Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00051
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/23/2007
PARCEL: 2S 101 AA- 09100C
SITE ADDRESS: 12447 SW 69TH AVE ZONING: MUE
SUBDIVISION: TIGARD CORPORATE CENTER LOT: OOC JURISDICTION: TIG
PROJECT: HOUSEHOLD FINANCE
Project Description: Relocate (1) t -stat.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HOUSEHOLD CREDIT SERVICES ALLIANT SYSTEMS LLC
12447 SW 69TH AVE 1600 NW 167TH PL # 330
TIGARD, OR 97223 BEAVERTON, OR 97006
Phone: 503- 686 -2038 Contact #: PRI 503- 230 -8991
FAX 503- 230 -9238
FEES Reg #: ELE 34- 640LHR
LIC 153420
Description Date Amount
[ELPRMT] ELR Permit 2/23/2007 $75.00
[TAX] 8% State Surcha 2/23/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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: s_ _ iz22t) Permittee Signature: e , s(
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.
02/23/2007 00: 42 5032309238 ALLIANT SYST PAGE 02/04
. -.0 •
Electrical Permit Application -- __ 1,1,1k tll�l-l(.P.i!til�.Oi�l.
r ,
;' \ . t' r- 1 ‘ ' Received Pen ult bit • V
4 ,
City of Tigard — Datera .i :, l/ 1
» I • ° 13125 SW Ball Blvd., Tigard, OR 97223 Plop Review Other Permit:
I I Phone: 503.639.4171 Fax: 503.598.1 %0 - % 7 - 200/ 0 0 / Date/B ; ,mi,: Sec Page 2 for
Ins Line: 503.639.4175 Date Ready /hod: la Sec F ge 2 f o r nrmafinn
rl Ght:f. 1I Y ∎,t •.at:
Internet: www.tigard- or.gov „ 11af r 0gj u
' :I • � } , ri !�, i ' )➢ t,l Ull fliU if f!fidiC )
.., , ,, . t . $ . 1 '1 -t i 1 ' i)! �( pi llq : 'igl131' 1 '' .1 �!!il' �1 1 1j N i r !.i t.8hih, 1 a. „r 43/ 41,!17y1�1� ; . j UISrS,fa dA;: a,.m, Chi•
17 Uhi i. I .. ,,re,.. ,k . V.; iri!lill., l , ' : ( d a��,,,.•, r ... 1f_ !
°IglJ,�f!e(�alli)g141dC', ^.. ar'�,Ir:�l,:,• , ,.1;l 1 i'�;�i�� ;,;'- Fl �1�i:Ax:L�:� 1 . ,oit;:,fti� f¢ , •,: _ u seL SOf Inngw /itemaeheekedbdow):
1, . f w , a� , f, u , ,.,� : f�' i:'r! •• 1 • ,f-,„ I ' U Please cheek all that apply (sutnn P
❑ New constructi Addjtion/a ration /replacement ❑ Service or feeder 400 cps or more ❑ Building over three stories.
El Demolition ❑ — 1 m cxcee the
.000 able fault t150 o it or 0 Marinas and h ilboatyards,
1.0i V ' : , .... „ e r t3f11II1
,7 r , . " a :r; '' t:;G ;ii! ti . ,,.q. 1 fi; ti' , ;` . 1.1 f .'1' ; •- Sur! -S' exceeds 14.000 1:1 Commercial -use agricultural
I�t ..,,.1, ; > s>? • legato Rio nd,
Y; -''. 'ijic!rc •i';;i,...;J %,; r',. ,;+ PD g " ,,., . P f + u or
,;,igr�iillllr 1 .rtt�: ,7�FG5 di: �;.�:�....� �. ,,. -
amps for all other installations. buildings.
l
El 1 - and 2- family dwelling XConimercial/industrial ❑ Accessory building ❑ F� pip 0 Itmtallation OF 75 KVA or •
❑ Multi-family 0 Master builder ❑Other: D Emergency system larger separately derived system.
Y rr...,,lili i �i 1�1 `° r'r`''n!!r'c 1' motor load of „].3,'
i'-. ?.f d:i i" 1N; i r W�'t: 11. . n k7r; civ'cili Addition of now m ❑ "A.. E " - °l,
,,, . ..:r' ; t ,n i( i :N?IF S ^'� ''Ai,;i �r;, ' till ,1J 1.:'''.. ,'.. ❑ Add'd
{; r
.,i',...,•;',....,-:,',.;-, il��'ISIt1S�;,., ��, ... •1• . „r:,l�,,,;,. .,. .,, , .,,r mu „•,.....c,� ' _ ttD�cY• h,
� b� .,A✓<t �:rr,:. :
f.e....,- , .,.: •, • .. r , g s 100HP or morn occ
1 Job site address: 11 C ❑S 1 more residential traits. ❑ Recreational ve isle parka,
Job no.: ••• than
o
!] apply voltage fm mom
Health -cart facilities. S 600 vol l romina r
Ciry /State/Z1P: ❑ Haz+rdoos locations,
1 yf El 9ctvice or feeder 600 strips or more.
g. apt. no.: Project name: W G rib hill „:., u r 'fSetati tg.1 i;llipli z !1;Nit?IIh_
Suitc/bl.d / J I tt scr !,_ { c c1�.:•
ll;l (t_ 111 . ,,,,,•,�,ftlLCl �' y Om Ice. Total
•
Cross street/directions to job site: New residential single- or multi family dwelling unit.
• Includes attached garage.
1 sq.
Subdivision: I ft, of less 145.15 - 4
Lot no.: • 1.
- Ea add'15� sq. R. or portion 3
• Limited energy. residential 75.00 2
Tax map /parcel no -: . t � y � , �.:rnl >'; s`'`i,;iiiliue:;atrif'4r:i ` sl (with ebWcsq.tlJ
i - .. , is: }; , !t`. , � t . l t' i ` . I • . . .r1J• • ;•• -"'' WEfl1!.WC,,:_. '. Ifh• !•1', {i,, L.� 1 • f' ..i'�i LI imjtedCnC[ ,tRltlti family, 2
Services ,., � � . _ . .,,:� 1 .. .. 1. PY 75.00 •
- _ - `/ � !') +�� residential o (with stave a feeders Installation, f�1 �/ Ll 1 ces nr iltlon, alteration, and /or islets tine
200 amps or less _ S0,30 2
., .,,,�:,, �.yy++��yy '�l�`�11 ' ' ".r ":;. ,r • ltf >,,,;t:11;u 400 ' 106.85 2 , 201 amps to ;''...i.r l.i''iii ) i,fiiq �., .fi:i t . : P... •0 ,•; w.,. - ..'
t 1 1 Ll1 A•` • I i "'; r. "ii , „i fl. 2
•,� p. iii
j''''''':...'''''''''''''' 1 f i 1! � l�' ... .. 16 0 . 60
401 amps to 600 amp -
Name: 601 amps to 1,000 amps 240.60 2
Address:
Over 1.000 amps of volts _ 454.65 2
Temporary services or faders inataltatinn, alteration, andlor
City/State/ZIP: relocation
Phone: ( ) Fax` ( ) 1
that T own which is not
200 amps or less 66.85
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property 401 amps to 599 amps 133.7 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701- Brunch circuits new, alteration, or extension, peryancl
Date= A. Fee for branch circuits with
Owner signature: — , �y / u et,a,i't above service or feeder fee, 6.65 2
(;,..,61!!)'!,;!!!).,!,;;;',.,.:4.:.! 9 il , •' , d 1 i; . :1 1 : ' ' , ':., . ; i , ; I 41 . each branch circuit f ,
X ;;;il..
Business name: • W 71 B. Fee for branch circuits
without service or feeder fcc, 46.85 2
Contact name: Prt'Ci In 4 r p firstbraneh circuit
't' �� Each add'1 branch circuit • 6.65 2
Address: l �/)��') Rik) p " �/ ' . " D Miscellaneous (service nr feed not included)
City/State/ZIP: 4 l ! 0 / / Each manufactured or. modular 90.90 2
dwelling, service and /or feeder 2
. ! /.' t Fox:: °- 0 ) �D r/Ij Reconncctonly 66.85
Phone:) p 1 on circle 53.40 2
Pump or irripti
E-mail: �yc „i r ne li tip 53..40 2
',rt ii 'a,
:r '1 d' i „ >14!,• ..li �r t� :YkW� : 'b< ii; 111 214iii ! flli . 't',.irl , `',; ;;i; i.ir Pf 1; . Y'i; <1 11;t Sign or outll S _
'i,iiiSL ?!1' = )t : � t1,,!! .! S ,l.: , , ......: • .g "4:•: .. Signal circuit(s) or limited
Business name: a _ energy panel. alteration. or
Address: 2
extension. Describe: Page 2 ,6104,ice
L itch additional inspection over allowable in any of the above
City/State/ZIP: �— Per inspection t 62,50 1
Fax: ( ) investigation per hour (1 hr min) 62.50
Phone: ( ) � • � 73.75
tCv v , , J r Industrial plant per hour
CCB Lic.: Electrical T,ic '>�,fD Prv. Lic.: , +'t ii ,t ,.ART, "l,i•'1�� , f ff u' r
.,,r,..�,y ;IlrJii'I�al;c . ;� J!I+r�l , i %I
L ` aL; Subtotal:
Suprv, Electrician Signature, required: �,L . ` A j _
r _ Plan review (25% of permit fee):
Print name: j ' fie 1 State surcharge (8% of permit fee):
�� TOTAL PERMIT FEE: f
Authorized signature:
r This penult application expires If a permit (8 not amino] within a1�
Print name: r ` / I/ r Da te: . days after it has been accepted ex eompicte.
[ i • Number of inspections allowed per permit.
t: lBuildmAPe+mnsmc- remlitApp.dee 05,23106 440 615T(11/0! /COM/WE0
•
CITY OF TIGARD
ali BUILDING DIVISION PERMIT #: ELR2007- 00051
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: 2/23/2007
Phone: (503) 639 -4171 oil
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_.. .
INSPECTION WORKSHEET FOR DATE: 3/21/2007 TIME: 7:02AM PAGE: 53
SITE ADDRESS: 12447 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD CORPORATE CENTER LOT #: OOC TYPE OF USE:
PROJECT NAME: HOUSEHOLD FINANCE
DESCRIPTION: Relocate (1) t -staff.
OWNER: HOUSEHOLD CREDIT SERVICES, PHONE #: 503 -686 -2038
CONTRACTOR: ALLIANT SYSTEMS LLC PHONE #: 503-230-8991
Inspection Request Scheduled For: Date: 3/21/2007 Pour Time:
Code # Inspection Description C onfirm # Contact # Message
199 Electrical final 045120-01 971- 563 -3371 N
Corrections /Comments /Instructions:
/
APASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C ` 68 Date: 3 'L-I on Phone #: (503) 718- y