Permit 7 3 -e/D 5 L- V- / B
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00474
a l i t DEVELOPMENT SERVICES DATE ISSUED: 7/14/2005
alit SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT : 002 JURISDICTION: TIG
Project Description: Electrical TI.
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: 0
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 3 W /SERVICE OR FEEDER: 135 PER INSPECTION:
201 - 400 amp: 1 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:
TIGARD PROPERTIES INC ADVANCED WRING SERVICES INC
8320 NE HWY 99 PO BOX 644
VANCOUVER, WA 98668 CLACKAMAS, OR 97015
Phone: 360 - 574 -6255 Phone: 503 - 310 -3655
FEES Reg #: ELE C7
LIP 162591
Description Date Amount
SUP 4675S
[ELPLCK] ELC PIn Rev 7/14/2005 $311.37
[TAX] 8% State Surcharge 7/14/2005 $99.64 REQUIRED ITEMS AND REPORTS
[ELPRMT] ELC Permit 7/14/2005 $1,245.10
Total $1,656.11
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.
Issued By: 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:
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.
A.. . CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00474
�L �li DEVELOPMENT SERVICES DATE ISSUED: 7/14/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT : 002 JURISDICTION: TIG
Project Description: Electrical TI. Limited energy systems are: audio /stereo, data, fire alarm, HVAC, intercom /paging & protective
signaling.
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: !S
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 3 W /SERVICE OR FEEDER: 135 PER INSPECTION:
201 - 400 amp: 1 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:
TIGARD PROPERTIES INC ADVANCED WRING SERVICES INC
8320 NE HWY 99 PO BOX 644
VANCOUVER, WA 98668 CLACKAMAS, OR 97015
Phone: 360 - 574 -6255 Phone: 503 - 310 -3655
FEES Reg #: ELE C7
LIP 162591
Description Date Amount
SUP 4675S
[ELPLCK] ELC PIn Rev 7/14/2005 $311.37
[TAX] 8% State Surcharge 7/14/2005 $99.64 REQUIRED ITEMS AND REPORTS
[ELPRMT] ELC Permit 7/14/2005 $1,245.10
Total $1,656.11
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 dire esfitChs to O C 57
503 - 246 -6699 or 1 -8" 2 -2344.
Issued By: � / 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:
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 1t t ED r(')R alp FILE (sc ONt.N
Cit of Tigard o v ed 7 bh tg PennitN .C I S -D. A
13125 SW Hall Blvd., Tigard, OR 97223 , Plan Revie /)( / �"
Other Permit:
• Phone: 503.639.4171 Fax: 503.598.1960- 0 !? ih, . 2005 , - ' 1 Date/By t /)-
Inspection Line: 503.639.4175 __ , 'f �� Date Ready/By / �� .d tins: ® See Page 2for
Internet: www.ci.tigard.or.us CITY OF f lGARD Notified/Method: 7f f3/ c / � C ` Supplemental Information
1 V'PE 1 OF"WORK VN PLAN REVIEW
El New construction )� + Addition/alteration/replacement P a check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ❑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 gj Commercialindustrial ❑ Accessory building DSystem 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 41 ) ■TION DEgress/lighting plan RV park
Job no.: Job site address: q � / . ` � ^' � , p IA ❑Health -care facility DOther:
. l . � �- tl� soap Submit 2 sets of plans with any of the above.
City/State/ZIP: T( a. G 17ZZ3 (',, ' �^ C- e-- The above are not applicable to temporary construction service.
�lJl FEE* SCHEDULE
Suite/bldg. /apt. no.: ZSU Project name: x6)0(6 5u ?ee ST(s-
Description I Qty. I Fee. I Total L **
Cross street/directions to job site: 1,1a / c1Li W New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. R or less 145.15 4
Subdivision: 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
1-6A1 A , f r '� p '^` IE � J , dwelling, service and/or feeder 90.90 2
KN O A Services or feeders installation, alteration, and/or relocation
• 200 amps or less 3 80.30 2 ,: C 2
I d - PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 1 106.85 ) 0 b, 85 2
� 401 amps to 600 amps 160.60 2
Name: 7a1b &1itagb me._.., 601 amps to 1,000 amps 240.60 2 -
Address: 3 k,f___ /4 v ?i F Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP:I f /F jtt ✓ ...... bih 46 e Temporary services or feeders installation, alteration, and/or
Phone: ( ' k) 67z1 6Q9-5 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
X] APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 135 6.65 S11,15 11,1s 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone ( ) 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: kD / J 3C o 1 Z.I 06- S v I CEO t )
. Address: 17 b , goy rQ a4 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Q ,1 k ? f f c 5 , op. 9 '70 IS Investigation per hour (1 hr min) 62.50
Phone: (563 ) 3 10 - 313% Fax: (e503) 08 _ 1,372. Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 11 j Electrical Lic.: '7 S .rv. Lic.: $ 41o755 Subtotal I!,,t4 10
.'$ Suprv. Electrician ?;i V2re, required: 7 / r �� ,,/ /4/ /07 Plan review (25% of permit fee) 3 1. 1 , 3rl
' ✓
Print name: 50%..A1 � , / Date: -7/(, /206 c State surcharge (8% of permit fee) 19q
, TOTAL PERMIT FEE 1 6,6 / I
Authorized signature: / This permit application expires if a permit is not obtained within 180
/f
days after it has been accepted as complete i
Print name: Date: • Fee methodology set by Tn- ounty Building Industry Service Board
•• Number of inspections per permit allowed.
' i:\ Building \Permits\EI -C- PennitApp.doc 12/03 410-4615T(I0/02/COM/WEB
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*
• ❑ Burglar Alarm
❑ 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:
• n Audio and Stereo Systems •
El Boiler Controls •
•
° o ,
❑ Clock Systems
• Data Telecommunication Installation
El Fire Alarm Installation
El'
• ❑ Instrumentation
•
Q Intercom and Paging Systems
E❑ Landscape Irrigation Control*
El Medical •
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
111, Protective Signaling
E] Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations .
is \Building\Prnnib\ELC- PcmilApp.doc 04/03
-OF TIGARD
BUILDING DIVISION PERMIT #: ELG2005 -00474
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 711412005
Phone: (503) 639 -4171 1 # 11 dlp� � i
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' ,,!!+� ^ ' I ..
INSPECTION WORKSHEET FOR DATE: 9/29/2005 TIME: 7:08AM PAGE: 107
SITE ADDRESS: 11945 SW PACIFIC HWY 250 CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE:
PROJECT NAME: JO -ANN FABRICS
DESCRIPTION: Electrical TI. Limited energy systems are: audio/stereo, data, fire alarm, HVAC, intercom /paging &
OWNER: protective signaling. PHONE #:
CONTRACTOR: TIGARD PROPERTIES INC PHONE #: 360 - 574 -6255
ADVANCED WIRING SERVICES INC 503-310 -3655
Inspection Request Scheduled For: Date: 9/29,2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 016927 -01 503-833.2980 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY Are.... 66(-G Date: Q 21106 Phone #: (503) 718- 19 t44 .