Permit III C TY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00336
TIGARD DATE ISSUED: 9/12/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134AA-02100
SITE ADDRESS: 10340 SW NIMBUS AVE NB ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: PST
Project Description: Low voltage for TI.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
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: 2
Owner: Contractor:
ROBINSON, CONSTANCE A + STONER ELECTRIC
ROBINSON, LYNN + BELL, KAY ET ) 1904 SE OCHOCO STREET
BY INSIGNIA COMMERCIAL GROUP MILWAUKIE, OR 97222
BEAVERTON, OR 97008
Phone: Contact #: FAX 503- 659 -2824
PRI 503- 462 -6500
FEES Reg #: ELE 26-122C
LIC 44823
Description Date Amount SUP 3496S
[ELPRMT] ELR Permit 9/12/2007 $150.00
[TAX] 8% State Surchar€ 9/12/2007 $12.00 REQUIRED ITEMS AND REPORTS
Total $162.00
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, 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 - : - •AR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.24. •699 or 1.800. ' 2 .
I ,/ •
Issue• By: • `L l L Ai, _)) % Permittee Signatu � ,
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:
•
C9NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: f, 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.
09/10/'007 08:28 FAX 5036592824 STONER ELECTRIC 0 001
w
E ms. "CAY I'erinit Application •O1c (.ii• i is l• :1 ,l: O\l.v
City of Tigard Revi ved 9 AN d,3—
/ • -
Y) / Permit No.: , 6 /
13125 SW Hall Blvd., Tigard, OR 972 . ECEIV f 6
Phone: 503.639.4171 Fax: 503.598.1 - ':1 ' +it11�� Other
Inspection Line: 503.639A175 r . s JJ _ _.. Dena Ready/By; ,2j is ® See Paget for
Internet: www.citigard.or.us S E P 1 ( ) >'" i / Notified/Method:
���'7{�Ofg� .�y{ PLAN r `3WPlemeote]In[armadoa •
El New construction % „.,, 4 : t . :,.. , assbent Please check all that apply:
El Demolition ❑ ()then ❑Service over 225 amps, comni 1 ['Hazardous location
CAT'EGOR1f OR CONSTItIICTION ❑Service over 320 amps - rating 013nildng over 10,000 sq. R.,
.; ' ; . ! , ,' ... , of 1 - and 2-family dwellings 4 or more new residential
-
❑ 1 and 2 family dwelling / ErCommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories [Weeders, 400 amps or more
ID Multi family El Master builder ❑ Other.
❑Occupant load over 99 persons ❑Marud'acturcd structures or
:.JO$.•SITE 'INFORMATION:'AND VACATION - DEgess/ighting plan RV park
Job no.: 735 V I Job site address: 10 a�40 � y i / � im%it AE ❑1•lglm `�' ❑ Other.
]►Y S u b m i t 2 sets of plans with any of the above. .
.
City/State/ZIP: Ties pte,„ O p' X 1 - 7 223 The above are not applicable to temporary construction service.
Suite/bidgJapt no.: I Project name: ! FEE +''&CTT1t4b11I E'•.+ ' .' :� '-
Deeviptia• I Qty. I tree, I Tavel I
Cross street/directions to job site: As New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. it. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. R or portion 33.40 _ 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
Limited energy. non-residential 75.00 2
. 0 , DESCRIPTION OF 'WORK . . • • Each manufactured or modular
V w 1n i 1"� Fe Q LJt) Nat K rT.ov y2M> 6 � _ dwelling, service and/or feeder 90.90 _ 2
le Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
' . ❑,',pgOPERTY "OWhilfl e ' l • „ in 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: ( ) Fax:( )
relocation 1
Owner installation: This installation is made on property
200
O 201 amps to or 2 less 66.85
being p pt:rty filet I own which is not 20l 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 signatur : - - Da te: Branch circuit - new, alteration, or extensi per panel
. :i•e, •r. • f] APPLYCANT.. . ,„ , '..I • , • . yt CONTACT PERSON ' . • A. Pee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
—
T � B. Fee for branch circuits •
Contact name: ) u ' f tS without scrvicc or feeder fee 46, SS 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: 1H,scellaneons (service or [ceder no t included)
Phone: ( ) I Fax: ; ( ) Pump or irrigation circle 53 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited- / 0,
CONTRACTOR . energy panel, alteration, or / �JV
extension. Describe: ,. Page 2 4-6 2422.6- 2 -
Business name: STONER ELECTRIC
Address: 1904 SE OCHOCO - Each additional inspection over allowable in any Of the above
Per inspection 62.5 '
City/State/ZIP: MILWAUKIE, OR Investigation per hour (1 hr min) 62.50
Phone: (503) 462 -6500 I Fax: (503) 659 - 4968 Industrial plant per hour _ 73.95
ELECTRICAL', PERMIT: FEES•' • ,: /.'I'
CCB Lic.: 44823 I Electrical Lic.: 26 -122C Suprv. Lic.: 3496 Subtotal
Suprv. Electrician signature, required_ /yiid 11, Plan review (25% of permit fee) / 2„00
T 9 J A , State surcharge (8% of permit fee) 8 �f
Print name: MICHAEL FALCONER Date: / 1 U
TOTAL PERMIT FEE
Authorized signature; This permit application Mires if a Permit it sot obtained within 180
r days after tt has been accepted as complete
Print name: I Dale; • Fust mrrhrwlnlnov art hw Tei- CNrnrw R„' • • inriery Sirr 0
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00336
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2007
Phone: (503) 639 -4171 1 , w c M4\
Inspection Requests (24 Hrs.): (503) 639 -4175 ` _ _ . .
INSPECTION WORKSHEET FOR DATE: 9/18/2007 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 10340 SW NIMBUS AVE NB CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: PST
DESCRIPTION: Low voltage for TI.
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: STONER ELECTRIC 1>P0 1 N Cl.. PHONE #: 503462 -6500
Inspection Request Scheduled For: Date: 9/18/2007 Pour Time:
Code # Inspection Description ' •• # Contact # Message
135 Low voltage c (j 055863 -01 - 503-806-1386 Y
Corrections /Comments /Instructions: ---
-...K.;\ \
iv ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: dV % I Date: ` ( on Phone #: (503) 718- .LLIJ
....