Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 -00287
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/28/2006
PARCEL: 1 S 134AA -01800
SITE ADDRESS: 10110 SW NIMBUS AVE B2 ZONING: I -
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: 002 JURISDICTION: TIG
Project Description: Low voltage for data. Job No. 260030
• A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ROBINSON, CONSTANCE A + CAPITOL ELECTRIC CO INC
ROBINSON, LYNN + BELL, KAY ET 11401 NE MARX ST
BY INSIGNIA COMMERCIAL GROUP PORTLAND, OR 97220 -1041
BEAVERTON, OR 97008
Phone: Contact #: PRI 503- 255 -9488
FAX 503- 257 -7121
FEES Reg #: ELE 26 -496C
LIC 48748
Description Date Amount SUP 3132S
[ELPRMT] ELR Permit 11/28/200E $75.00
[TAX] 8% State Surcha 11/28/200E $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 r-if -work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility otification 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\ : o U C at 503.246.6699 or 1.800.332.2344.
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Issue By: , ALA° ` j Permittee Signature: x (A) R/Y1(Lt Le 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.
FOR OFFICE USE ONLY
Electrical Permit A • Received p�j
\ Date/By: // db Oa, Permit no.: Ed/1z t c 7
City of Tigard Plan Revie `l
13125 SW HALL BLVD., TIGARD, OR 97223 A Date /By: Other Permit:
Phone: (503) 639 -4171 Fax (503) 598 -1960 CITY OF TIGARD Date Ready /By: Juri • U See Page 2 for
Inspection Line: 503- 639 -4175 Notified/Method: _ I _ Supplemental Information
Internet: www.ci.tigard.or.us
TYPE OF WORK PLAN REVIEW
LI New construction 0 Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'I ❑ Hazardous location
CATEGORY OF CONSTRUCTION • ❑ Service over 320 amps - rating ❑ Building over 10,000 sq.ft.
Lf 1- and 2- family dwelling El CommerciaUindustrial ❑ Accessory building of 1- and 2- family dwellings 4 or more new residential
❑ Multi- family ❑ Master Builder ❑ Other ❑ System over 600 volts nominal units in one structure
JOB SITE INFORMATION AND LOCATION ❑ Building over three stones ❑ Feeders, 400 amps or more
Job no.: 260030 Job site address: 10110 sw Nimbus Ave B -2 ❑ Occupant load over 99 persons ❑ Manufactured structures or
❑ Egress /lighting plan RV park
City/State/ZIP: Portland, Or. 97223 ❑ Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
Suite bldg_ /apt. no.: Project name: Chapman Insurance Group The above are not applicable to temporary construction service.
FEE SCHEDULE
Cross Street/Directions to job site: Description I Qty. I Fee. I Total I
New residential - single or multi - family dwelling unit.
Subdivision: Lot no.: Includes attached garage.
1000 sq. ft. or less $ 145.15 4
Tax map /parcel no.: Ea. Add'I 500 sq. ft or portion $ 33.40 1
DESCRIPTION OF WORK Limited energy residential $ 75.00 2
Tenenat Lighting and Outlets Limited energy, non - residential $ 75.00 2
Each manufactured home or modular
U PROPERTY OWNER I U TENANT dwelling, Service and/or feeder $ 90.90 _ 2
Name: Service or feeders installation, alteration, and/or relocation
200 amps or less $ 80.30 2
Address: 201 amps to 400 amps 5 106.85 2
401 amps to 600 amps $ 160.60 2
City/ State/ZIP: 601 amps to 1000 amps $ 240.60 2
Over 1000 amps or volts $ 454.65 2
Phone: Fax: Reconnect only _ $ 66.85 _ 2
Temporary services or feeders installation, alteration, and/or
Owner installation: This installation is being made on property that I own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less $ 66.85 I
Owner signature: Date: 201 amps to 400 amps $ 100.30 2
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401 amps to 600 amps $ 133.75 _ 2
U APPLICANT I U CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
Business Name: CAPITOL ELECTRIC CO., INC. A. Fee for branch circuits with
service or feeder fee, each
Contact name: Jim Eddington branch circuit S 6.65 2
B. Fee for branch circuits
Address: 11401 NE MARX ST. without service or feeder fee,
each branch circuit 1 a 40.8) 4b.89• ---s 2
City/State /ZIP: PORTLAND, OR 97220 -1041 Each additional branch circuit: ...3--5--6.45-49-45-- 2
Miscellaneous (service or feeder not included)
Phone: 503 - 255 -9488 Fax: 503 - 257 -7121 Pump or irrigation circle $ 53.40 2
Sign or outline lighting 5 53.40 2
E -mail: Signal circuits(s) or limited -
CONTRACTOR energy panel, alteration, or •st°
Describe ^ /'T T � Page 2 /J 2
Business Name: CAPITOL ELECTRIC CO., INC. extension
Contact name: Jim Eddington Each additional inspection over allowable in any of the above
• Per inspection _ $ 62.50
Address: 11401 NE MARX ST. Investigation per hour (I hr min) $ 62.50
Industrial plant per hour $ 73.75
City/State/ZIP: PORTLAND, OR 97220 -1041 ELECTRICAL PERMIT FEES
Subtotal e88.80
Phone: 503 - 255 -9488 Fax: 503 - 257 -7121 Pl r eview (25% of permit fee)
State surcharge ( 8% of permit fee) '9'34•"
CCB Lie.: 48748 (Electrical Lic. b 96C ISuprv. Lie.: 3132 5 TOTAL PERMIT FEE j21A --
Suprv. Electrician signature, required: � This permit application expires Ile permit Is not obtained within 180
4714.14,44,0 Ma
days after It has been accepted as complete �, 00
Print Name: DARRE�L. MCNEEL Date: 10/13/06 " Fee methodology set by Tri- County Building Industry Service Board
Authorized signature: D C14444404.0 MX' " "Number of inspections per permit allowed.
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Print Name: DARRELL MCNEEL
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OCT -13 -2006 FR 10 :01 AM F AX N0, P. 02
SCHOLLS BUSINESS CEN
10110 SW Nimbus Avenue, Suite B -2
Portland, Oregon 97223 •
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Office .
483 SF
..., 7 ___
L i iir. •
` ` _ • • Warehouse,
. 582 SF
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� �� SUITE B -2 •
Site Plan Approximately 1,065 SF N 'K � ey Plan
Scale: 1/8"=P-0" NTS
N Verified: 06/01/05
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III ANKROM MOISAN „` ' ,
A•CNITICTUR, INIiRI01i PLUNNING INVESTMENT
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•7aR SK'.•.•o•.- $..PTg IW, ron...u. 0.11:1407711 MANACF.MFNT
• tel 503.598.9980 www.kginvestment.com fax 503.598.9982
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• _ - OCT- 13-2006 FRI 10:02 AM. FAX N0. P. 03
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10/13/2008'08:19 FAX 50335207'33 Chapman Insurance Group a001
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CITY OF TIGARD
BUILDING DIVISION •, PERMIT #: ELR2006- 00287
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2006
Phone: (503) 639 -4171 Auto 4W ,
Inspection Requests (24 Hrs.): (503) 639 -4175 A-
INSPECTION WORKSHEET FOR DATE: 12112/2006 TIME: 7:01AM PAGE: 9
SITE ADDRESS: 10110 SW NIMBUS AVE B2 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: CHAPMAN INSURANCE GROUP
DESCRIPTION: Low voltage for data, Job No. 260030
OWNER: ROBINSON, CON STANCE A +, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503255 - 9488
Inspection Request Scheduled For: Date: 12/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040973-01 971 - 506 -2873 Y
Corrections/Comments/Instructions:
S I NIIV
N v 1 727A :' j: �' A
■ PASS ❑ PARTIAL ' ° "OVAL ❑ CANCEL ❑ NO ACCESS
;1` 4, . • :,) - CT • • i' • a D ` IO , - S ASSESSED
Inspector: v N wa Date: 1 I 6 `0 Phone #: (503) 718 - ilk
CITY OF TIGARD
BUILDING DIVISION e, u PERMIT #: El R2006-00287
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 12/612006 TIME: 7 :01AM PAGE: 25
SITE ADDRESS: 10110 SW NIMBUS AVE B2 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: CHAPMAN INSURANCE GROUP
DESCRIPTION: Low voltage for data. Job No. 260030
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503-255..9488
Inspection Request Scheduled For: Date: 12/6/200; Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040739-01 971- 506.2873 N
Corrections/Comments/Instructions:
?( 30\) I b Si el N 11 ail ERSVN
io'NI(�14 SUe.Q..V 56(L ()(0 Ps a RiAti iVi 4-V*5
.Eu[ %—o o2., -'J
J2 A b- o l
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❑ PASS ► PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ c LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V Y v 0_, L Date: kV 4- Phone #: (503) 718- 2
ti
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR200&00787
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2006
Phone: (503) 639 -4171 ��'!�
Inspection Requests (24 Hrs.): (503) 639 -4175 -!
INSPECTION WORKSHEET FOR DATE: 11/30/2006 TIME: 7 :00AM PAGE: 62
SITE ADDRESS: 10110 SW NIMBUS AVE B2 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: CHAPMAN INSURANCE GROUP
DESCRIPTION: Low voltage for data. Job No. 260030
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503.255.946B
Inspection Request Scheduled For: Date: 11/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040451 - 01 971 N
Corrections/Comments/Instructions:
vo lb taA c6,61 -E j raa.. ems:
1146%.% G M co Nb‘;‘t sictif5 Act Al o1'r'
Nt\cleczywac T o >; iree0 cA8Le .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
�] FAIL X CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 a L Date: It %info Phone #: (503) 718- Z"rf-°