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Permit CITY OF TIGARD ELECTRICAL PERMIT ° v COMMUNITY DEVELOPMENT PERMIT #: ELC2007-00786 DATE ISSUED: 11/20/20/20/20 07 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S136DA -00101 SITE ADDRESS: 11410 SW 68TH PKWY ZONING: MUE SUBDIVISION: PERS SITE LOT : JURISDICTION: TIG PROJECT: PERS Project Description: Install (1) branch circuit to move switch. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL: MANF HM/ SVCI 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: 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: OREGON, STATE OF PUBLIC CONDUIT ELECTRIC EMPLOYEES' RETIREMENT FUND 19461 SW 89TH AVE 11410 SW 68TH PKWY TUALATIN, OR 97062 TIGARD, OR 97223 Phone: Contact #: PRI 503 692 - 1428 • FAX 503 - 692 -3652 FEES Description Date Amount Reg #: ELE 26 -905C [ELPRMT] ELC Permit 1 1/20/200' $46.85 LIC 109669 [TAX] 8% State Surcharge 11/20/200' $3.75 SUP 4501S Total $50.60 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: , / , �/ _ ' Permittee Signature: OA/ /97 ¢70/- 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: D/✓ // 2, Z.i e/7 /7G 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. . ' 2007 /N0V /20 /TUE 05:00 PM Conduit Electric FAX No.5036923652 P.001 Electrical Perm ,,.•,-;~ a 4 .: FOR OFFICE t Sl_ ONL\ V E ..... . City of Tigard Received ; PI: mit No- :--;!C ao. 7 -00 p 13125 SW Hall Blvd, Tigard, OR 97 O 1�U1 �a P]® R eview Other Permit Phone: 503.639.4171 Fax 503.598. `' M i Date/B . Inspection Line: 503.639.417 4. 'L L Date Ready/By 116 5: • El See Page 2 for. . Internet: www.ci.tigard.or.us ' j I Ur t 1.k3 . • t/ • )4665edlMahohl $upp1etaeatal information • :'t:.,•,...:...�- ,r c, +: 'h cs� � - M `.'1 -'r r�. 7�0� # '�.: , , .,� .;o.�t t!!:• -��K , ry,�.,a��y rr . :..+ ' s . : ,.- u•. .' " f i3� ' :aDia��i�l9�'�.:r71�1�llit )jl���� w.�3^ . f r• . ... .... _. Y: ., -.,, -r :.Ab,. � ❑ New construction — 1:i Addition/alteration/replacement P lease f -]heck all that appl • ❑ Demolition ©Other. _ ❑Servlce over 225 amps, comm'1 ❑I•iazardous location ❑Service over 320 amps rating []guildng over 10,000 sq. II, ,;;4,"i ./. :;. ;`y ;Iip' ;'ir�: Y:..ti�..• ■�P ^•a . ;. .. '• of and 2•fanu dwellings 4 or new 1 ,ar` �::w�.� .r •:a,:, : � ; LAFAiEC�>�+� < .QFit:'�D14iB�. Q�;; ".:.. >� � .. 'sr;;; ]Y Ss more residential . ... .,., _III . "nom ?`:.:..- ..: , : ���: , r:r:,. : r . ❑ 1= and 2 family dwelling g Commercial/'mdustrial ❑ Accessory building CI System over 600 volts nominal units in one structure Master builde �J ether ❑Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑Occu ❑Nlmtu pant load over 99 persons factuted structures or : ``ti`M , ="` :y ?1.7011:i ND''iLOC IN u �; a ; a .'. Egress/lighting ` '., �i:?'t ;,... , , : (�$,�`i�'�!iF[1Jlf 1Y�2# .... . TICO, .. , . y�'3< ,. ❑ lan. RV park p Job no.: tab�tctl Job site address: .g Iy ID S (o4 7 ) A ❑ nth care facility ❑ Other: i Submit,/ sets ofplans w any of the above, City /State/ZIP: ` rl ( t/t rd op q7c:,1=13 The above are not applicable to temporary construction service. Slute/bldgJapt no.: Project name: /��} ; ,Y ,�l:?;•`?�i c �i ' ; �C� ' ,.:. . �,4:t., : w. t` ` � Deserlor I Qty. I pea Tatar �-. Cross street/directions to job site: . New residential single- or multi - family dwelling unit. Includes attached garage. • 1,000 sq. It or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. R or portion 33.40 1 • Limited energy, residential 75,00 2 Tax map/parcel no.: Limited energy, non-residential 75.00 2 '': _ .., f. ;1; .p:it•1`r,'; ... �_:;;,0:40. l 1.101,,Ii* CVO .: _w ; r.: =l.tAl .:'fr•.'....r:. Each manufactured or modular avt t )11-Gh dwelling, service and/or seeder 90.90 2 Servtces or feeders installation, alteratlon, and/or relocatioO 200 amps or less 80.30 2 wwII : : -.. .'. y044 1i}.\,,}'fi - ,t✓ ;,;3• 0,:i ,ti:F-aniL:�' )S� ,.� ..4 . ;n �:f ;ale 201 WITS ta 400 amps 106.85 . 2 i :. a:,. ',.a:. ...,,.- <.:,,. :...W, „ :.,,....,.;:•: 04,:, rid . .. . . :. a0l amps to600amps • 160.60 z ■ Mute: . 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 – Reconnect only 66.85 2 City /State/ZIP: . Temporary services or feeders installation, alteration, and/or relocation • Phone: ( • ) — relocation I Fax: ( ) 206 amps or less _ 66:85' 1 Owner installation: This installation is being made on property that I own which is not 201 atops to 400 amps — 10030 . 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits – new, alteratlion, or extension, per panel ;tv '' a7(�.?ui +xr 1 'r ' . - '^�;4�'(r,"'a°•�P' ^. '"``"r r + „PC'Q T ., ,� m' A Fee for branch circuits wph service ,��._ ...1L�7CrA`k� . rs �rfi �p ° ,<_....,,.., . � ... .. .. . .......... 'rte °a;,, = ,Cft31�►�C'�;�`R�O�:�,...r �. fee, or feeder fee, 6.65 2 Business name: branch circuit B. Fee for branch circuits' Contact name: withotfl servii a or feeder fee, each branch circuit 1 46.85 q t0 2 • ,Address: - Eachadd'i-btun ircuit = -,,55 2 -- City, /State/ZlP: Miscellaneous (service or feeder not included) _ ..- -- .. ..... .... ..... ... ...... ....... _ ...... .......... . ......... ......._ ._ .- . p or inigadon_circ . ._. 53.40 2 _ Puce le Phone: ( ) �ax ; _ ( ) Sign or outline lighting 53.40 2 E mail: Signal circuit(s) or limited- • : ._ i -:_ :' „ •i,•;:,•y 1. 1 . : :;r:: =', ?. :;s energy panel, alteration, or extension. Describe: Page 2 2 Business name: _ ri . Each additional inspection over allowable in any of the above Ad�ess. l r 1 - tl n � S(.() (1 • h1 U Per inspection • 62.50 City/State/ZIP: 'Tv rt s a 1-, n / e q- D D _ Investigation per hour (1 br min) '• 62.50 Industrial plant per hour 73.75 Phone: ( , , • ' 4 ` d Fax: .., . � t� is .FrhF aT Yr: M>E.FC *': :,:w'C:; a;: CCB Lic.: /�Z/ _ , � 0' Electrical Lic.: a , ,,,,. s 1 "' . Lic.: < _, • • Subtotal £. , IS . Suprv. Electrician signature, required: 7' / , �` . Plan review (25% of permit fee) ✓ State surcharge (8% of permit fee) 3 Y Print name: (�1C�.1lt� .. p c): P .f� Date: ijxy TOTAL PERMIT FEE - so Authorized signature: . ibis permit application expires if a permit is not obtained within 180 days atterit has beta accepted as complete print name: • ' • • Date. • • Fee medrodology.set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed intoildrnaVermilrl21C PmmiLApp .den 17/03 44046157 (10W2rCOy)/WP9 . . ' CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007- 00786 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2012007 Phone: (503) 639 -4171 Iwm , I I I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1713112007 TIME: 7 :00AM PAGE: 37 SITE ADDRESS: 11410 SW 6HTH PKWY CLASS OF WORK: SUBDIVISION: PERS SITE LOT #: TYPE OF USE: PROJECT NAME: PF RS DESCRIPTION: Install (1) branch circuit. to move switch. OWNER: OREGON, STATE OF PUBLIC, PHONE #: CONTRACTOR: CONDUIT ELECTRIC PHONE #: 503 - 1428 Inspection Request Scheduled For: _Date: 12/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 062322 -01 503 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Cr- be L Date: IV 51'01 Phone #: (503) 718 - 1-11100 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007.00786 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 Phone: (503) 639 -4171 Aviopsii, Inspection Requests (24 Hrs.): (503) 639 -4175 R__.. INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7 :03AM PAGE: 77 SITE ADDRESS: 11410 SW 68TH PKWY CLASS OF WORK: SUBDIVISION: PERS SITE LOT #: TYPE OF USE: PROJECT NAME: F?ERS DESCRIPTION: Install (1) branch circuit to move switch. OWNER: OREGON, STATE OF PUBLIC, PHONE #: CONTRACTOR: CONDUIT ELECTRIC PHONE #: 503 -692 -1428 Inspection Request Scheduled For: Date: 12/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 061978 -01 503 616.3197 N Corrections/Comments/Instructions: -------(Dt f•t4a4 P X11 V RTr.5 - C'1 G-ki . ileN. 110 -"g A 0 410.07 (.) t'C‘ o -, iArot tsUL ',Lc v.mQ » ❑ PA: AL APPROVAL ❑ CANCEL ❑ NO ACCESS ■ T ip rA CALL FO' SPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \ 1 ■ Date: 1 Z! • Q') Phone #: (503) 718 - "l41/ -