Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00518
COMMUNITY DEVELOPMENT DATE ISSUED: 7/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S134AD -06202
SITE ADDRESS: 10500 SW NIMBUS AVE T ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT : JURISDICTION: TIG
PROJECT: SOLID ROCK FELLOWSHIP
Project Description: Install (25) incandescent light fixtures and (5) outlets.
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 13 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 + SHAW WEST COMPANY
ROBINSON, LYNN + BELL, KAY ET PO BOX 1427
BY INSIGNIA COMMERCIAL GROUP TUALATIN, OR 97062
BEAVERTON, OR 97008
Phone: Contact #: PRI 503 - 682 -3939
FAX 503 - 682 -3723
FEES
Description Date Amount Reg #: ELE 34 -70c
[ELPRMT] ELC Permit 7/26/2007 $133.30 LIC 63142
[TAX] 8% State Surcharge 7/26/2007 $10.66 SUP 221S
Total $143.96 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.
g p as
Issued By f �/ Permittee Sig / ,
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.
Electrical Permit Applicaticr' IlI9 • a •
Receved i
'City of Tigard - Dateiv : 2l/ Permit No.: - 0
f3125 SW'Ha1l Blvd., Tigard, OR 97223 A Plan Review
Phone: 503.639.4171 Fax: 503.598.196 Ii i t i\ Date/B y: Other Permit:
E.c4 L
Inspection Line: 503.639.4175 r _ Dat ReadyBy: RI See Page 2 for
Internet: www.ci.tigard.or.us pp Notified/Method: y+ Supplemental Information
. - TYPE OF K . ; U I' PLAN • REVIEW ` .. :
❑ New construction [l Additi tialt a r I nt Please check all that apply:
❑ Demolition ❑ OthtFg: I ['Service over 225 amps, comm'l ['Hazardous location
UI4J�IhIC DIVISIO►� ['Service over 320 amps - rating DBuildng over 10,000 sq. ft.,
CATEGORY :OF _ CONSTRUCGION -• ,; • .''.;. - of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling IN Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
0 Building over three stories 0 Feeders, 400 amps or more
❑ Multi- family 0 Master builder
❑ Other: ['Occupant load over 99 persons DManufactured structures or
";r, -,,,; JOB :SITE INFORMATION _•ANDrI OCATION, `. :' ` =-.'., ;`• :' DEgress/lighting plan RV park
' c, .
.• DHealth-care facility ['Other:
Job no.: ST2511 Job site address: 10500 SW Nimbus Ave • . Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
,` ,FEE* SCITEDULE
Suite /bldg. /apt. no.: Project name: 30 Id L l k TC 1J6WSkf
Description. Qty. Fee. Total ••
-
Cross street/directions to job site: Scholls Ferry to Nimbus New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
• Subdivision: I 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
- DESCRIPTION; OF WORK; - _ . . Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Install 25 incandescent light fixtures and 5 out1P.tS Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
, . 201 amps to 400 amps 106.85 2
' 'it) PROPERTY -OWNER' [] TENANT .'. 401 amps to 600 amps 160.60 2
• Name: KG Investment Management 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
10740 SW Ni TrIbIlS AUP STF'. T. Reconnect only 66.85 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I 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 600 amps 133.75 2
Owner signature: Date: . Branch circuits - new, alteration, or extension, per panel
CONTACT - PERSON .- '; i A. Fee for branch circuits with
❑: AtpPLICANT - Q 'CONTACT or feeder fee, each
6.65 2
Business name: branch circuit
• - B. Fee for branch circuits
Contact name: • without service or feeder fee,
each branch circuit 1 46.85 46.85 2
Address: Each add'l branch circuit 13 6.65 86.45 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
energy panel, alteration, or
extension. Describe: Page 4 2 2
Business name: Shaw West Co. '
• - Each additional inspection over allowable in any of the above
Address: PO Box 1427
Per inspection 62.50
City/State /ZIP: Investigation per hour (1 hr min) 62.50
Tual al i r4 OR 9709
Phone: ( Z F es ; ( Industrial plant per hour 73.75
503 682 -3939 x03 s -3723 , ELECTRICAL PERMIT FEES* '
CCB Lic.: ( Electrical Lic_ S r. Lic.: 1- ?C Subtotal 133.30
Suprv. Electrician signature, required: 4r d. , ` / -ice," Plan review (25% of permit fee)
State surcharge (8% of permit fee) 10.66
Print name:
Clair nS Q 7 2...3 - 67 TOTAL PERMIT FEE 143.96
Authorized signature: , / /. This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete
Print name: %�� � L am/ Da :? `f 7.- Z.3 ...
• Fee methodology set by Tri- County Building Industry Service Board
v (� •• Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PermitApp.doc 12/03 440 - 4615T(10 /02/COM/WEB ,
1
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: ELC2007 -00518
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2007
Phone: (503) 639 -4171 „4 7:1 2
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9128/2007 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 10500 SW NIMBUS AVE T CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SOLID ROCK FELLOWSHIP
DESCRIPTION: Install (25) incandescent light fixtures and (5) outlets.
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: SHAW WEST COMPANY PHONE #: 503.682 -3939
Inspection Request Scheduled For: Date: 9/28/2007 Pour Time:
Code # Inspection Description C Contact # Message
199 Electrical final 056564 -01 971 -227 -3952 \ Y
Corrections /Comments /Instructions: J
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,n.al. vb. I lb & 110. A. s.
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* L- Pi0S)N N120.X. s
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G Ndej L ' Date: q 11 4101 Phone #: (503) 718 - Liyl