Permit CITY OF TIGARD ELECTRICAL PERMIT
TIGARD #: ELC2006 -00726
COMMUNITY DEVELOPMENT
DATE ISSUED: 12/22/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 AA- 02900A
SITE ADDRESS: 12123 SW 69TH AVE ZONING: MUE
SUBDIVISION: TIGARD CORPORATE CENTER LOT : OOA JURISDICTION: TIG
Project Description: BLDG. A. (3) branch circuits for handicap access. Job #608234- 30733.
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 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: 2 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:
TIGARD CORPORATE CENTER BROADWAY ELECTRIC - COCHRAN INC
12123 SW 69TH 626 SE MAIN
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: PRI 503 - 234 - 6564
FAX 503 - 238 -2098
FEES
Description Date Amount Reg #: ELE 37 - 546C
[ELPRMT] ELC Permit 12/22/200( $60.15 LIC 72942
[TAX] 8% State Surcharge 12/22/200( $4.82 SUP 3447S
Total $64.97 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: -2? - ' Permittee Signature: 5,,,e P
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FOR OFFICE USE OILY
Electrical Permit Ap 1 Gatiii . 1
' , I Received � ! , Permit No � ��
City of Tigard L; (a
. r - JJ Date/13 : / J _/ . ��
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other P erm it:
Phone: 503.639.4171 Fax: 503.598.1 � � 1 Date Plan •
; n u ■ � " i Date Ready/By: MI ® See Page 1 for
ectt ww. 503.639.4175
igard. r.us f Supplemental Information
�P F ; „ - Notified/Method: Internet: www.ci.tigard.or.us � .w, ��:{�.� ;�a _;
i .�. L ,ayvj? MV ret _ .1 ., : r f_ ✓ : G * ,PA ti:37$ " r ".r•'id : ', .2� x 1 '''
� -�.5 +a 't - ' .'` 7l `' 6A'6'. '?' ��. „fit "f ' ' ":4J �ddak`tCt, Ple
`
jPw;l�1'w'n'�,(` ;;AS �„ �� Y'•x � }�.�t��� ase check all that apply:
❑ New construction Addition/alteration/replacement ❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other: _ ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
o o- �i C ty � p . v u � .7 t�q ' i l l Fi • I of 1 and 2- family dwellings 4 or more new residential
; < : ._y .� r W ;� ����;'���t��'���i sn� r � ^ ��..i�i� units in one structure
❑System over 600 volts nom units in one
amps or more
❑ 1 -a nd 2 family d welling /:'. CommerclaUindustrial ❑Accessory b uilding ❑Building over three stories ❑
Master uilder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or
El Multi family ❑ M b RV park
x •: e r . -+ - • c• _ > r,1; tom, ❑gress/lightingplan
, , ��.I�;s � • A ,•t {d ):. � ., � "� .�,., I ` 9 AU� .�? �I •, F �S.r�:', �. �:� E ❑Other:
q ❑Health -care facility
Job no.: � 3 37 33 Job site address: / .1 /) 5 si C / rh' Submit 2 sets of plans with any of the above.
OR - The above are not applicable to temporary construction service.
City/State/ZIP: T p � �� ��� '�
/L � :x .2. i�.ra s ,r�`3,GE
Qtr I� 1 I
New residential single - or multi - family dwelling unit.
Project name: / /lf.c,v.`l�' Descrlpuoa Fee Totol
Suite/bldg. /apt. no.: I j �L.� �-
Cross street/directions to job site: Includes attached garage.
1,000 sq. ft. or less 145.15 4
f Lot no.: Ea add'1500 sq. ft. or portion 33.40 1
1
Subdivision: ` Limited energy, residential 75.00 2
Tax map/parcel no.: a< , ,: " i a, k ,i.
Limited energy, non - residential 75.00 2
},et "�1' +,A i-''''' "':' '''< ° ° H r te(9 401 'W6i'. t , .il' 4 .. > '-',3','P.4. . ,„x Each manufactured or modular 2
e f ` s * fi t_` dwelling, service and/or feeder 90.90
(�7, 4 /_d9 C /4 C ' / j 7 Services or feeders installation, alteration, and/or relocation
J 2
v " 2
`���(/® G /f G / S 200 amps or less 80.30 2
,--,, 4 >t r 201 amps to 400 amps 10 6.85
,Rr° -, y , i f � 1L t ry',4 ' 1 ir 1 a i ? , d? Ny I r' ,,. ; a �. ' '' : 4 401 amps to 600 amps 160.60 2
,,AA 601 amps to 1,000 amps 240.60
Name: r !J� c ...4 9 �� ��
�e Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
City/State /ZIP: relocation
Phone: (
Fax: ( ) 200 amps or less 66.85 1
2
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 • 401 as to 600 as 133.75 2
circuits - new, alteration, or extension, per panel
• Date:
Owner si .afore: •.• .,,p� :, A. Fee for branch circuits with
p a .41 P I ca s � service or feeder fee, each 6.65
t � %` f ' b �� branch circuit
Business name: B. Fee for branch circuits
Contact name:
7 (re.--4.1 , 94: - 7/) � 7f" / without service or feeder fee, i 46.85 � V-- 2
/ each branch circuit
Address: Each add'1 branch circuit A
6.65 /,.? . 2
Miscellaneous (service or feeder not included) 2
City /State/ZIP: Pump or irrigation circle 53.40 ,
Phone: (3 /{d 7 l c fvU I - Fax: : ( ) Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
E - mail: 7 a l ,, :7 , ;" e -. energy panel, alteration, or
r YiJ•, �' , '6a.•i, r ce ( . :.<. �. /' - ;'r' to � . F: 1 extension. Describe: Page 2 2
d
Business name: ?..),,...6 G. , t...4 o.`1 .. \ c_ N- 4 - ■.c-• Each additional inspection over allowable in any of the above
Address: Co 2 c, '5 0 M a \„, Per inspection iii 62.50
City/State/ZIP : m
Investigation per hour (1 hr min) - MI
62.50
r� , .t,,, � , ;(2_ - 7 2` 7 3
•� 2 o Industrial plant � et hour 75
(5 63 Z3 H2O D .'` �r.. e ;s uf �r °�.1 ,�I `'eFll . `.7 �n�
Phone: (S�3) 23�'�oSCo y Fax ) ,. 3 : � ,. i ,A5, ,.' .
Su rv. Lic.: 3 ` 4 - • Subtotal ` 6 - `'
CCB Lic.: 7 2. 9 I Electrical Lic.: 3/-5 6c.. I p
Plan review (25% of permit fee)
Suprv. Electrician signature, required:
State surcharge (8% of permit fee) at
\G � ��0 Date: /1._d_ . 6 TOTAL PERMIT FEE G 97
Print name: ev.vA�
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete
• Fee .,.. methodology set by Tri- County Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL C20:. -00726
13125 W HdII Blvd., Tigard, OR 97223 DATE ISSUED: l :2 22/2_O0i.,
Phone: (503) 639-4171 arO I i I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/290006 TIME: 7 7 :0QAM PAGE: /19
SITE ADDRESS: 12123 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD CORPORATE. CENTER LOT #: 00A TYPE OF USE:
PROJECT NAME: TIGARD CORPORATE CENTER
DESCRIPTION: BLDG. A. (3) branch circuits for handicap access. ,hob 4€0e234
OWNER: TIGARD CORPORATE CENTER, PHONE #:
CONTRACTOR: BROADWAY ELECTRIC COC:.HRAN il'JC PHONE #:
Inspection Request Scheduled For: Date: 12/2 t,,2QOF, Pour Time:
Code # Inspection Description Confirm # Contact # Message
f;9 Electrical ill 041600 -01 503 ':,22 -7381
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
`J l Zc 7 ' 2 _ I-/4 ,
Inspector: `- Date: 0 b Phone #: (503) 718- I