Permit •
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELC2007
DATE ISSUED: 3/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AA-01400
SITE ADDRESS: 10215 SW HALL BLVD ZONING: C -
SUBDIVISION: METZGER ACRE TRACTS LOT : 037 JURISDICTION: TIG
PROJECT: INTEGUMEND
Project Description: 2 branch circuits. Low voltage: Data /tele.
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: 1
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:
INTEGUMEND LLC BOONES FERRY ELECTRIC INC
10215 SW HALL BLVD PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 - 682 -4936
FAX 503 - 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
[TAX] 8% State Surcharge 3/9/2007 $10.28 LIC 88482
[ELPRMT] ELC Permit 3/9/2007 $128.50 SUP 4918S
Total $138.78 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 at 503.246.6699 or 1.800.332.2344.
Issued By: ,„„ Permittee Signature: ` ?a L )U Lu",_
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.
• Electrical Permit Application � ' �' FOR OFFICE' U SE ONLY v - '
. 5 'r City of Tl and ' Received 2 i r. y . ` J g 4 y l ' ,. Da te /B :tom Permit No' jo .- pt5N
13 SW Hall Blvd., Tigard, OR 9722312.
Plan Review
P hone: 503.639.4171 Fax: 503.598.1960 Other Permit:
�" Date /B
IG Inspection Line: 503.639.4175 pry O t , '1001 Date Ready /By: 12I See Page 2 for
/ -.a Internet: www.tigard - or.gov VId't 5 k, Notified /Method: Supplemental Information
..:tea d.�< T. t�..,�',.... ��'�i 1145,41A.!
��. _ :t�; �: iG IIW
❑N 1 U
ew construction .Addition /altera'[io e4jacetnenCh�F1.T + Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑Other: a El Service or feeder 400 amps or more El Building over three stories.
where the available fault current ❑ Marinas and boatyards.
+'t ;<l "ys &�' ,r F
„Ce11 • ,,GORY,; Ii' ,QN,,S IlRUG7`ION: , ..,• , , exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
pN:
:> :: . „.. ::., es to ground, or exceeds •
°� `' "• '� °' 't ° °`°; "`' `� ` "``" "'""' "' `, " °" less ds 14,000 0 agricultural
❑ 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
.':_ .: system. system.
Eme sys 1 larger separately derived
;, • ' . J(?I A,„ , G.- ..I N F ORIVIA ' 1' I OIY A NA " :L + OCA' I` IO. � .
�..��� ' • r > -. - >_. �� :.�.� >,.� ,�a: �eacze ,. ..., s� 0 Addition of new motor load of
Job no.: I, 6- Job site address: 10)Q RJJ t \ — 6 \43 . 1001 -IPor more. occupancy.
❑
0 Six or more residential units. Recreational vehicle parks.
City /State /ZIP: \ Oil A Ji a'� 1 ❑ Health -care facilities. ❑ Supply voltage for more than
` r ❑ Hazardous locations.
600 volts nominal.
� • m
Suite /bldg. /apt. no.: Project name: \ ALa — \ J..JCr ❑ S ervice or feeder 600 amps o r more
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no..
t .:r ,;, >,..> < •h ,,, :,<<,.: ;, <,�� ��- �<:�r••. ����::,: ,,,< residential 75.00 2
Limited energy rest
.„ "_. r:DFSCTZII TIt�N (1t? W012 `off ; : ' , • 8 (with above se. ft.)
k_ C 1 _ 1 �' Limited energy, multi- family
.` i residential (with above R.) 75.00 2
Services or feeders installation, alteration, and /or relocation
amps or less 80.30 2
< CA0 04,tX oWNGR 't `�" X27 '° ;:F amps 106.85 2 201 amps to 400 am
�:;v - ;�..,<I..<,��.b, ,. , .. _��v�:;. ,:��;�.��� .....: ; ��'t . „ u .. >;Es� LNAN'I'� my:, a ..: ° �ff p P
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Idress: 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
”, •< <�,
q' ,.,AP.I'I "IC N . e CON C7:1'> IZ80N ': :• above service or feeder fee
,tea, s . s�;, �;:�,•�,�,,��,n,:,a��,'•;s.,.< .. - s r , ., :� >�.,,.. >,�m.. ,,�.__. ... �.•,`i� 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, t 46.85 2
first branch circuit
Address: Each add'I branch circuit 1 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 9090 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
° %• ry " " r.CO 7`RACTO 4i. •.> ' 1:Y > - ;.0 Si n or outline lighting 53.40 2
Business name: Boones Ferry Electric INC Signal circuit(s) or limited -
energy panel, alteration, or x15
Address: P.O. Box 628 extension. Describe: i Page 2 2
City /State /ZIP: Wilsonville OR 97070 Each additional inspection over allowable in any of the above
Per
Phone: (503) 682 -4936 Fax: (503) 682 -7946 inspection 62.50
per hour (I hr min) 62.50
CCB Lie.: 88482 Electrical Lie.: 3 -2 .. C Suprv. Lie.: Industrial plant per hour 73.75 • •• ', ' "- �LCCMfRICA>` �FFCS v; �'
Wit.: ,�„ ki��;rw ' °`�w' s��l'
Suprv. Electrician signature, required: //� j , Subtotal: ;ag x sO
� ..vvV
3 Plan review (25% of permit fee):
riot name: ��/; t/1 � �\ iV' 1 (� Date: f Q �� State surcharge (8% of permit fee): \®, ,D
'-
Authorized signature: t ! r 1 t TOTAL PERMIT FEE: ' �� 1g
t 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 penult.
1.\ Building \I'ermits\Et,C- PermitApp doe 05/23/06 440- 46151111/05/COM /WEB
CITY OF TIGARD A .
BUILDING DIVISION PERMIT #: ELC2007-00147
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/912007
Phone: (503) 639-4171 7114,1 I I
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/26/2007 TIME: 7:00AM PAGE: 3t3
SITE ADDRESS: 10215 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: METZGER ACRE TRACTS LOT #: 037 TYPE OF USE:
PROJECT NAME: INTEGUMEND
DESCRIPTION: 2 branch circuits. Low voltage: Data/tele.
OWNER: INTEGUMEND LLC, PHONE #:
CONTRACTOR: I300NES FERRY ELECTRIC INC PHONE #: 503-682-4936
Inspection Res uest Scheduled For: Date: 3/26/2007 Pour Time:
Code # Inspection Descn. • n Cor4fi Contact # Message
199 Electrical final 045380-01 503-6824936
Corrections omments/Instructior4:
t,
:4( PASS pi PARTIAL APPROVAL LII CANCEL fl NO ACCESS
fl FAIL fl CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: CI • me da Date: $'247' Phone #: (503) 718- 2,14
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00147
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/12/2007 TIME: 7:01AM PAGE: 42
SITE ADDRESS: 10215 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: METZGER ACRE TRACTS LOT #: 037 TYPE OF USE:
PROJECT NAME: INTEGUMEND
DESCRIPTION: 2 blanch circuits. Low voltage: Data/tele.
OWNER: INTEGUIvIEND LLC, PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503-682-4936
Inspection Request Scheduled For: Date: 3/12/2007 Pour Time:
Code # Inspection Description Co kia- Contact # Message
125 Wall cover 0 4 g 503-682-4936
Corrections/Comments/Instructions:
7 . cv B ock.vpa) RS
-2 • 1 Z- .5 1-71- S NkfMnA V \ A 05 a
PASS PARTIAL APPROVAL 0 CANCEL n NO ACCESS
fl FAIL fl CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
Inspector: • Nt g Date: '6 • 2-• 01 Phone #: (503) 718- - 1, 1 4 1 4k
_ .