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Permit Ili CITY OF TIGARD ELECTRICAL PERMIT ii 'z- r. COMMUNITY DEVELOPMENT DATE ISSUED: 3/27/2007 ' TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PERMIT #: ELC2007 gale PARCEL: 2S 102AA - 00600 SITE ADDRESS: I vZ 6.4/5- 5a) iVcL ZONING: CBD SUBDIVISION: TIGARD HIGHWAY TRACTS LOT : 012 JURISDICTION: TIG PROJECT: 7 Project Description: 6 branch circuits. 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: 5 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: ALPROP CO BECK ELECTRIC INC 6149 SW SHATTUCK RD 15600 SE FOR MOR CT #B PORTLAND, OR 97221 CLACKAMAS, OR 97015 Phone: Contact #: PRI 503 -656 -7396 FAX 503 -656 -4397 FEES Description Date Amount Reg #: ELE 3 -5C [ELPRMT] ELC Permit 3/27/2007 $80.10 LIC 2629 [TAX] 8% State Surcharge 3/27/2007 $6.40 SUP 5024S Total $86.50 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: E��t Permittee Signature: 6 C2 / H2 t CG( ----- OWNER INSTALLATION ONLY 7 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. t / 26 07 01:45p p .1 cal Permit Application. "- : FOROFF.ICE UE ONLY • • Ef Cit of Tigard it $ t oR .t` ee e ��� / :3125 SW Hall Blvd., Tigard, OR 97223 . ,Datet8 •: �Q /e � `( �L� / f De Plan Revi• Phone: 503.639.4171 Fax: 503.598.19601: q r) C. Date/13 •: Other Permit: TIGARD Inspection Line: 503.639.4175 "h!i /' (j 200] Date Ready/By: luris:� El See Page 2 for Internet: www.tigard or.gov I Nati tied/Method: 7 Supplemental Information / . . TYPk,.:; UFv .OR . _ ' �_ ,A .t f ki t ,;l' 4 . � _ •• • ...:. ... ... . ' PLAT\ REY'IE \V ., x °' m.. • r , - y �'° t' P lease check all that apply (submit plans below): ❑ New construction , Addition /alter ation /replacement• I7. Tr pp y ( bmit 2 sets of lans w /items checked below " ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where fain current Marinas and boatyards. crc t e available 1 ❑ < ya s. • CATEGORY, OF_•CONSTRUCTIOiY .. .. • exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I- and _- family dwelling I$ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or Emergency system. larger separately derived system. .. JOB SITE "I'\FORM.-ITION A 'LOCATION: : _ " ::. :, ❑ Add e y 't� load Addition o f new motor oa of ❑ "A" "E" "1 -�^ "I -3'• Job no.: ‘Z71C) Job site address: ri 1.5' 9. ° " tt' 111 It I ' 'I� 100HPormore, occupancy. v s ���' ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: 1 �(V3 ` / I ""j Z . ❑ Health - care facilities. 0 Supply voltage for more than va 1 l ❑Hazardous locations. 600 volts nominal. S uiteibldg. /apt. no.: Project name: Pro + ❑ Service or feeder 600 amps or more. J -�_ .. S � v r � . - .'- . FEE: - SCHEDULE • Cross street/directions to job site: Description I One. 1 Fee. l Total 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 i I Tax map /parcel no.: Limited energy, residential . '. _ DESCRIPTION : OF WORK'':.:' :. ., (with above sq. ft.) 75.00 2 • Limited energy, multi- family G TW / 1C S - ' '' kQA/11 residential (with above sq. R.) 75.00 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 PROPERTY OWNE • TENANT:,, 201 amps to 400 amps 106.55 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 1 2 Owner signature: Date: Branch circuits - new, alteration, or extension, er panel A. Fee for branch circuits with • . _ :.... ❑.. APIT,ICANT :. , 65 • 1 � COI�TACT'PERSOI� above service or feeder fee, each branch circuit 6. 2 Business name; B. Fee for branch circuits without service or feeder fee, I 46.85 2 Contact name: first branch circuit Address: Each add'I branch circuit 5 6.65 I --3. 2.5 2 Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 1 • dwelling, service and/or feeder Phone: 90.90 1 2 ( ) Fax: ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 ,:;'., ' e lighting 5340 2 Sign or outline y Signal circuit(s) or limited - Business name: � - - 1 . -�,...1'v L energy panel, alteration, or �v0 extension. Describe: Page 2 2 Address: ` Sk410 SC- ter M G� UV City /State /ZIP: G_r (A„C.. - tC_c. t .," --.c, s t 0 !Z - 9.1 ( C 3 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (55 ) l,oSca. e Fax: (Si ) tt� -_ l'{ C 40 (D � i ---] Investigation per hour (1 hr min) 62.50 CCB Lie.: e,: Suprv. Lie.: o�.� q 1 Electrical Li p 50„..).`-i S Industrial plant per hour 73.75 .. .' :, . i :. ELECTRICAL', PERryIIT° FEES Suprv. Electrician signature, requires - • % , % � Subtotal: ' O. i U Print name: �✓ Date: 3 Plan review (25% of permit fee): S ti A% 01 State surcharge (8% of permit fee): t.l -�`d Authorized signatu L % �. c TOTAL PERMIT FEE: %' 0 This permit application expires if a permit is not obtained within 180 Print name: c Cl. Da te: „-�� ,^,rat 5 �'� I /, V� days after it has been accepted as complete. ' Number of inspections allowed per permit. / 1:\ BuildingWnrmits \ELC- PermitApp.doc 05/23/06 4 3),)1) 0-lti s1 1t /05 /COM/WEB `( \rU�f • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00185 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/27/2007 Phone: (503) 639 -4171 / Inspection Requests (24 Hrs.): (503) 639 -4175 ...' _.. INSPECTION WORKSHEET FOR DATE: 4/5/2007 TIME: 7 :03AM PAGE: 46 SITE ADDRESS: '12045 SW HALL BLVD 7- ELEVEN CLASS OF WORK: SUBDIVISION: TIGARD HIGHWAY TRACTS LOT #: 012 TYPE OF USE: PROJECT NAME: 7-11 DESCRIPTION: 6 branch circuits. OWNER: ALPROP GO, PHONE #: CONTRACTOR: BECK ELECTRIC INC PHONE #: 503-656 -7396 Inspection Request Scheduled For: Date: 415/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 046019 -01 503 - 656.7396 Y t _ Corrections /Comments /Instructions: N'Zt Cs ' Al\ , 0 �, - 5' kA y � W Q v i W - R vA0 4� v wALLf . i N AL i1/4Nc j No`y 1 . - frE4 — " M II. i L ' A W:41 : . VAN M, Yysic A b tp C. X PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I l FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: " ' • ‘A) ) e ) Date: Phone #: (503) 718- 144 .(_—_0___