Permit CITY OF TIGARD ELECTRICAL PERMIT
°. u COMMUNITY DEVELOPMENT
PERMIT ISSUED: ELC2007
DATE ISSUED: 11/20/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 134AA -01800
SITE ADDRESS: 10110 SW NIMBUS AVE B1 ZONING: I -
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : 002 JURISDICTION: TIG •
PROJECT: POINT TO POINT
Project Description: Install (3) branch circuits for heat pump.
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: SIGNAUPANEL:
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: 2 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:
ROBINSON, CONSTANCE A + BROADWAY ELECTRIC - COCHRAN INC
ROBINSON, LYNN + BELL, KAY ET 626 SE MAIN
BY INSIGNIA COMMERCIAL GROUP PORTLAND, OR 97214
BEAVERTON, OR 97008
Phone: Contact #: PRI 503 - 234 -6564
FAX 503 - 238 -2098
FEES
Description Date Amount Reg #: ELE 37 -546C
[ELPRMT] ELC Permit 11/20/200' $60.15 LIC 72942
[TAX] 8% State Surcharge I (/20/200' $4.81 SUP 3447S
Total $64.96 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: 41 j _ ' Permittee Signature: ON' C 9 % /ON
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 INSTAL LATION ONLY
SIGNATURE OF SUPR. ELEC'N: DN f7970/04. ,0
/ eel/' / 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 USE ONLY
City of Tigard A Received ,
ik
Date/B : // e2e 0 7 I vy Permit No.Z c . 7- do 745
13125 SW Hall Blvd., Tigard, OR 9713E EWED Plan Revie
Phone: 503.639.4171 Fax: 503.598.19fr "
U v 2 0 nil/ . 1rit r il t's Date/B : Other Permit:
Inspection Line: 503.639.4175 o ,, Date Ready/By: lil See Page 2 for
,_......,
Internet: www.ci.tigard.or.us CITY0E-11GAHEI Notified/Method: Supplemental Information
• 4' ...,„ — . ,
0 New construction R Addition/alteration/replacement Please check all that apply: .
0Service over 225 amps, comm'l EJHazardous location
0 Demolition 0 Other:
['Service over 320 amps — rating IDBuildng over 10,000 sq. ft.,
: 1 ' -. , - - ' - - • _ CATEGORY. OF CONSTRUCTION ,1 • .::-7:,..,- , , ,.. ,-: of 1- and 2-family dwellings 4 or more new residential
1:1 1- and 2-family dwelling 14 Commercial/industrial 0 Accessory building ['System over 600 volt§ nominal units in one structure
['Building over three stories [IFeeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other:
['Occupant load over 99 persons 1:Manufactured structures or
SITE INFORMATION AND LOCATION - - .. ' ' DEgyessnighting plan RV park
16ple 0 1 0Health facility ['Other:
Job no.: Job site address: lois, 50 A
Ila Wit IS IN Itiltot) S So ■Te D-it- Submit 2 sets of plans with any of the above.
City/State/ZIP:1 )ii. The above are not applicable to temporary construction service.
.
[ FEE* S
Suite/bldg./apt. no.: 0_4 Project name
Description I Qty. I Fee. I Total I .•
Cross street/directions to job site: tDo u1 TO Po [MT- New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: .
, Limited energy, non-residential 75.00 • 2
..
DESCR . ' IPTION. oF WORK • ' - • Each manufactured or modular
. .
• 71 dwelling, service and/or feeder 90.90 2
rao ¥J or tot CA a r A v.t b t &' C-'% iZecscrrAcLE Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 . 2
EE .PROPERTY A.,,... 201 amps to 400 amps 106.85 2
LL,PKOPER.Lir OWNER . _ - , 0 TENANT - ,-..' `. ..:, .
- . - 401 amps to 600 amps 160.60 2
Name: 14 6 i tali al _ 1 ,..,, s.„:„.. 601 amps to 1,000 amps 240.60 2
Add Over 1,000 amps or volts 454.65 2
ress: L a MA .,,, — I
L. a V4-0012
,.t li) Reconnect only 66.85 2
City/State/ZIP: to (so $i,c.. NI te.4 So L to Temporary services or feeders installation, alteration, and/or
relocation
Phone: (5 )5,g .44 (g . b Fax: ( 9 5 .3 ) S — 41411 g 1._ 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
. _ P . A. Fee for branch circuits with
0 .AP ,, . .
.. - - 0 CON'TACT PERSON .
, service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, / 46.85 2
each branch circuit
Address: A
Each addl branch circuit fr g 6.65 LS , .. 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
.
.•. - , ,. ' - ' CONTRACTOR . .. , ". - energy panel, alteration, or
- - • • extension. Describe: Page 2 2
Business name: 'P.. •
1 , e•e•-■...4 ..... "E e c. r i Each additional inspection over allowable in any of the above
Address: (.,,, -2_ (..... 5 E. K t■
I.. ■ C...k./.. Per inspection 62.50
City/State/ZIP: — \-- 4 ,.... 4 „_ op._ co 2_■t4 Investigation per hour (i hr min) 62.50
Phone: (563 ) 2_3(.1 --C t_l Fax: (563) z. _zocrg Industrial plant per hour 73.75
.. 'VL;ECTRICAL PERMIT FEE.S. : _:_•; ;. ,::, ."").-.... .
CCB Lic.: 7 2.c:ova_ Electrical Lic.: 31-5 L Suprv. Lic.: 3 .44 5 Subtotal (90 ,1 s"
Suprv. Electrician signature, required: V_ .).. 3 N(1. _ . • MA/AO/0 Plan review (25% of permit fee)
State surcharge (8% of permit fee) Z-I, 87
•
Print name: y_ emw , e X- \-\ V. c...X-C■ Date:
TOTAL PERMIT FEE & tt, ge
Authorized signature: This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
- •'" Number of inspections per permit allowed.
iMluiliiinoWernsits \ ELC-PermitAno.doc 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E1.C2007.007t33
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2007
Phone: (503) 639 -4171 v yi i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7:03AM PAGE: 66
SITE ADDRESS: 10110 SW NIMBUS AVE . g / CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS C�ER LOT #: 002 TYPE OF USE:
PROJECT NAME: POINT TO POINT
DESCRIPTION: Install (3) branch circuits for heat pump.
OWNER: ROBINSON, CONSTANCE A •a, PHONE #:
CONTRACTOR: BROADWAY ELECTRIC INC PHONE #: 503 - 234 - 6564
Inspection Request Scheduled For: Date: 12/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 NC or heating unit circuit 062017 -01 971 -235 -4310 N
Corrections /Comments /Instructions:
I \
\ I
1
l
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N 06 IX Date: 110 21 01 Phone #: (503) 718- Offt.