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Permit 4 j ~ CITY OF TIGARD ELECTRICAL PERMIT il '° PERMIT #: ELC2007 -00529 COMMUNITY DEVELOPMENT D ATE ISSUED: 7/31/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113AC -00103 SITE ADDRESS: 07216 SW DURHAM RD 200 P ZONING: I -P SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG PROJECT: WELLPARTNER Project Description: 2 circuits for office furniture power. 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: PACIFIC REALTY ASSOCIATES MILESTONE ELECTRIC 15350 SW SEQUOIA PKWY #300 -WMI 1800 NW 169TH PL. SUITE B700 PORTLAND, OR 97224 BEAVERTON, OR 97006 Phone: Contact #: PRI 503 - 645 - 5323 FAX 503 - 690 -4843 FEES Description Date Amount Reg #: ELE 34 -618C [ELPRMT] ELC Permit 7/31/2007 $53.50 LIC 153480 [TAX] 8% State Surcharge 7/31/2007 $4.28 SUP 4574S 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 set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC :t 503.2.6699 or 1.800.332.2344. Issued By: �,� / ��: P ermittee Signature: - 1.,i''.41.' ,�`+ /�' OWNER INSTALLATION ONLY Z 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. 'Electrical Permit A lication _ ' e FOR OFFICE USE ONLY - '° City of Tigard �° t3r'i/ Recerved7 _ .� — �o� `J g , . G, t Date /By: 0 ' F'1 42 ", Permit • .. 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.196JU I 3 1 200/ ; /?� jI Y i. Date /By Other Permit: Inspection Line: 503.639.4175 ' J�� Date Ready Jul El See Page 2 for . Internet: www.ci.tigard.or.us CITY u2 „--' ►r`. PAD Notified/Method: / Supplemental Information . t U`F wbRY5�il 1 ` ,PtiA■REVIEWa : ,Y; , . ❑ New construction IN 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 0 System over 600 volts nominal units in one structure ❑Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family 0 Master builder 0 Other: ❑Occupant load over 99 persons ❑Manufactured structures or JOB• _SITE". INFORMATION AND LOCATION • ['Egress/lighting plan RV park ❑Health -care facility ❑Other: Job no.: — 2 33‘ Job site address: 7 I S 3 i �►t r :o PA Fi- aOil Submit 2 sets of plans with any of the above. City /State /ZIP: 1 9 7 D'� The above are not applicable to temporary construction service. car 1a(\ 0 r l • •: FEE *. SCHEDULE • ' Suite/bldg. /apt. no.: Q 1 C �. Project name: -tM nt 1 +N 6 t .' mil .0Q r _ 1 Description l Qty. I Fee. Total I "* Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less I 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 OFD WORK,. _, Each manufactured or modular e� �O KT _S dwelling, service and/or feeder 90.90 2 `�``n,5 'I 4 wo lUV `T'1D A r Kl_S -e�- ( S Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 T',',;OWNER . , 201 amps to 400 amps 106.85 2 • ❑ PROPERT 0 - 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 ( Business name: b c ruder fee, each 1406 1 ( te.4..Ap_ r ranch 6.65 2 f , - B. Fee for branch circuits g Contact name: f'. r\O 4 u + l e 9 �r without service or feeder fee, 1 46.85 96 2 Address: no each branch circuit Each add'l branch circuit 1 6.65 G 6 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (so3) r-1 I g S Fax: : (5o3) 7 O 5-20 I Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- - CONTRACTOR .: . . energy panel, alteration, or 1 extension. Describe: Page 2 2 Business name: V� l e_Si_pn E I��� c 1 c Address: 1 (19 v 1 69} h p ( c A + 7 co Each additional inspection over allowable in any of the above ' / Per inspection 62.50 City /State /ZIP: , J epkJ erTo A © fly q -7 Q e Investigation per hour (1 hr min) 62.50 Phone: ( ) G1-15 53 `a -3 Fax: ( ?) 690 q 1-1 3 Industrial plant per hour 73.75 ,. - ELECTRICAL PERM IT FEES CCB Lic.: J 53 L L r , Electrical Lic.: 39L- 7 t_ Suprv. Lic.: �S7 ! Subtotal S3 '--5-°' Suprv. Electrician signature, required: < Plan review (25% of permit fee) r^ ' State surcharge (8% of permit fee) 14 g _" Print name: �, a �� _ � Date: 3 (-U TOTAL PERMIT FEE 5? Authorized signature: /J This permit application expires if a permit is not obtained within 180 p days after it has been accepted as complete Print name: /,./, �� 4 .. te: 7-3/- ? * Fee methodology set by Tri- County Building Industry Service Board " �l ^ ** Number of inspections per permit allowed. i.\ Bui !ding \ Permits \ELC- PermitApp,doc 12/03 440- 4615T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK =ONLY: ' . _ '.:::<:. Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System * ❑ Vacuum Systems* ❑ Other: CODIMERCIAL WORK <`: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* n Medical n Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required • for all other installations \ Building \Permits\ELC- PennitApp.doc 04/03 • CITY OF TIGARD BUILDING DIVISION PERMIT #: ac.2on. 29 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171mglll "� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: ,- B - 0 $ TIME: PAGE: SITE ADDRESS:12- Ib S W bOKA N CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: vas,U- P6RTN DESCRIPTION: 2 acts . • OWNER: PHONE #: CONTRACTOR: YYs110 1. 0 I` V C PHONE #: Inspection Request Scheduled For: Date: I-- 2 - 0 53 Pour Time: Code # Inspection Description Confirm # Contact # Message ti (-"+�� ON Fitt-Z Corrections /Comments /Instructions: • N. PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 6.— 066 Date: ' 131 Phone #: (503) 718 - 1/41110