Permit ELECTRICAL PERMIT
,�. CITY OF TIGAI� ®. PERMIT #: ELC2006 -00115
1 ' I'I4 DEVELOPMENT SERVICES DATE ISSUED: 2/13/2006
m il 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112AC -02400
SITE ADDRESS: 14655 SW 72ND AVE ZONING: I -
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (3) branch circuits for break area. Job #91243.
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/ 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: 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:
PGE OREGON ELECTRIC GROUP
121 SW SALMON 1010 SE 11TH AVE
PORTLAND, OR 97204 PORTLAND, OR 97214
Phone: 503 - 464 - 8179 Contact #: FAX 503 - 535 - 2763
PRI 503 -234 -9900
FEES
Description Date Amount Reg #: LIC 203
[ELPRMT] ELC Permit 2/13 /2006 $60.15 SUP 4460S
[TAX] 8% State Surcharge 2/13 /2006 $4.81 ELE 26
Total $64.96 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: . 5,4. A
T1
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 503439 -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.
FEB -10 -2006 04 :01P1A FROI4 -OR ELECTRIC SERV h 5035352163 T -188 P.001/002 P -3T1
= City of Tigard - I !/ iB / ( t „itNe.t d(,c�d -1,41i I
13125 SW Hall Blvd.. Tigard, OR 97223 b > Review
Phone: 503.639.4171 Pax 503.598.1 pD 1 1 0 20 0 ... - 1:.A .' Dete/By Other Penes:
InspodiemLine: 503.639.4175 D " , 4 • J., Deelteady/By: - i I SI See Rge 2for
latotttet• www.ci.tigardesr.ua ^ ; NotiLcdll(ethod — I Sapplc at Tcroemofioo
�Gi ' . ,; ,� PLA REVIEW
El New construction !it.. : `•. _ •"�,� , sm Plano check all tha apply:
❑ Demolition ❑ Other. ❑Service overt 225 amps, comm'1 Obbaa:ardoue locution
❑ Service over 320 gaps - rating [IB uldeg over 10,000 sq. 0.,
CATEGORY OF CONSTRI lefION of 1- and 2- family dwellings 4 or mare new rocidceaial
❑ 1 - rand 2- family dwelling El Commercial/industrial ❑ Accessory building OSystmo over 600 volts nominal wails in one muctare
❑ Multi-f ly ❑ Mesta builder pother ❑Banding ova three stories O FOAM. 400 ompa or more
['Occupant load over 99 persons Okdanufacbued atnedsnts or
JOB SITE INFORMATION AND LOCATION CI ightig plan RV park
Job no.: 91243 I Job site address: 14655 SW 72" Ave. D 'cars facility []0t6er:
Submit 2 sae orphans with any of the above.
City/State/UP: Tigard, OR 97223 The abovo arc not applicable to temporary conatuction service.
FEE* SCHEDULE
Suite/bldg./apt no.: I Project name: PGE Fleet Major Maintenance 1 Qv 1 Its 1 i•a+ I ••
Cross street/directions to job site: Near SW Redwood Lane on SW 72nd New reddmttat stn . or return -ramibr dwelling waft.
litdudes attached gag.
).000 at ft micas 145.15 4
Subdivision: 1 Lot no.: Ea. edd'I 300 sq. R or portion 33A0 1
Limited energy. academia 75.00 2
Tax map/parccl no.: Limited amp, non-reaidaotia) 75.00 2
. DESCRIPTION OF WORK Each manufactured or modular
Install three outlets on three circuib for new break area. dwelling. MOM and/or feeder _ 90.90 2
Serviced or feeders fafioa, alteradotf, and/or rdamtdon
200 amps or ices 80.30 2
O FROFIIATY OWNER D TENANT 201 amps to 400 amps 106.81 2
- 401 amps to 600 amps 160.60 2
Nance: FGE 601 amps to 1,000 amps 240.60 2
Address: 121 SW Salmon Over 1,000 amps or volts 454.65 , 2
Raomect only 66.85 - 2
City/State/ZIP: Portland, OR 97204 Temporary srrvises or feeders instoltetlon, alteration. imd/or
Phone: (503)46.8179 I Fax: ( ) ' >tslocadon
200 amps or lase 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 salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 - 2
Owner signature: Date Stanch dra ltair� - new, allauffoa, or extension, per panel -
0 APPLICANT 1 ❑ ODNTAL7 PERSON A. Fcc for branch circuits with
$ervim or fxdcr fair, each 6.65 2
Business name bnmcb circuit
B. Fee for branch circuits
Contact name : b =vice io , 46.85 b S � 2
Address:
Each add, branch circuit a _ 6.6571 .
City/State/Z P: 114 (service or feeder not bsdnded) -
Pump or inigRion circle 53.40 2
Phone: ( ) I Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: _ Signal circuit(a) or limited-
CONTRACTOR energy panel. aeration, or
extension Describe: Page 2 2
Business tawone: Oregon Eleatic Group _ - - -
Address 1010 SE 11th Ave Each additional Inspection over allowable In of the above
Per inspccdon 62.50
City/State/UP: Portland, OR 97214 Investigation per hour (1 hr ma) 62.50
Phony (503) 234.9900 I Fax (503) 535.2763 _ Indu plant per bout - 73.15
ELECTRICAL PERMIT FEES•
CCB Lic.: 203 I Electrical Lie.: , , . S 1v . I.ia: 4460S Slibtoml 6D .
—
Sum. Electrician signatu e, required: , - PIim review (25% of pes>,tit fee)
State surcharge (896 of permit foe) L�
Print name: ( s.:i : 2n' 1 • i
t e•
M 0.Y k , 1 TOTAL PERMIT FEE � b 7 .9 ktO
Authorized signature ' Ths permit appueatla► expires ire permit. is nut obtalaurr within 180
days after It has been accepted al camplate
Print name: p,k S, h h ill..._ C) te: 2/10/06 • Fa methodnio®r sat by Tti.Casmty Building Industry ice Board
Nsanber ix:maims ea ecrosit allowed. /
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FE C200C 0O I1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 22/13/2006 6
Phone: (503) 639- 4171;:�S
Inspection Requests (24 Hrs.): (503) 639- 4175J,` __..
INSPECTION WORKSHEET FOR DATE: 2/21/2006 TIME: 7 2AM PAGE: 109
SITE ADDRESS: 14655 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PGE
DESCRIPTION: (3) branch circuits for break area. Job #91243.
OWNER: PGF PHONE #: 50-
CONTRACTOR: OREGON ELE. C RIC GROUP PHONE #: 503234 -99t)0
Inspection Request Scheduled For: Date: 7J21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 027172 -01 503.849.2433 Y
Corrections /Comments /Instructions: GOINV
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (*0 Date: _ 1 4 'M tri) Phone #: (503) 718- __a_A_____