Permit +� a CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00108
COMMUNITY DEVELOPMENT DATE ISSUED: 2/26/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134AA -01800
SITE ADDRESS: 10260 SW NIMBUS AVE M2B ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : 002 JURISDICTION: TIG
PROJECT: SCHOLLS BUSINESS CENTER
Project Description: Electrical service
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
ROBINSON, CONSTANCE A + GUILD ELECTRIC INC
ROBINSON, LYNN + BELL, KAY ET PO BOX 674
BY INSIGNIA COMMERCIAL GROUP BEAVERTON, OR 97075
BEAVERTON, OR 97008
Phone: Contact #: PRI 503 - 957 -1173
FAX 503 - 291 -1532
FEES
Description Date Amount Reg #: ELE C21
[ELPRMT] ELC Permit 2/26/2008 $80.30 LIC 109116
[TAX] 12% State Surchar 2/26/2008 $9.64 SUP 3868S
Total $89.94 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 :1 • ays. • ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 - 001 -0010 throug OA- • .2 -101 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued r:2 / 4., // Permittee Signature:
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:
CO TRACTOR INS�TION ONLY � �/
/
SIGNATURE OF SUPR. ELEC'N: DATE/` / o9Y / 0
LICENSE NO: ( �i J
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.
Eleetric'al Permit Application
Received n iy ,
III City of Tigard Date/ay: D Permit No.: e /D 7
13125 SW Hall Blvd., Tigard, O 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Ti G n R D Inspection Line: 503.639.4175 Date Ready/By: //-- ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: (t:../. Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 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
JOB SITE INFORMATION AND LOCATION
13 Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: ‘ $ l' NIMSPUf ave. M/Z b Six or or more residential Recreational 0 or more residential units. ❑Recreation al vehicle parks.
City/State/ZIP: p Q� ❑Health -care facilities. ❑ Supply voltage for more than
d 1'� — (3 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
J Description I Qty. I Fee. I 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'l 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.)
et
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 01.- 80.30 70, 0 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: --- tf ' • vIT"'c r LA.-Z.. 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: L/ Over 1,000 amps or volts 454.65 2
City/State /ZIP: ' O Fi 9 1223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (5-0) Y/8 99'3 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 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
CONTRACTOR Sign or outline lighting 53.40 2
Business name: //,� Signal circuit(s) or limited -
(� ilA .e cL energy panel, alteration, or
Address: PO (7)t_ Db 74 extension. Describe: Page 2 2
City/State /ZIP: J 4 ® A_ n70 7S Each additional inspection over allowable in any of the above
Fax: ( ) Per inspection 62.50
Phone: ( )
95 � / 73 Investigation per hour (I hr min) 62.50
CCB Lic.: 10/ (/ ( Electrical Lic.: Z I Suprv. Lic.: vie S Industrial plant per hour _ 73.75
+
, Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES ' 56
Print name: 1 v `aG I /\)e `sue h Date: Plan review (25% of permit fee): .-
State surcharge (12% of permit fee): 9 ti
Authorized signature: TOTAL PERMIT FEE: <19 , 1
•
Print name: Date: This permit application expires if a permit is not obtained within 1 (
0
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard • T"
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener* •
•
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
i COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
p Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ 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 #: ELC2008 -00108
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2008
Phone: (503) 639 -4171 az=, ;i
Inspection Requests (24 Hrs.): (503) 639 -4175 "__..
INSPECTION WORKSHEET FOR DATE: 2/27/2008 TIME: 7:00AM PAGE: 32
SITE ADDRESS: 10260 SW NIMBUS AVE M2B CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: SCHOLLS BUSINESS CENTER
DESCRIPTION: Electrical service
OWNER: ROBINSON, CONSTANCE A .t, PHONE #:
CONTRACTOR: GUILD ELECTRIC INC PHONE #: 503957 -1173
Inspection Request Scheduled For: Date: 2/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical fine( 06572601 503 -957 -1173 N
Corrections /Comments /Instructions:
b
p2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G . I Date: 211 • 6 Phone #: (503) 718-