Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00457
COMMUNITY DEVELOPMENT DATE ISSUED: 7/5/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102DA -00401
SITE ADDRESS: 13125 SW HALL BLVD PD ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: POLICE DEPARTMENT
Project Description: 1 branch circuit for above ground tank.
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: 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:
TIGARD, CITY OF NORTHWEST PUMP & EQUIPMENT
13125 SW HALL 2800 NW 31ST
TIGARD, OR 97223 PORTLAND, OR 97210
Phone: Contact #: PRI 503 - 519 - 6056
FAX 503 - 205 -1465
FEES
Description Date Amount Reg #: ELE 26 -852C
[ELPRMT] ELC Permit 7/5/2007 $46.85 LIC 64567
[TAXI 8% State Surcharge 7/5/2007 $3.75 SUP 4884S
Total $50.60 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 questio . . c C . 503.24. tIN,or 1.800.332.2344.
Issued By: 6, J- /(.) Permittee Signature: -!s�`
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.
w , z .,, E1 vi r - - - - ,
ZiElectrical Permit Applica is t :FOR OFFICE ,UsE ONLY
/ a ��� o1n�7�U J
Other Permit:
14 City of Tigard JUL Q 20 Date /B 6 Receivedry Q /7 lU� Permit No
- ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi-
Phone: 503.639.4171 Fax: 5031.8. DateB
T I GARD Inspection Line: 503.639.4175 OF I It) A Date Ready /By: Juris: ® See Page 2 for
Internet: www tigard -or.go TYPE OF WORK Notified/Method: Supplemental Information
� .�..! • IN DIVISJ PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction 4 Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use 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
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION
r( �� ❑ Addition of new motor load of ❑ "A ", "E ", "1- Y', "1 -3 ",
Job no.: I Job site address: f •3 D,s 5u ((( ii e� 100HP or more. occupancy.
�r I1 ❑ Six or more residential units ❑ Recreational vehicle parks.
_�
City /State /ZIP: 1 1 n, d'0i J 02 q 7 •); 3 ❑ Health -care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
�"�) o f
Suite /bldg. /apt. no.: I Project name: 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. 1 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.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Q Limited energy, multi - family 75.00 2
1)(n) A eh) �,Op,)G\,l�, #c) kbode-e� residential (with above sq. ft.)
( Services or feeders installation, alteration, and/or relocation
Ill w) kJ 200 amps or less 80.30 2
❑ ,PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 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 2
Branch circuits — new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
N APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, I 46.85 1(_5 2
first branch circuit `
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CO N Vp TOR Sign or outline lighting 53.40 2
Business name: /.) r � �� S ,
Signal p anel, alteration, limited
•
' ` L teerr ation, or
Address: � 6f 4 J ) t . energy extension. Describe: Page 2 2
City/State /ZIP "p (k apt) OP 97 t V Each additional inspection over allowable in any of the above
inspection � Per sped on 62.50
Phone: �?,) �� • / .. 1 LL a x : il ._ _ ' .0�11 0 Investigation per hour (1 hr min) 62.50
CCB Lie.: Suprv. Lie.: m Industrial plant per hour 73.75
• • CM= ..A . I► -. v� ELECTRICAL PERMIT FEES /
1
Suprv. Electrician signature, required: � � . �=
_ A. "= ( (( � Subtotal y l /
0 e
Print nam in G, U �� e • Date:. G Plan review (25% of permit fee):
l I l State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obta ned with in 1
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
L\Building\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(I I /05 /COMM'EB
Electrical Permit Application - City of Tigard r
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*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 260 - 260)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other
Total number of commercial systems:
*No 'licenses are required. Licenses are required
for all other installations
I. \Building\Permits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00457
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5120017
Phone: (503) 639 -4171 ,164_011 II
Inspection Requests (24 Hrs.): (503) 639 -4175 ...:.�
INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:00AM PAGE: 64
SITE ADDRESS: 13125 SW HALL BLVD PD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: POLICE DEPARTMENT
DESCRIPTION: 1 branch circuit for above ground tank.
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: NORTHWEST PUMP & EQUIPMENT PHONE #: 503 -515 -6056
Inspection Request Scheduled For: Date: 7/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051676 -01 503-519-6056 N
Corrections /Comments/ Instructions:
,N
../
,gAi PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CT' R 66 ( Date: 11 ( O Phone #: (503) 718- Ziti (,
..
, , .. . ..
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00457
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007
Phone: (503) 639 -4171 g '"' p ' ro ll iil
Inspection Requests (24 Hrs.): (503) 639 -4175 °1_..
INSPECTION WORKSHEET FOR DATE: 7/6/2007 TIME: 7:06AM PAGE: 29
SITE ADDRESS: 13125 SW HALL BLVD PD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: POLICE DEPARTMENT
DESCRIPTION: 1 branch circuit for above ground tank.
OWNER: TIGARD, CITY OF, PHONE #:
-- , CONTRACTOR: NORTHWEST PUMP & EQUIPMENT PHONE #: 503- 519 -6056
Inspection Request Scheduled For: Date: 7/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/; lab cover 051530 -01 503-519-6056 Y
Corrections /Comments /Instructions:
A*
r
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
• FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: (3" J v ' v e ) (.-_R Date: 1 ' b • 01 Phone #: (503) 718- 144(0