Permit C ITY OF TIGARD ELECTRICAL PERMIT
v , 4■ PERMIT #: ELC2006 -00190
-,, ) DEVELOPMENT SERVICES DATE ISSUED: 4/11/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101 BC - 00100
SITE ADDRESS: 08185 SW HUNZIKER RD A ZONING: I -
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Replace 2 ea. dispensers. Low voltage comm. between dispensers and card reader.
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:
KNEZ, JOHN S SR + JEANNE M NORTHWEST PUMP & EQUIPMENT
8185 SW HUNZIKER RD 2800 NW 31ST
TIGARD, OR 97223 PORTLAND, OR 97210
Phone: Contact #: PRI 503 - 519 - 6056
FAX 503 - 777 -4152
FEES
Description Date Amount Reg #: ELE 26-852C
[ELPRMT] ELC Permit 4/11/2006 $128.50 LIC 64567
[TAX] 8% State Surcharge 4/11/2006 $10.28 SUP 48845
Total $138.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: /3 Permittee Signature: CM /T„/1 1"
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
04/07/2006 FRI 11:21 FAX 5032274006 2002 /005
,t )Electrical Peri App ka�tiona IN/ ED FOR OFFICi'; USE ONLY
---
City of Tigard d� / Received
13125 SW Hall Blvd., Tigard, OR 97223 ® Date/BY 6i> -�� � Permit Na.L�6 60 90
Phone: 503.639,4171 Fax: 503.598.1960 � f 2006 , ', a , ; / ast i . . ,;, Plan Review
'r, Date /By: Other Permit:
Inspection Line: 503.639.4175 - - „ a j " 1 I 1 Date Ready /By: Jvgn- j - S ec Page 2 for
Internet: www.ci.tigard.or.us
CITY OF TIGAFtU Notified/Method.
I icA Supplemental Information
}p7}yi?c' °£ ' :.i:y ! ='' 01B ,�.'ssUkFri 3 • t 1; 8'ti' .P i }I P ll s :p..„ r 'VOA K t...
:eYfll$ ', Ed 4 • , J, " ��i_ . ,.&..'S; -s i 1• a , #'^ i' li t, IL a I 8 t l I .,..°T tl :t ' ."."'. 3 �` lt i s i n.: 7 �4 i a
!•.:', !«..di ...t I ..z • s , 3 .,ls7 5.ut i' n ,� r•,;. i !Sl .`` t :[ l?! I.5 it .� jL�I t.�.li..: I s81� -° NM i „ �d "` s .t r ' � ; t t �i �j t`if ` S ' '.
El New construction , Addition /alteration/replacement Please check all that apply: l f }L �' 1 i
❑ Demolition 0 Other: ❑Service over 225 amps, comm'l ['Hazardous location
M y 4 1 1 } t` 1p � 1i.v , a 0 ai07.4 1 0: I Jil 1I . 1 l t f n' ; '� t„4 � 1i ❑oService and 2 amity dwellings g ❑ 4 or more new residential
�1i
❑ 1- and 2- family dwelling a Commercial/industria1 ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three Stories ❑Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other
4i' r e lla 11 t s +l s l %dts �� �,< t 3 F' taI#t } f ❑Occupant load over 99 persons ['Manufactured structures or
:.T , r• .l„i? 14. ❑Egress/ligh RV pads
Job no.:` O ` Job site address: 8/63.5-557.2.) 44 Jz time_ ❑Health - care facility ['Other:
f Submit 2 sets of plans w any of the above.
City/State/ZIP: �e. r 9 .g3 -8,2.2c1 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: ®f f ? .s T I �� Gila" 1, ,K .z' �' 17I O '� s l 1, `} ;`
Fri ter �l�t�rsfs�C r ... t -.--'-t,, 'i To z
Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
-" , �a '";L i, .. W , „ Limited energy, rion- residential 75.00 2
_ v �i _ r�r+_ .l t .sit Se'sthl� s , c ;- a si a,''_ /C 4 :i 1'1 i ?lt MA RV ir ''
-,12,,...,.W.4., el. ... Jhru �qh:a ' -; Each manufactured. or modu
a / dwelling, service and/or feeder 90.90 2
r ` i'- " , b.l'Li�., �a Services or feeders Installation, alteration, and/or relocation
.1 ' * 200 amps or less 80.30 2
'`o I .LJ R Y �}�
t (l .• M 1 r a y '3 ii� 1rJ Id El Ithx Mr - t a ° � 1 , t i I l ,l A • 201 amps to 400 amps 106.85 2
. ;�s,= s9 � 3atu tw.. ?.,sees + - � �.� . +;r, .�vs- 1 .�,,�,�.,Firr24s.�..�
- -6 "° 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
City/State/ZIP: Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
made on property 200 amps or less 66. 1
Owner installation: This installation is being p perty that I own which is n ot 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
K". [ -*•.i 1 `�.j§ E6, 3 ifi i ., ... gM ' r "Fay" sv,,.e, }4 ar I a I A. Fee for branch circuits d
. «', +,. ��Zt��£: t •�- . IlS,vt�? °c `,ti te,5iii�a� � ��� t 1. 0 . �.� � @ �. �t with
'° " ' "'' " "s service or feeder fee, each
Business name: branch circuit 6.65 2
• Contact name: B. Fee for branch circuits
without service or feeder fee 46.85 ,Vh B 2
Address: first branch circuit
Each add'l branch circuit / 6.65 4,, 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
E -mail:
Sign or outline lighting 53.40 2
���� >- .
. Signal circuit(s) or limited -
Si� _ '. 1r 1 „ 1 i` 0 " 1 , 9 C�'1'+ s f„,- i` ed t¢�. rr�. �' ,! ' .,r wan .C�
lsT�.; • >��.ak.....: �o:l>�• � ill :ea Pz��:�' �; 1 � � � ta�11i�'i:�tit.�n'13k energy pane], alteration, or g 7J1 2
Business name: / extension. Describe: Page 2
Address: ABCO itAj 3/ S1 Each additional inspection over allowable in any of the above Per inspection 62.50 Aug
• City/State/ZIP: I
�` s . -' ' ° , ,Z aj , 7 e2 / Q Investigation per hour (1 hr min) 62.50
Phone: (53)
( "�cct c a /.2,S3 II Fax: 1 . 5 h 6 _Rot el( O � t 4 Industrial plant per y 2
CCB Lic.: CC/ L �l Vim 7 I Of,� G.J��C `f !4S 73 75
5. Alt's, .S' i f; f M76 j ty L; P;R:.:
Electrical Lie.: Suprv. Lic.: I. S Subtotal /f > )
Suprv. Electrician signature r=. uirfr-ry1 ' • Plan review (25% of permit fee)
AM. !. W_, alit • i `Z.£. Z
Print name: • 1 J� v Date: State surcharge (8% of permit fee) ,/ a
�� Q04, TOTAL PERMr1' FEE i r
Authorized signature:
/01124 / ealL This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name:
ii, C-E- .(j, Date: Li/ 7 I 0 / _ # Fee methodology set by Tri-County Building Industry Service Board
1 1 �O " Number of inspections per permit allowed. / 3 Q d� 79
:\ B
i uilding \rermits\ELC- PermitApp.dec 12/03 440-4615T(I0 /02 /COM/WEB
04/07/2006 FRI 11:22 FAX 5032274006 004/005
^ w
CFN card lock fueling site
8185 SW Hunziker Rd.
Tigard, OR 97223
Building
Seal -off
r
Dispenser
01 0
Seal -off
e4 EWINNAMI
O p klh-
Card
reader 3 �„
L Conduit
Replace only existing dispensers with new, utilizing all existing
underground conduits.
To comply with articles 500, 501, 502, and 514 of NEC.
Northwest Pump & Equipment Co.
Philip Gauntlett Z84S
503 -519 -6056
CITY OF ��m n n ��n TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00Y90
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 4K11/2O0$
Phone: (503) 639-4171 A,„„ 01 1 ,4
Inspection Requests �4Hmj:�Q3)G30��175 �
INSPECTION WORKSHEET FOR DATE: 5/19/2006 TIME: 7:01Aivl PAGE:
SITE ADDRESS: 0818589VHUNZ/KER CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: F!TZ[NlERPR|SES/CFW
DESCRIPTION: Replace 2 ea. dispenser. Low vIte comm. between dispensers and crd read6r.
OWNER: KNEZ, JOHN S +,}EANNEk4. PHONE #:
CONTRACTOR: NORTH W1ST PUMP & EQUIPMENT PHONE #: 503-61960GS
Inspection Request Scheduled For: Date: 5V19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
199 Electrical final 030226.01 W3-205.2128 N
Corrections/Comments/Instructions:
•
•
PARTIAL APPROVAL �� CANCEL r7 NO ACCESS
- FAIL ri CALL FOR INSPECTION I | ADDITIONAL FEES ASSESSED
��-�� �l���� | 7� ����� /�� gip--
Inspector: �� ��`�/ Uw[��� L_�� Date: = " \ `�� w Phone #: (503) 718'��~/�1��