Permit ,.. CITY OF TIGARD ELECTRICAL PERMIT
o t �� PERMIT #: ELC2006 -10086
DEVELOPMENT SERVICES DATE ISSUED: 3/29/2006
Ait''''Alil 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102AD -02200
SITE ADDRESS: 08900 SW BURNHAM ST F004 ZONING: CBD
SUBDIVISION: BURNHAM TRACTS LOT : 006 JURISDICTION: TIG
Project Description: (2) branch circuits for a/c & GFI. Job No. 4477
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: 1 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:
BURNHAM BUSINESS + STORAGE LLC HILLSBORO ELECTRIC
9500 SW BARBUR BLVD STE 300 21185 NW EVERGREEN PKWY #110
PORTLAND, OR 97219 . HILLSBORO, OR 97124
Phone: 503 - 620 -7204 Contact #: PRI 503 - 439 -9666
FAX 503- 601 -3680
FEES
Description Date Amount Reg #: ELE 34 - 4399C
[ELPRMT] ELC Permit 4/6/2006 $53.50 LIC 134481
[TAX] 8% State Surcharge 4/6/2006 $4.28 SUP 4941S
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 -246 699 or 1 -800 -. • •
Issue B y: 1 ,' Jj4 l,' Permittee Signatu ,d / ' -)
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
„. „..CONTRACTOR INSTALLATION ONLY
N
SIGNATURE OF SUPR. ELEC'N: -:'��� J '� DATE:
//
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03- 29 -'06 08 :55 FROM- Hillsboro Electric 503 - 601 -3680 T -343 P002/002 F -844
Pit? of 'kio rd !i Rccoived /y
: a 9 64, OM Permit No.: �• {.Ci, �r .. f
13 SI Hall Blvd., Tigard, Of _ Plan . Review
Phone: 503,639.4171 Fax: 50 ` �'!fti S' 1 ^' D 0� Dnte/w: Other Permit .
Inspection Line: 503. 639.4175 9 2 006 -11 D
Internet: www.ci.tigard.or.us MAR 2. Date Ready/fly:
N oti y ficd/Method : s e ntal I nr
See upnlen *entallnrermetion
T .
�' :! PLAN REVIEW
❑ New construction ~�� d$i tt lTdi placement - Please check all that apply:
, comm'I
❑ Demolition r Other: Service over 225 amps, P Hazardous location
CATEC OF CUNSTRUCTiON °Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.
� of 1- and 2- family dwellings 4 or more new residential
1- and 2- family dwelling ❑ Commercial /industrial 111 Accessory building ❑System over 600 volts nominal units in one structure
El Multi - family ❑ builder ❑ Other: three stories ❑Feeders, 400 amps Or more
... JOB SITE INFORMATION' LOCATION . • :'.. °'
ut ng ov the
Occupant load over 99 parsons ❑Manufactured structures or
. RV plan RV park
Job no.: Job site address, i ❑Health -care facility DOther;
/ State/ZIP:
�� £ 4 _' I Submit 2 sets of plans with any of the above.
Ci
ty f g (/, f I I The above are not applicable to temporary construction service.
Suite/bldg /apt. no.: ,„....
Lio Project name: rJ ' : FEE'.: '
J e: /A l i� :.,;:, SCHEDEILE,:: :
Description Qty. Fee, Toul
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
' _1,000 sq. ft. or less 145,15 4
Subdivision: . - 1 Lot no,: La. add'l 500 sq, ft, or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
: :
Lim
DESCR[PTION OF W sia::2 : :.;.,.:�: 75.00
ORK.
Limited energy, non-residential enpal 2
•• � : � - � H Each manufactured; modular
_dwelling, service and/or (ceder 90,90 2
Services or feeders installation, alteration, and /or relocation
200 amps or Less 80.30 2
: Q :PROPERTY•. OWNEt amps to 400 am
. . . .:.. `': "` . ' � "TENA]YT'' ": `c . r 201 amps 106.85 401 amps to 600 amps 160,60 2
.h 2
Name: /J L d2. t�) t dlovi Pa -�A � S 4- O rMietd e- �-�--C... „
601 amps to 1,000 amps 240.60 2
Address: 9 S 44/(6/4/1._ &Alb • Ore- .3,00 Over 1,000 amps or volts _ 454.65 2
City / State/ZIP: POt21-( CA- `+7419 Reconnect only 66.85 2
R �
Temporary services or feeders installs ion, alteration, and /or
Phone: ( ) s TFax: ( ) relocation
m ade on property 200 amps or less . 66.85 1
Owner Installation: This installation is being P perty that I own which is not - 20 t amps to 400 snips 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 7
; Owner signature: o , extension, per pa
panel C ❑ A >r
_ Date: Branch Circuits new, alteration a nor 'on e r
���s;'' � .�GONT CT'P � R50K =;;:ii;:; A. Fee For branch circuits with •
Business name: s ervice or feeder fee, each 6.65
if./ ' branch circuit
Contact name: B. Fee for branch circuits -
without service or feeder fee, ' 46,83 r i . 2
Address: each branch circuit l
-- - ._ Each add'1 branch circuit t 6,65 AS '. 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ( ) Pump or irrigation circle 53.40 2
•
E -mail: — Sign or outline lighting 53,40 2
: •.:.::!:.:.: . ... '''CONTRACTOR.:...;-:"!...:::::::::.'n: , .
• „;• , tbm circuit(s) or limited-
�., energy panel, alteration o
Business nanl . extension. Describe: P 2 2
H illsboro Electric L.L.C. _
-
Address: 21185 NW Everctreen PRWY Ste # 1 1 0 _Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Hillsboro, OR. 971 24
investigation per hour ( 1 hr min) 62.50
Phonc: 439 -9666 Fax:(503 )601.. -3680 Industrial plant per hour 73,75
ELECTRICAL .PERMIT FEES*
CCB Lic.:1 4481 Electrical Lic.:3 4-4• • C Suprv. Lie.: 4 9 41
® /a / / Subtotal
Suprv. Ele • rtctan signature, required: ` / Q / Plan review (75% of permit fee)
Print name: Joey Vi tc1CC0 pa °Cd6 State succllnrge ofpeni it fee) TOTAL PERMIT FEE ,')
Authorized signature:
This per application expires ire permit is not obia red within 180
Print name Date: • days after it has been accepted as complete
Fee methodolo set by Tri -County Building lndusny Service Board .
■duilding \Pmniis \�{„(;- 1'crmilApp.dx t?!Oi ” Number of inspections per permit allowed.
44046117fIi iJco iwEa
CITY OF TIGARD ELC.
BUILDING DIVISION PERMIT #: c----L1 (06.4.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 / emu - , 9Pi,ktl "
Inspection Requests (24 Hrs.): (503) 639- 4175�'I
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: F / 0 0 /2 .?J. )4..j /1/ 4 fl CLASS OF WORK:
SUBDIVISION: / LOT # TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3-3 0 - O Pour Time: /4
Code # Insp , tion D cription Confirm # Contact # Message
/<. L i 3 7--
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
W66 Li-
Inspector: '. Date: 31401,____ Phone #: (503) 7181-*