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Permit • • `-CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00520 4 DEVELOPMENT SERVICES DATE ISSUED: 7/25/2005 f II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134AA-02100 SITE ADDRESS: 10300 SW NIMBUS AVE P ZONING: I -P SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : JURISDICTION: TIG Project Description: Electrical TI, (6) branch circuits. 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: 5 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 + REESE + SONS ELECTRIC ROBINSON, LYNN + BELL, KAY ET 16310 SE RHONE BY INSIGNIA COMMERCIAL GROUP PORTLAND, OR 97236 BEAVERTON, OR 97008 Phone: Phone: 503 - 969 -2191 • FEES Reg #: LIC 49883 tion Date Amount SUP 2 1691S Description ELE 26 - 506C [ELPRMT] ELC Permit 7/25/2005 $80.10 [TAX] 8% State Surcharge 7/25/2005 $6.40 REQUIRED ITEMS AND REPORTS Total $86.50 • 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 suspen or more than =0 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rule re set forth in OAR 95' -I 0 -10 a hrough OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 50 246 -6699 or 1- 800 -332 ' • • Is ed By: ` � � � ice . , �� Permittee Signature: K 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: C e NTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: a�� .�: DATE: 74506 LICENSE NO: /1" 5 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. Electiicai Permit Application voR o i i i l•: I , s I.: O N IN City of Tigard ` / Permit No.: w c 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review w �� /b a0s� Phone: 503.639.4171 Fax: 503.598.1960 , DateIB . Other Permit: Inspection Line: 503.639.4175 �_ _tll , '� �� Date Ready/By: ®See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental TYPE OF WORK PLAN REVIEW ❑ New construction ►ddition/alteration/replacement Please check all that apply: ❑Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2 family dwelling prCommerciallindustrial ❑ Accessory building El System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lightingplan RV park Job no.: I Job site address :Ia3g0 S i (, �� / fi rm ❑Health -care facility ❑Other: A,3 /c Submit 2 sets of plans with any of the above. City/State/ZIP: 7 - a , , © rD The above are not applicable to temporary construction service. � ' 1 J / FEE* SCHEDULE .. Suite/bldg./apt no.� , / S u � r rc J name: 6j/� f I . I I I / /64/61511r5 Description Fee' Tote! Cross street/directions o job site: New residential single - or multi- family dwelling unit. Includes attached garage. f / / 1,000 sq. ft. or less 145.15 4 Subdivision.. ,5 %o jL $ > ?U. $ 7f. L wi r I Lot no.: Ea. add'I 500 sq. ft or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular �41�� j 4 , YD ✓e /Ne ' 7 L dwelling, service and/or feeder 90.90 _ 2 / �° ll Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 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 Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or Phone: ( ) I Fax: ( ) relocation 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 ❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 0 �s Address: each branch circuit 46.85 * 2 Each add'l branch circuit .3 6.65 3,3,2,5 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2 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: e P 5 B ,4' 50 z �Ir/ , , zi e. Address: // 3 / � � A) »' ' Each additional inspection over allowable in any of the above tY'7 ( Per inspection 62.50 City/State/ZIP: y// v- q © l 723,6 Investigation per hour (I hr min) 62.50 Phone: (6 9d el,.... 2` q/ / Fax:663) /`6D 61 3 industrial plant per hour - 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: W? 3 I Electrical Lic.: ,, — 515ZCI Suprv. Lic.: /6q/-5 Subtotal go . l'8 Suprv. Electrician signature, required: J�ci ,�_, Plan review (25% of permit fee) State surcharge (8% of permit fee) 6 . YO Print name y/� Lo�o Date: 7 "75 • 5 Vv��l��� s A TOTAL PERMIT FEE O 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. i:\ Building \PennilsELC- PermitApp.doc 12/03 440.4615T(10/02/COM/WEB /(e h f lR7 Electrical Permit Application - City. of Tigard 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* El Burglar Alarm El Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning ' System* ❑ Vacuum Systems* ❑ Other: • COMMERCIAL WORK ONLY: Fee for each commercial system. $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: El Audio and Stereo Systems El Boiler Controls • ❑ Clock Systems ❑ Data Telecommunication Installation El Fire Alarm Installation ❑ • HVAC • El Instrumentation ❑ Intercom and Paging Systems • ❑ Landscape Irrigation Control* ❑ Medical El Nurse Calls El Outdoor Landscape Lighting* El Protective Signaling ❑ Other • . Total number of commercial systems: • *No licenses are required. Licenses are required for all other installations is Building\Permits\aC- PrnnitApp.doc 04/03 rff YOFTIGARD .. BUILDING DIVISION PERMIT #: ELC2005 -00520 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/25/2005 Phone: (503) 639 -4171 / °' x'41 ti`iil i Inspection Requests (24 Hrs.): (503) 639 -4175 -- INSPECTION WORKSHEET FOR DATE: 8/1/2005 TIME: 7 : 05AM PAGE: 14 SITE ADDRESS: 10300 SW NIMBUS AVE P CLASS OF WORK: SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE: PROJECT NAME: NET BIZ ADVISORS DESCRIPTION: Electrical TI, (6) branch circuits. OWNER: ROBINSON, CONSTANCE A +, PHONE #: CONTRACTOR: REESE + SONS ELECTRIC PHONE #: 503 - 969 -2191 Inspection Request Scheduled For: Date: 8/1/2005 Pour Time: Code # Ins.e . •0 ! = - - .e '. Confirm # Contact # Message 199 Electrical final 012654 -01 503.9692191 N Corrections /Co -1 s/I s: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 4 / OS Phone #: (503) 718- _____144_______