Permit CITY OF T I C A F? D ELECTRICAL RERMIT
PERMIT #: ELC2004 -00700
,e(0i DEVELOPMENT SERVICES DATE ISSUED: 11/2/2004
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2 S 112 -01800
SITE ADDRESS: 15055 SW 72ND AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING. I -L
BLOCK: LOT : 046 JURISDICTION: TIG
Project Description: Replace existing dispensers with new. ,
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: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'LIINSPECTIONS
1
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:
TRUAX HARRIS ENERGY COMPANY NORTHWEST PUMP + EQUIPMENT
PO BOX 607 2800 NW 31ST
WILSONVILLE, OR 97070 PORTLAND, OR 97210
Phone: Phone: 227 -7867
Reg #: ELE 26 -852C
LIC 64567
FEES SUP 4884S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 11/2/2004 $60.15
[ELPLCK] ELC Pln Rev 11/2/2004 $15.03 Elect'I Final
[TAX] 8% State Surcharge 11/2/2004 $4.81
Total $79.99
i
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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: � ., Qp /. Permit Signature: Az ,
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 639 -4175 by 7:OOpm for an inspection the next business day
Electrical Permit Appli EIVE . soli orricl�: USE ONLY
City of Tigard Received
: — -Ov A
, M Permit No.: _ V- e ? Q
13125 SW Hall Blvd., Tigard, OR 97223 NOV it
Phone: 503.639.4171 Fax: 503.598.1960 O I Review
" 4 '/(6 l c Plan DaDate/By: Other Permit:
Inspection Line: 503.639.4175 CITY 3.639.4175 ; ' '- I Date Ready /By: 1 "ry5., ! 1 ® See Page 2 for
Internet: www. 8 ard.ocus OF TI "' " " '.' "- -, Notified/Method: ( � Supplemental Information
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
DOccupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV parlik /
Job no.: Job site address:.�6659 SW 72 " Ave. ❑Health -care facility ��(
�L�1 C 0 7 _ Submit 2 sets of plans with any of the above. % )
City /State /ZIP: Tigard Or 97224 41
.',- The above are not applicable to temporary construction servi. -.
Suite /bldg. /apt. no.: Project name: FEE* SCHEDULE � �•
Description 1 Qty. I Fee. I Total
Cross street/directions to job site: C YeI b f5 New residential single -or multi - family dwelling unit.
1 Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Replace existing dispensers with new. dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
iROPERTY OWNER I ❑ TENANT ' ' 201 amps to 400 amps 106.85 2
, 7 „... C- ., 1 4 i 401 amps to 600 amps 160.60 2
Name: _ a f/AQQ i S 1 ACt Fi c ex. id) Q 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address:
12 A X 4 6 7 (..e2/ Reconnect only 66.85 2
City /State /ZIP: W 1 L s t— de l
A ....
c yt,_ 7 p 7 0 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (s a3) 6 3 v4 c. 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 600 amps 133.75 2
Owner signature: • Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 1 ® CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Northwest Pump & Equipment Co. branch circuit
B. Fee for branch circuits
Contact name: Philip Gauntlett without service or feeder fee,
each branch circuit I 46.85 yp 2
Address: 2800 nw 31 Ave.
Each add'I branch circuit 6.65 2
City /State /ZIP: Portland Or 97210 Miscellaneous (service or feeder not included)
Phone: (503 ) 519 -6056 Fax: : (503) 205 -1465 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: pgauntlett @nwpump.com Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Northwest Pump & Equipment Co.
Address: 2800 Nw 31 Ave Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Portland Or 97210 Investigation per hour (1 hr min) 62.50
Phone: (503) 519 -6056 Fax: (503) 205 - 1465 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES *
GCB Lic.: 64567 Electrical Lic : 26 852C , Suprv. Lic.: 4884S Subtotal /O
Suprv. Electrician signature, required:cp 441. - Plan review (25 % of permit fee) f 5 * 03
Print name: W mares Date: 11 -01 -2004 State surcharge (8% of permit fee) .81
` TOTAL PERMIT FEE -7q ! 94
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i. \Building \Permits \ELC- Penni1App.doc 12/03 440- 4615T( I0 /02/COM /WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
// BUP
Received Date Requested / 1 _j ( P AM PM BUP
Location 7 Suite MEC
Contact Person .,� � .�� Ph ( ) .Sl 9 j — 'C (c" PLM
Contractor P Ph ( ) , - - SWR
BUILDING ( �I, Owner r" � -- /Lt ELC 4-6 6 — 6 �
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam OZ 1/ 6
Shear Anchors i , /(/ - (((///1 /
Ext Sheath/Shear • = - 4// - • _mod=- - I
Ina Sheath/Shear L _ /J
Framing a
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam C
Under Slab
Water he
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS / PART FAIL
$ Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 0t/ Inspect « Ext
Other:
Final DO NOT REMOVE thls Inspection recor rom the b site.
PASS PART FAIL