Permit 40# kee'/Wkel fz, / ht4 c ,04id vc 1 T.
q CITY OF TIGARD ELECTRICAL PERMIT
Per
`F COMMUNITY DEVELOPMENT Permit #: ELC2010 -00676
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2010
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10110 SW NIMBUS AVE BI1
Project: Horiba Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project Description: Electrical for TI. 12/29/10, Reprinted permit to include (1) 200 amp panel and (1) branch circuit.
Contractor: ALL AMERICAN ELECTRICAL CONTRACTORS Owner: ROBINSON, CONSTANCE A &
PO BOX 1426 ROBINSON, LYNN ET AL
GRESHAM, OR 97030 BY KG INVESTMENT MGMT
10240 SW NIMBUS AVE #L3
PORTLAND, OR 97223
PHONE: 503 - 657 -4351 PHONE:
FAX: 503 -496 -3995
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 12/07/2010 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/07/2010 $10.30
Type of Use: COM Electrical
Class of Work: ALT 1 ea Services or Feeders - 200 12/29/2010 $100.70
amps or less
Type of Const: 1 crt Branch Circuits w /Purchase 12/29/2010 $7.42
Occupancy Grp: Service or Feeder
13 12% State Surcharge - 12/29/2010 $12.97
Electrical
Total $217.25
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of - • -s or direct questions to OUNC by calling 503 32.1987 or 1.800.332.2344.
Issued By • �L. / - Permittee Signature: • L. /- - - .�
i�
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 00676
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2010
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10110 SW NIMBUS AVE B11
Project: Horiba Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project Description: Electrical for TI.
Contractor: ALL AMERICAN ELECTRICAL CONTRACTORS Owner: ROBINSON, CONSTANCE A &
PO BOX 1426 ROBINSON, LYNN ET AL
GRESHAM, OR 97030 BY KG INVESTMENT MGMT
10240 SW NIMBUS AVE #L3
PORTLAND, OR 97223
PHONE: 503 - 657 -4351 PHONE:
FAX: 503 - 496 -3995
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 12/07/2010 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/07/2010 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow th-_ ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through 0 ='.=e -I01 -0090. You m- obtain a .. o e ru - • direct questions to OUNC by calling 503.232.1987 or 1.800.332.234
•
Issued By: _ 2 Permittee Signature: J✓ f
AO 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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
� r`
Electrical Permit A licatio • ' �► u t 1 ,r • E t
City of Tigard Received , ,
Permit No ; -00C9 � G
i 1 -� �?
13125 SW Hail Blvd., Tigard, OR 97223 7 2010 �„ e/11 : Rev
,
N Phone: 503,639.4171 Fax: 503,Sy8.I%0 t7ale/Dy, gt Perm S
Inspection Line: 503.639.4175 1]atn Rca <iyll ;y; lu �.� See Pagel fur
l 1 i � A.lhl >' p CITY OF TIGARD Notified /Method; I r' v Supplemental Iaformalion
• 1ptcrnel; Wvvw.11gard- or.gav 111 fl A I/` f /IC' t11 ___ -. - -°�
�' -
..... ` ° ....re:"... PLAN REVIEW
TYPE OF IV _ .
Please check all That apply (aub,nit 2 sets of plans w /items checked below): •
❑ Ncw construction Addi lion /alteration /repiacemcnt ❑ Service or feed, 400 amps or more 0 Building over throe storica.
❑ Derno1l1i01) ❑ Other: - where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 ,nips at 150 volts or 0 Floating buildings.
_ •. It to ground, or exceeds 14,000 Q Comn,mt use agricultural
❑ 1- and 2-family dwelling is Commercial /industrial �❑I Accessory building amp for all other installations. buildings,
El Multi-family ❑ Master builder
U Other: lip Fire pump. 0 Installation of '75 KVA or
❑Emergency ayxtem• larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of
t 1- J IWill' or 11101-4 occupancy.
dab no. Job site address: I O 11 - ,�• � � MIA S 6 n R e 4� ❑ Six u1- mnro residential units. d Recreational vehicle parka.
--�� to �+ t p 0 Hazardous rare faciions, • 0 Supply voltage for more than
(amity /State /ZIP: I ptyU - s�4 [� Hazardous locations. 600 volts nominal.
CI service or feel r 600 ramps or more,
Spite /bldg.lapt. no.: f Project Warne: FEE SCIIEDULE
Cross stIeet/directions to job site: - DescrinII ti„ . 1 . Qiy F . - T-61"t 7—
-- -T �— New residential single - or multi- family dwelling unit.
Includes attached garage,
m
Subdivision: ! 1.ot Ito.: 1 sq 11. un less 168.54 4
- ---- -'- Ea. add'I 500 sq. ft, or portion 33.92 I
Tax leap /parcel no.: - —
Limited energy, residential 75.00 '-
� DESCRIPTION OF WORK - (with above sq, ft...)
_ - - Limited energy. multifamily 75.00 2
�� / K S _( (j. 0 K, � 5 3 L W 4 6 „1, , t c _ ; V -. t � i 4` residential (with above 5 . ft. ,
__ �� 1 ... Services or feeders installation, alteration, and/or relocation
200 amps or Icss 100.70 2
❑ PROPERTY OWNER ^ El TENANT 20! amps to 400 amps 133.56 2
- -- � ^T �~ 401 amps to 600 amps 200.34 2
Name: „_ 601 amps to 1.0_00 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
.. - Temporary services nr feeders Installation, alteration, and /or
City /State /ZIP: relocation
2 00 a mps o r less 59.30 1
Phone: ( ) Fax: ( — 125.08 2
_ 20 amps to 400 amps
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - ucty, alteration or extension .e1- anal
Owner signature:_,._._ .___ Date: __„..� A eaFee for branch ch branch circuit
Wilt El APPLICANT
0 CONTACT` PERSON Ter fee, 7,42 2
13. Fee for branch circuits without
Business name: service or feeder fee, Elul 2
. �., -. -.. 56,14 54,18
Contact name: branch circuit
Each add'I branch circuit IMEI 21,44 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular G7 84 2
City /State /ZIP: _ mm dwelli service and/or feeder
..- Reconnect only 07.84 2
Phone ( ) , Fax: ( ) . - Pump or irrigation circle 67.84 2
F.,-mail: Sign or outline lighting 67,84 2
CONTRACTOR Signal circuit(s) or limited - energy
' /�,,,� ���� panel, alteration, or extension. P 2 _, 2
Business name: 4/ - 4, co co [ „ . s. r � , Each additional inspectio n over allowable in an of the &boy
Address: ?a 0t� 1 Zb Additional inspection (I lir min) 66.2,5/ )v
Investigation (1 hr min)
�-1 66.25/ hr
City/State/ ZIP: ye s �� 9 ! 03 b , hldastrial (slant (1 hr min) - 78.1g/ lir
Phone: ($03)6, 51- L ? 3 ', • . Fax: (+5'o3) C 3915 Inspections for w ch no fee is 90.00 / hr
specifically listed CA hr train
CCI3 Lie.: I Syg90 Electrical Lie.: 2.4 -wit/ Suprv, Lic.: Li, ELECTRICAL PERMIT FEES
S ubtotal: E . ,
Suprv. Electrician signature, required: 7) ___�,/�4 ,4, _ Plan review (25% of prnnit fee):
Print name: 1:). Illy �-��1 +Y- ~ I
" t Date: 11- / 6 �D
t?
State surcharge (12% of permit fee): . 3O
TOTAL PI RM1T FEE: ' 4.
Authorized signature: / -' 1 i 'nit permit application expires if P permit is not obtained within 180
-. V n days a fter it has been accepted as comple
Print name: �1 t r c. l�.`td Date r �' w �V " Number of inspections allowed per permit.
I .unuitdiegWKola \F.LCRnmitApp.Lo 07 /01 /t0 440 -4615T(11/05 /COMAVEn
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Electrical Permit Application
C A,. 1.1)14 01..F1(1.. I'.SI. !'.7\1.1
Line; 503.639.4175 CM G
010 Permit No,: Q•0
City of Tigard EC 2 b 2 b., ELC?�i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit; lU -I rr )
Ins cti
Phone: 503.639.4171 Fax: 503.598.1960 -`1GAR i tletefini -� (4
un D l, al . ti Rends /n furl y: - ^ ^�, See Paget far
i I r • A 1' 1'r
Internet: vvww.tigafd•or.gov �v n1 A1 otified/MethoJ �-�� f — -- Supplemental Information
�' J 1`76 1` V —
TYPE OF WORK PLAN REVIEW
Name check all that apply (submit a sets of plans w /items checked below):
❑ New construction ❑ Service or feeder 400 amps or more ❑ building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ vfarines and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or j7 Floating buildings.
less to 0 aund, or exceeds 14,000 Q Cummerciat•uso agricultural
❑ 1 and 2 family dwelling latommercial/industrial 0 Accessory building amps for all other installations. buildings.
r ❑ Other: ❑ Fire pump. ❑ install tiun of 7 KVA or
❑ Multi- family ❑ Master builder ❑ Emergency system. larger separately derived system,
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of 0"A", "E", "1 -2 ", "1 -3 ",
ee�� p IO0HP or morn. occupancy.
Job no.: Job site address: Q `p S (a r i lo 1-fe. 11311 0 Six or morn residential units. ❑ Recreational vehicle parks.
❑ HenIlh•raro facilities. ❑ Supply voltage fur more than
Ctly / Stoi c /ZIP: ( ♦IL. q ❑ Hazardous locations, 600 colts n ominal.
1-1.01/_;10,:k. ❑ Service or fee 600 ntorc -
,
Suitelbldg. /apt, no.: Project name; der 0 amps or
• FEE SCHEDULE
Cross street/directions to Job site: `aerlptmn F Tat
New residential single- or multi - family dwelling unit.
includes attached garage.
1 .01 no.: 1, 0(10 sq. R. or less 168.54 4
Subdivision: Pa, add' 1 500 sq. f. or portion 33.92 I
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
- - limited energy, multi - family 75.00 2
te
,�o it, l 2e o +4 n s p. e.J ,4i �a� residential (with above sq. ft.)
!! Services or feeders Instatlatlon, alteration, and/or relocation
1 - 0 Z I 1 �• ` a I) C4 - - ? { y fat. t 200 amps ur less 1 100.70 Job ; ] 0 2
`� I ❑ TENANT 201 amps to 400 amps 133.56
❑ PROPERTY OWNER 401 snips to 600 amps 200.34 2
Name: 601 amps to 1,000 setups 301,114 2
Address: - Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, and /or
City /Statc/ZIP: relocation __,..,..
200 amps or less 59.36 Phone: ( ) Fax: ( ) 125.08 9
201 amps to 400 amps _ 12.0 2
Owner Installation: 'Chia installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits new, niter or extension, per Ha nel
Owner signature: _ — ,._ „_ Date: __ A. Fee fur branch circuits with
above servo a ur feeder fee, ' 7 42 ') .y Z 2
❑ APPLICANT ❑ CON'CACT PERSON each branch circuit _ .
B. hee for branch circuits without
Business !lame: service or feeder fee, first 56.18 2
branch circuit
Contact name; --- Each addl branch circuit 7A2 2
Address: Miscellaneous (service or feeder not Included)
Each manufactured or modular 67.84 2
City/State /GIP: dwelling, service and/or feeder
Reconnect only 67.84 2
Phone: ( ) 1 Fax:: ( ) Pump or irrigation circle 67,84 2
E -mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
v � � , , � I C el, alteration, or exten Pa e 2 2
Business name: f _ � ga) F, y., f i' �7t:. Each additional Inspection over allowable In any of the above
Address: /(/), 4, Additional inspection (I hr min) 66,25/ hr T
I Q r •
+� �� -• Investigation (I hr min) w 66.251 hr
City/State/Z1P: ay ¢.H.. 0 _9763 Industrial plant (I hr min) in 78.181 hr
Fax: () Y16 3995 inspections for which no fcc is 90 / hr
Phone: (�03) (p� 7� 3�/ 3a3 7 ..... -, s ificail listed F,hrmin
CCB Lic_ /52ggo Electrical Lie.; 2.4 • / ffS(, Suprv. Lie.: t'f73/ -$ ,..._ ELECTRICAL PERMIT FEES
Subtotal: 10R,12._ ,
Suprv. Electrician signature, required: D. /b it _ Plan review (25% of permit fee): .m
Print name: £, l Nt l.� Jp. U t ' Date: /L Z I B / 0 State surcharge (12% of permit fee): 12 .11
r TOTAL PERMIT FEE: la( a P q
Authorized signature:
L This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: are, e Ir -Id Dale: /2 /7,8 /0 + Number of inspections allowed per permit.
I.lauildingaPe riiAttP.C- PermitApe 07 /01 /10 410 417T(11Rt/C0MAVCa
ZOOIZI XV'd LZ :TZ 0T0Z /9T /fi0