Permit ,,•
4 CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC2005 -00942
��4i DATE ISSUED: 12/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102DB -00100
SITE ADDRESS: 08840 SW BURNHAM ST ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 4 branch circuits.
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'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: 3 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:
VERIZON NW E C COMPANY
180041ST ST PO BOX 10286
PO BOX 1003 A \WA 010 4 -LB PORTLAND, OR 97296
EVERETT, WA 98206
Phone: 425 - 261 -5408 Contact #: PRI 503 - 220 -5377
FAX 503 - 295 -3012
FEES
Description Date Amount Reg #: ELE 26 - 45C
[ELPRMT] ELC Permit 12/6/2005 $66.80 LIC 49737
[TAX] 8% State Surcharge 12/6/2005 $5.34 SUP 4040S
Total $72.14 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 1-80 344.
Issued By: e, Permittee Signature: del- cz 7 1.._
r
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.
12/06/2005 02:56 5032205347 .PAGE 01
1 f ' El '
lectrical Permit A.pplicat .. S) l•'r>~Ii ()i' FI(E USE ()Nil'
/ / .:
City of Tigard ,.. G rB ; i ,I / 0 . / . 11 _ C-_ o • a' a 13125 SW Hall Blvd., Tigard, OR 9 1 ' an . • • 0W
Pcmit No
Phone: 503.639.4171 Fax: 503.59 . 1964 0 �+ �» '' � '� • -1 1 t ' D ,a Other Permit:
:y , u „ y' , gee Page 2 for
Inspection Line: 543.639.4175 V j gi ' C � c p t e 2 fa
Internet: www:ci.tigard.or.us ()� NotlSetUMct o� Information
• VV N N • .. ..... r ...: ... ........ „', f...i`..i` m . •
1:::] New construction ❑ Ad. n•, __ cp(acemctit Please check all that app Y
❑Service over 225 amps, comm'1 ❑Hazardous location
❑ Demblition p Oth/a'A\`' ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
rra- , . :; , ;:i.:::..' > ::.. , -.., .,, : ...... , .... , .....,... r .;,,.., , I r., ,,' ; . ............1:.. of 1 -and 2- family dwellings or more new test enna •
�, %.H ❑System over 600 volts nominal units in one structure
❑ 1- and 2- family dwelling ❑ ComtnerciaYi idustriai ❑ Acccssoty building ❑gttilding over three stories ['Feeders, 440 amps or more
❑ Nvlultd- family Q Master builder ❑ Other: COccupant load over 99 persons ❑lvlanufactured structures or
r:::::1,13':';‘:,..,..•:. . .. ;.:......,: ., .. ;:i;: ['Egress/lighting plan RV park
c r:
�1 :..,..., y nn : Health -care facility th ..,.,r
Job no :: q ( .0 1 ..... Fob site address: % 0 S Us.) ., , (..i 1 h S Submit sets of plans with any of the above.
City/State/ZIP: k X 0 t, The above are not applicable to temporary construction service.
i r 1l` J : D `.. llla tr'f:10,
Suite/bldg. /apt, no.: Project Warne: e....Q - L 1 v Notripnoa Qtr v "° Total ."
Cross street/directions`to job site: New residential single' or multi- amity dwelling unit.
IucIudes attached garage.
1,000 sq. ft. or less 145,15 4
Subdivision: Lot no.: P a . add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax um/parcel no.: Limited energy, non - residential 75.00 2
( P �t ` , 1, �' : r , .. � , . , Each manufactured or modular
' a t'" "'7 'kr ' �
dwelling, service and/or feeder 90.90 2
k Q , R e e . s; C, a Services or feeders installation, alteration, and/or relocation
200 amps or leas 80,30 2 •
P;7/1;1'.',F,.','.': „..nainrp :,Y,, ,. , ,,,,;, , ,;,,, , , , ,,;;,,, .......
,.: �a,: g
,.5 ;:.i,.:. ,.. .::..: ?',.... ;. . ,,,, :,' ;• ; L : ?"'• . ; + , ... `iF)' :1.ai': %.5;'i 2
: ::. .., 1. a.,.......:. , a0 t a to 600 amps 160.60
601 amps to 1 ,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: 0 d : �( Reconnect only 66.85 2
City /State/ZIP: F, L r L p, , Temporary services or feeders i mutilation, alteration, and/or
relocation
Phone: (4..k1,5) G \ , S y b g. .Fax: ( ) 200 amps or less 66,85 1
Owner installation: This installation is • eing made on property t at 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 _ I 133.75 2
Owner signature: Date: Branch circuits new, alteration, or extension, per pone,
. ....... ....... ,,,,v.:,
,,•:,.: :., „,, %.,,,,�, >::;,,,,...,, a: ....:;,..:- . , „ ...... .. :: ,,,, !! :,- �; M.,,; Fee for branch circuits , ,r T y r'l .,A 4 �.,�:�. 1 :, � . , , ,
t� t , � � A F ifs with
1 ;5 ., -a :,,. , „ ".:f . . .. „ eder fee, each
.
, 1
l az , : :,r l : ..,. ,..e,� -e,., . , .:. .. , ,, .:.. r ,.:. . ....... . • . �.. . • . , ,,,. , service or feeder 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: wilhonu service or feeder fee, t 46.85 S 2
each branch circuit t\Lg
Address: Each add'I branch circuit 5 6.65 2
City/State/ZIP: 1Wlscellaneaus (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E - ma il : Signal circuit(s) or limited-
� r ,:,,, N, ., .!::;;.., _ .... ,:u,rr�,:; an or
, • : ,,, ; .,, .. ; ...,.,.,..__,. . r ,, , , , , . ,M� . r ,.,...., c , a terahon o
P2iS }11 ,
; :;.r . ,: ` , .,., :' `" ” energy p extension. Describe: Page 2 2
Business name: ' C co r, 6 pt
Ades. Each additional inspection over allowable in any of the above
0 0 Per inspection 62.50
City/State/ZIP: j) ' k 0 , , C1 `1 1 . Investigation per hour (1 tot min) 62.50
Phone: (cyr. /) 5 a U - S `S 1”) Fax: (So ) 0101S-11)11- industrial plant per hour 73.75
i ': l i t rt 1 �. J Ta' ^ nt
HC:P
:. ter- ,r., ,..c�t: r .,..,,,.awb s ., =4:
CCB Lic.: �` \ 31 Electrical Lie.: � C'yS L Suprv. A 7 � .: subtotal G G -2�
Suprv. Electrician signature, required: 4 ,41111Mir lrriOgFAIIIIII Plan review (25% of pemnt fee)
lia II 07
State surcharge (8% of permit fee) 5 $
Date: �• G O _
TOTAI, PERMIT FEE " 1� , 1 k,
Authorized signature: this permit applicadon expires if a permit is riot obtained within 180
days after it has been accepted a7 complete
Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board
" Nuntltar of inspections per permi allowed.
;:t BaildineterrtitinEi _C•Permiwpp.doc 12/03 440.4615t(10/03/COM/WEB
CITY OF TIGARD .. ,-
BUILDING DIVISION PERMIT #: ELC2005 -00942
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2005
Phone: (503) 639 -4171 . udgp�l��
Inspection Requests (24 Hrs.): (503) 639 -4175 ....„34 _...
INSPECTION WORKSHEET FOR DATE: 12/13/2005 TIME: 7:02AM PAGE: 86
I
SITE ADDRESS: 08840 SW 13URNHAM ST CLASS OF WORK: 1
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON v ., DESCRIPTION: 4 branch circuits.
OWNER: VERIZON NW, PHONE #: 425.261 -5408 rt-4\- ci CONTRACTOR: E C COhll!'ANY Ct ,J 'yl E � 1(} 3R � IS
Il
Inspection Request Scheduled For: Date: /2/1312005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 023308 -01 513 - 220.6587 N
Corrections /Comments /Instructions:
1 - '71,3
O "kV l� ()fi GOikA b0.y TO) N,9 3 q '' 15 6r kli, AZ i(,14*
DN r 4 kirseT IX\ cs5J4011 To 61 Ci- RI*
. /,‘9-11.---) 'S
•
)
n PASS 1 I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
Y� " FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
/ d
Inspector: mfr .. .. Date/ /i Phone #: (503) 718 - W
CITY OF TIGARD . ,•
BUILDING DIVISION ' PERMIT #: ELC2005.00942
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2005
Phone: (503) 639 -4171 ho do H I" l
Inspection Requests (24 Hrs.): (503) 639 -4175 W' -11.
INSPECTION WORKSHEET FOR DATE: 12/8/2005 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 08840 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON
DESCRIPTION: 4 branch circuits.
OWNER: VERIZON NW, PHONE #: 425. 261 -6408
CONTRACTOR: E C COMPANY PHONE #: 503 -220 -5377
Inspection Request Scheduled For: Date: 12/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wail cover 023112 -01 503-220-3587 N
Corrections/Comments/Instructions:
I
I
APASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: " ' ° 1% la Li Date: i t Phone #: (503) 718- 4 Li u 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200500942
1.3125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12!&2005
Phone: (503) 639 -4171 ll �
Inspection Requests (24 Hrs.): (503) 639 - 4175±+
INSPECTION WORKSHEET FOR DATE: 12/14/2005 TIME: 7:01AM PAGE: 36
SITE ADDRESS: 08840 SW BURNHAIVI ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON
DESCRIPTION: 4 branch circ it;.
OWNER: VERIZON NW, PHONE #: 425- 261 -5408
CONTRACTOR: E C COMPANY PHONE #: 603 220 - 5377
Inspection Request Scheduled For: Date: 12!14/2005 Pour Time:
Code # - : - '. I - . iption Confirm # Contact # Message
199 Electrical final 023460 -01 503- 2203587 N
Correcti• - - • ents /Instructions:
•
lA PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CT"KCtS' N o e Date: 1 I Phone #: (503) 718- 2y410