Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00376
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/07/2011
Parcel: 1S135BB00501
Jurisdiction: Tigard
Site address: 10575 SW CASCADE AVE 130
Project: Hemcon Subdivision: Lot:
Project Description: (1) subpanel and (3) branch circuits for standby transformer.
Contractor: BOONES FERRY ELECTRIC INC Owner: HEMCON MEDICAL TECHNOLOGIES INC
PO BOX 628 10575 SW CASCADE BLVD
WILSONVILLE, OR 97070 BEAVERTON, OR 97223
PHONE: 503 - 682 -4936 PHONE:
FAX: 503 - 682 -7946
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/07/2011 $100.70
Specifics: amps or less
3 crt Branch Circuits w /Purchase 07/07/2011 $22.26
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/07/2011 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137.72
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 aEe set forth in OAR
952- 001 -0010 through 0 952 -001 -0090. You op • • - les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �►,r - Permittee Signature: . - 1 .a
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.
Jul. 6. 2011 2:52PM CEIVED No, 7 . P. 1
Electrical Permit t pnlicatt l OR i11.`l 1( 1. l til :, r)tii.1 '
City of Tigard ,..t- 11 S
, I 0 6 2011 Du®1B : 7 t No-
il 13125 SW Hall Blvd., Tigard, OR 97 Plan Review
Phone: 503.718.2439 Fax: 503.598.1 Other Permit:
T t t -" ii " ]nspactton Line: 503.639.4175 C OF TIGARD
Date/By: r,;,;;; See Page 2 for
• Internet: wwW.tigard -or.gov BUILDING DNISION Notified/Method: w J / Supplemental Information
- _ TYPE OF WORK PLAN REVIEW •
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 1 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where die available fault current Cl Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floati buildings,
less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder El Other: 0 Fire pump. 0 Installation of 75 KVA or
- -- _ AND LOCATION UEmergency system. larger separately derived system.
JOB SITE llVllOR117
. l3 Addition ofnewmotorloadof 1:1"A", , "!- 2 ",`l� ",
•
Job no.: 183011 lob site address: 10575 SW Cascade Av 10011P errors. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard OR 97223 [(Health facilities. ❑ supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: / Z Project name: Hemcon ['Service or feeder 600 amps or more.
_
Cross street/directions to job site: Deeap0on FEE SCIL qt J
L J F. I Tow I •
•
New residential single- or multi - family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
' -- Limited energy, multi-family 75.00 2
Optional standby Transformer and Subpanel • residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
_ 200 amps or less 1 100.70 100,70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
` 401 amps to 600 amps 200.34 2
Name: . .
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
- Temporary services or feeders installation, alteration, and/or
City / State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less T 59,36 -- ' 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 am 125,08 2
intended for sale, lease, rent, or exchange, according ID ORS 447, 449, 670, and 701. 401 amps to 599 amps 166.54 2
Branch circuits- new, alteration, or extension, ■ r panel
Owner signature: Date: A - Fee for branch circuits with
[] APPLICANT ❑CONTACT PERSON above service or feeder fee, 3 22.26
each branch circuit 7,42 2
Business name: B. Fee fer branch circuits without
service or feeder fee, fast 56.18 2
Contact name: branch circuit
.... . . . . Each add'I branch circuit 7,42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax:: ( ) Reconnect only . . . 67.84 2
E-mail: - Pump or irrigation circle 67,84 2
Signor outline lighting 67.84 2
CONTRACTOR Signal circuits) or limited - energy
Business name: Booties Ferry Electric panel, alteration or extension, Page 2 2
Each additional inspection over allowable In any of the above
Address: P.O. Box 628 Additional inspection (1 hr min) 66.25/ hr
City/ State/ZIP: Wilsonville OR 97070 Investigation (i hr min} 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 682.4936 I Fax: (503) 682 -7946 Inspections for which no fee is 90" hr
- specifically listed Ili hr anal_ " " _
CCB Lie.: 88482 1 Electrical Lic.: -223C l Suprv. Lic.: 4918S ELECTRICAL 1�'ERM1T FEES _
Suprv. Electrician signature, required: /(1/Y- A' /� Subtotal: 122.96
plan review (25% of permit fee); N/A
Print name: Stan Herron Date: 7/6/11 State surcharge (12% of permit fax): , ,JM7 -- /t 4
TOTAL PERMIT FEE: ] 1')"7.`7 8.
Authorized signature: This permit application cacpiras tie permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per peanut.
l:\ B »adunglpermhs\ELC- rezmitApp.aoc 07/01/10 440-461ST(11 /05/COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10575 SW CASCADE AVE 130, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2011-00376
Herb Stabenow
Violation Summary:
Inspector Contractor