Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00193
' COMMUNITY DEVELOPMENT DATE ISSUED: 3/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135BC - 00700
SITE ADDRESS: 10795 SW CASCADE AVE ZONING: I -P
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: PORTLAND VINEYARD CHURCH
Project Description: Reconnect (2) a/c units. Job No. 306040 -7
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 HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
AMB PROPERTY L P GREENWAY ELECTRIC COMPANY
BY TRAMELL CROW NW INC 9460 SW TIGARD STE. 104
8930 SW GEMINI DR TIGARD, OR 97223
BEAVERTON, OR 97008
Phone: Contact #: PRI 503- 620 -6020
FAX 503 - 620 -6124
FEES
Description Date Amount Reg #: ELE 34 -617C
[ELPRMT] ELC Permit 3/30/2007 $160.60 LIC 153421
[TAX] 8% State Surcharge 3/30/2007 $12.85 SUP 5025S
Total $173.45 REQUIRED ITEMS AND REPORTS
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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 -01 :: : roug ' " 9 - 001 -0100. You may obtain copies of these rules or direct questions OUNC at 503.246.6699 or 1.800.332.2344.
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Issued =y: ( ` I , � Permittee Signature:
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: r.� 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.
Ejectrical Permit A A. �, '!': ; yl.,': FOR OFFICE USE ONLY
City of Tigard = °. ���® Date/B .. D -I Permit No.:�GC ,i7_
13125 SW Hall Blvd., Tigard, OR 972 M 0 2007 Plan Review
Phone: 503.639.4171 Fax: 503.598.19db '1 44 ' � . Date/B : Other Permit:
_A1 �I
//111� �
Inspection Line: 503.639.4175 //C {{{{((((����® ®®® u Date Ready/By: H See Page 2 for
Internet: www.ci.tigard.or.us B U Y' PL •C� Notified/Method: Bal Supplemental Information
TYPE OF WORK - PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY- OF CONSTRUCTION. of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑ Master builder ❑ Other: ❑Building over three stories 0 Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
DHealth-care facility ❑Other:
Job no.: 306040 -7 Job site address: 10795 SW Cascade Ave
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: Vinyard Church FEE* SCHEDULE
Description I Qty. I Fee. Total I "
Cross street/directions to job site: Greenburg & Cascade New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Reconnect 2 AC units dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less a 80.30 40 ..6,0 2
❑ PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
® APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Greenway Electric branch circuit
B. Fee for branch circuits
Contact name: .Bygoa.44ftyaletal -- ..._ 1 ,,,.. a� without service or feeder fee, 46.85 2
Address: 9460 Tigard St Suite 104 each branch circuit
Each add'I branch circuit 6.65 2
City/State /ZIP: Tigard Or Miscellaneous (service or feeder not included)
Phone: (503 -620 -6020) Fax: : (503 - 620-6124) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Greenway Electric
Address: 9460 Tigard St Suite 104 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Tigard Or Investigation per hour (I hr min) 62.50
Phone: (503 -620-6020) Fax: (503 -620 -6124) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 153421 Electrical Lic : 34 -617C Suprv. Lic.: 5025S Subtotal ' Q , tP r
Suprv. Electrician signature, required: ,� [/ Plan review (25% of permit fee) �-� -6�J
Print name: �' a e Date: .44464004— W . o State surcharge (8% of permit fee) (
J "� a ' / TOTAL PERMIT FEE / 2 . ys-
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: I Date: * Fee methndnlnov set by Tri- C'nnnty Rnildino Indn.stry Service Board
CITY OF TIGARD
A _
BUILDING DIVISION PERMIT #: ELC2007 -00193
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30/2007
Phone: (503) 639 -4171 .1if(ll
Inspection Requests (24 Hrs.): (503) 639 -4175 �_�
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7:0'1AM PAGE: 52
SITE ADDRESS: 10795 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PORTLAND VINEYARD CHURCH
DESCRIPTION: Reconnect (2) aic units. Job No. 306040 -7
OWNER: AIM PROPERTY L P, PHONE #:
CONTRACTOR: GREENWAY ELECTRIC COMPANY PHONE #: 503.620 -6020
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm-4 Contact # Message
199 Electrical final 046751 -01 503.849 -7206 Y
Corrections /Comments /Instructions:
PASSD n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: N 6L' Date: 14 I9 V) Phone #: (503) 718- .144