi 'i 7 Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ('3(01) 9 LH _ 7c1 Fax:: (3‘0 7 y y. - 70 13 Reconnect only 66.85 2
E -mail: Kam, 6 / ;mo `(e , , el t ,( Pump or irrigation circle 53.40 2
CONTRACTOR , • � . . ' , Sign or outline lighting 53.40 2
�, /� energy panel, er or t o limited-
Business name: 5 or
tj��- energy pane►, 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: ( 0g37 Investigation per hour (1 hr min) 62.50
CCB Lie.: 15s/g75 Electrical Lie.: Suprv. Lie.: 50595 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: /2 � Subtotal: A897. 20
Plan review (25% of permit fee): 11 Ll .30
Print name: c4 1tto Date: S Do] State surcharge (12% of permit fee): 1 2,1, 6 6
Authorized signature: /2 TOTAL PERMIT FEE: Z r 99. 1 6
Date: L � This permit application expires if a permit is not obtained within 180
Print name: 1 ef'l 5 irt .2 5 - / days after it has been accepted as complete.
* Number of inspections allowed per permit
I \Bt ilding\Permits\ELC- PermitApp doe 05/23/06 440- 4615T( I 1 /05 /COM/WEB
Electrical Permit Application - City of Tigard -
Page 2 - Supplemental Information
LIMITED) ENERGY PERMIT FEES:
RESIDENTIAL'WORKONLY ' W
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other:
COMMERCIAL WORKONLY::
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
Fr Audio and Stereo Systems
n Boiler Controls
Systems
Clock S
❑ Y
❑ Data Telecommunication Installation
- ` ❑ Fire Alarm Installation
❑ HVAC
I I Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
P\ Building \Permits\ELC -Perm tApp.doc 03/23/06
CITY OF. TIGARD. , . ELECTRICAL PERMIT
%• COMMUNITY DEVELOPMENT Permit #: ELC2009 -00074
Date Issued: 03/26/2009
D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S 101 C600500
Jurisdiction: TIG
Site address: 12670 SW HALL BLVD BLDG 1
Subdivision: Lot:
Project: APEX INDUSTRIES
Project Description: Install (13) 200 amp panels, (2) 201 -400 amp panel, (1) 1000 amp panel, and (60) branch circuits.
Job No. 20 - 660
Owner: FEES
GAZELEY, H WILLIAM Quantity Description Date Amount
PO BOX 230414 13 ea Services or Feeders - 200 03/26/2009 $1,043.90
TIGARD, OR 97281
amps or less
PHONE: 2 ea Services or Feeders - 201 03/26/2009 $213.70
to 400 amps
Contractor: 1 ea Services or Feeders - 601 03/26/2009 $240.60
ACCURATE ELECTRIC to 1000 amps
P.O. BOX 873425 60 crt Branch Circuits w /Purchase 03/26/2009 $399.00
VANCOUVER, WA 98687 Service or Feeder
PHONE: 360-944-7001 1 ea 12% State Surcharge - 03/26/2009 $227.66 in
• Electrical
FAX: 360- 944 -7013 1 ea Plan Review Electricial 03/26/2009 $474.30
Type of Use: COM •3110
Class of Work: ALT Type of Const:
Etgpancy Grp: •
omit
• Total $2,599.16
V Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. 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 the
180 days. ATTENTION: Oregon law requires you to follow the 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 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.lnspection.
CITYF TIGARD .
BUILDING DIVISION PERMIT #: Es.._ 2409.600'}4
13125 SW Hall Blvd., Tigard, OR 97223 � DATE ISSUED:
Phone: (503) 639 -4171 ' °� w�4p r
Inspection Requests (24 Hrs.): (503) 639 -4175 - I..
INSPECTION WORKSHEET FOR DATEci 19 f 4 1 TIME: PAGE:
V
SITE ADDRESS: I Z 61 O 6 W Atli. %L AO- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: • PHONE #:
Inspection Request Scheduled For: Date: S 1 //161 Pour Time:
Code # Inspection Description Confirm # Contact # Message
‘Ir 5 \lI Lit
Corrections /Comments /Instructions:
?ANwL 211 30 e:IRs .
v -2.4 Ai 16 G i .z,S
. 2.LWL. 6"
4 C 3 • X41 kW M ( e A`- izE5 Eta- ALL 6kW1
0 v-At -- 6' •
1) c.,o ■ L,g� ob� c 1 60 _5 W 0-91 6- 1 VI 9
sk) "g.clq i o* care s � lyx \,...Nv - nit.
111/41.4 v`�w
8) 1 ..1,13 Lig ki_L bl c (t4 N t5 j ArrbaleAtta.3 1 EI C-..
c:c.
n PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i� � �� Date: 5I 1 (flog Phone #: (503) 718- VA' 1 .
erri- OF TIGARD
BUILDING DIVISION PERMIT #:s4G 00x`1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: y I i 1 -ti O \ TIME: PAGE:
SITE ADDRESS: ‘ b1 6 t.J 'A A LL • csLV O 1 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 41 i 100( Pour Time:
Code # Inspection Description Confirm # ` Contact # Message
115 tAJALL. ego Ne(L.
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: N ! ' Date: 0 Phone #: (503) 718- 2K-