Permit - CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00415
Date Issued: 08/13/2009
71GARI) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102AD02200
Jurisdiction: Tigard
Site address: 8900 SW BURNHAM ST
Subdivision: BURNHAM TRACTS Lot: 6
Project: Burnham Business Storage
Project Description: Add (3) branch circuits. Work is in F08.
Owner: FEES
BURNHAM BUSINESS & STORAGE LLC Quantity Description Date Amount
9500 SW BARBUR BLVD STE 300
PORTLAND, OR 97219 3 crt Branch Circuits 08/13/2009 $60.15
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/13/2009 $7.22
Electrical
Contractor:
ELECTRICAL CONSULTING & DESIGN INC
22056 NE COUCH ST
GRESHAM, OR 97030
PHONE: 971 - 235 -5900
FAX: 503- 618 -7486
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $67.37
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. ATTENTI••. •rego -w re•uires ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 ' rough OAR 952 -06 I r I. • •ul may obtain a copy of the rules or direct questions to OUNC by calling 503.246.66 • or 1 800.332.2344
•�.�� /
Issued B : Permittee Signature: )c
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' t' Date: / 5 /c)
LICENSE NO. r 9-6O S
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.
Electrical Permit Application ,,,� e r rk FOR OF i l S E ONLY
City CI} of Tigard Mgr Received a lt
`� g `t D Plan Reate /Bvview : a 13 �T n
13125 SW Hall Blvd. Permit No.: 14 6. � {�S
Tigard, OR 9 Blvd., , " 9
Ill
Phone: 503.639.4171 Fax: 503.598.19601 U 20o DateB '. Other Permit:
TIGARD Inspection Line: 503.639.4175 I-j r �y Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov rl,,� (�E TI B U t Notified Method: Supplemental Information
. >= ,,..,�. ,,.,.,,.,, >...,,. ., :.« �..- .. .s ., � G+ � ....srm�- o^�*eaws:- ro�sr>• , . ,- : .�. - w =.�:�. > " >::. . "«�. -: .�.,.:.�. •;•.�• s. ��. --:. s.
mile : z > -._3,. 'x.;,,.. �, ", r ay ' . , '�'�..�.4 ; • -3 � .� , ci' 4 ,w,..� .- _ \ -r ` ,,. w
rs ; -x . Kr . .,,. :TYPE"-OF WO n a l i : -T rto, ` , l' . „ e- r, . ,.:..- . ..iP,,AN " REVIEW - _ .
❑ New construction kAddition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
a'�.k",� � *��� �;k•'. ��: air- �,-.�" w:.rxaF:x ��mmam�sea.,.;me^t�;*:ct+ -� -:. �sei:,.�,:= ;..w�..., .: -::c� � .,.u.�,:F ". >-= ,£� +,..cz._...�:v exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
i„ „- ,a `Ir .' ` , .,, OR _. =
t:- 'tt`t _ ?::. ,... .:.-.CA GORY >Q`F� x:. : .. :
°.=->4Y t r
''"` " "' "`�'�'�'�"'� ° �`"' "'�'"'` " �`"` �' ��" �" � ' `"�'�'�""'�'� °""� "°`` " "'�'`' `' `� °° � . �= "'"'' ° " " " °' less to ground, or exceeds 14,000 ❑Commercial -use agricultural
111 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
a. "s,< , .f - .; r .s. -• ' t;.:: fx . , ,nr�. c:_ :..zr,G - :,. ;._ x' P. .. ❑ Emergency system.
To T Io1 A1�7D:. L-OCAT,ION ' -
«� . . ;= r-Z . ,,,., r ,,„ >2;4 ,,a : w'at -rz v .x„ ...e.4.,. „ :a 4b.s. . ?z 4 .� ❑ Ad larger separately derived system.
Addition o new motor load of ❑
Job no.: Job site address: boo sv /8 ig 01 4. IN1 100HP or more. occupancy.
❑ ❑ Six or more residential units. Recreational vehicle parks.
City/State /ZIP: t C H C -- Q I- ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
job site: �� Fee. . . ,..
Cross street /directions to b i
R
J Description - � .,, Qty. I �mM �* Fee. I Total
�� •
�f
• �/ // New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
,G. ,.:.... -.r:. . aA. ..�,, ....,; "rw Limited energy, residential
u 75.00 2
'A.4- p...rs . �� ' aD S( RIP ION�.;®F W®RK Fa,: t . - g - �� ,..�, (with above sq. ft)
Limited energy, multi - family 75.00 2
,Q 3 G t ``ei 1, s `'1 S residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
", -' ;`" : R6TT' oR NER.. � :.k ® EN
TANT. %t : rii'"r j . 400 amps 10 .8
t,' . , .� ;M ®PROP „,.:�..�:;��_..r.,,�. r,,.::�:: r �4 �.* ': ,,_�.. �" V ., ,_...�. ;�,,.,,,: �,s:.:.: ; �, „«, g.> .t3 201 amps to 00 a ps 6 5 2
Name: 401 amps to 600 amps. 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
g A. Fee for branch circuits with
`V r Ili �APPLICI T' I , M # 7 CONTACT` "P. ,; ,, y above service or feeder fee, 6.65 2
` ' each branch circuit
Business name: B. Fee for branch circuits /
Contact name: without service or feeder fee, 46.85 l i. Vf 2
first branch circuit
Address: Each add'I branch circuit 6.65 ,'3 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
x 4 Est 3:; (' r ,, " O ", I. , ;. e„ CON I'RAC TOE , �,� ; z.
�,.,�,.,� �R��.�����.� .������� : v�" - „a.�_�.,,��w.,,�_.,�.__ �. -� .,.. - 'a`a� u�"�x -�� �,,.. -�si Sign or outline lighting 53.40 2
Business name: /_(G.4
O h S . v / /'J���� Signal circuit(s) er or limited -
�� 7- !� energy panel, alteration, or
Address: 0- Za5- to 'T/ -;a extension. Describe: Page 2 2
City/State /ZIP: (j:- SA , 9 7o5.0 Each additional inspection over allowable in any of the above
I Per inspection 62.50
Phone: (1.7) ) 3 s - r ep z 7 Fax: (5 , f ) 6/y t T ��'� investigation per hour (1 hr min) 62.50
L y- ie.: � J g by lectrical Lie.: �• 6 �� S
q uprv. Lie.: zz4vs Industrial plant per hour 73.75
(l CC Wigan' ET E C T RIG I P1IRM1 „i, FEES, ` :R =>a ? ';
Suprv. Electrician signature, required: c a...4; � //
i'44% /, � Subtotal: 6 -D ?
Plan review (25% of permit fee):
Print name: � �� MAP* rnA Q �C� II Date: State surcharge (12% of permit fee): -7 ?
Authorize signature: V � ' l TOTAL PERMIT FEE: 1
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
" Number of inspections allowed per permit.
l'\Buildmg\Permns\ELC- PermitApp doc 05/23/06 440- 4615T( I 1 /05 /COM/WEB
Electrical Permit Application - City of Tigard
- - • •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
*af#ENVWWZOUTCIEtfSRSELOMIM
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
fl Audio and Stereo Systems*
[7 Burglar Alarm
I 1 Garage Door Opener*
O Heating, Ventilation and Air Conditioning System*
0 Vacuum Systems*
O Other:
'0:ic
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
T i Audio and Stereo Systems
O Boiler Controls
n Clock Systems
I Data Telecommunication Installation
O Fire Alarm Installation
▪ HVAC
O Instrumentation
O Intercom and Paging Systems
O Landscape Irrigation Control*
0 Medical
O Nurse Calls
I I Outdoor Landscape Lighting*
0 Protective Signaling
0 Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\BuddingTermds\ELC-PermitApp doc 03/23/06