Permit C ( „,, ELECTRICAL PERMIT
Ilhi y CITY OF TIGARD
PERMIT #: ELC2007 -00165
COMMUNITY DEVELOPMENT DATE ISSUED: 3/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 10X8 -03101
SITE ADDRESS: 12950 SW PACIFIC HWY 275 ZONING: C -G
SUBDIVISION: HUDSON PLAZA LOT : 021 JURISDICTION: TIG
PROJECT: HUDSON PLAZA
Project Description: 3 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: SIGNAUPANEL:
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: 2 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:
HENDERSON, MARILYN DOROTHEA ORIENT ELECTRIC INC.
JENSEN HUDSON TRUSTEE 30532 SE BLUFF RD.
11795 SW KATHERINE ST GRESHAM, OR 97080
TIGARD, OR 97224
Phone: Contact #: PRI 503 - 663 -5881
FAX 503 - 663 -3187
FEES
Description Date Amount Reg #: ELE 26 -237C
[ELPRMT] ELC Permit 3/19/2007 $60.15 L[C 14261
[TAX] 8% State Surcharge 3/19/2007 $4.81 SUP 47525
Total $64.96 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.
Issued By: Permittee Signature: L - L 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.
j ar 15 07 10:04a Sandi 5036633187 p.
. •
Electrical Permit Applicat cENED FOR OFFICE USE ONL.1 . •
City of Tigard ► Received /� 01 66 Penult N C / — Obi (Q S
IN rs 13125 SW Hall Blvd., Tigard, OR 9722 1 1 5 200 Plan Revie
C Phone: 503.639.4171 Fax: 503.591 Date/By: Otte` Per
TI GA R D In Line: 503.639.4175 1 `(���® Date Ready /By: lu ' . Ea See Page 2 for
Interact: www.tigard or.gov V I4,� e if o DI`t S10" Notified/Method: Supplemental Information
TYPE OF v O W C` h` ii V PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction El Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑Demolition , ' Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY 01? CONSTRUCTION exceeds 10,000 amps at ISO volts or 0 Floating buildings.
less to ground, or cxt. r•ds 14,000 ❑ Commercial -use agricultural
t7 1- and 2- family dwelling la CommerciaVindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑.Master builder ❑ Other: ❑Fire pump. ❑ Installation of 75 K VA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑Addition of now motor load of ❑ "A ", "E ", `1 I l
Job no.: Job site address: [� n ' . 1 � a loo HP or more. occupancy.
Z l l) W AQ t � �t 1 1 �/ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /Slate /ZIP: ---FT � �- V I ,, Health facilities. ❑ Supply voltage for more than
❑ Hazardous locations_ 600 volts nominal.
Suite/bldg. /apt. no.: afl s I Project name: Do tt EP— (. 4 �" 0 ❑ Service or feeder 600 amps or more.
+ FEE SCHEDULE
Cross street/directions to job site: Description I qty. I lien. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add, 500 sq. ft or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft) • t multi-family
� - ei p w∎ 5 Nr� jj ik i D \ e residential (witha -fam R.) 75.00 2
i ` Ox Limited energy, multi- fam Services or feeders installation, alteration, and /or relocation
C 3 \ J t Y 0...l\ t S • 200 amps or less 80.30 2
❑ PROPERTY OWNER TENANT 201 amps to 400 amps 106.85 2
Name: t`J.-.-__ 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
• relocation
Phone: ( ) 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: bate: Branch circuits - new, alteration, or extension, per panel
A. Fec 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,
first branch circuit 1 46.85 (�� $ 2
Address: Each add'I branch circuit j, - 6.65 i 3:3 a 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: l 6�-{ -- E l w M � , e e erg y panel, circuit(s) al er li terati o n , or
nerg pn, alon, or
Address: '30 S i s (..- ■•1/4...P- `Qy� • extension. Describe: Page 2 2
City /State/Z1P ^
: t4 9 "/ L L ` t Each additional inspection over allowable In any of the above
t- ` �y-�J Per inspection 62.50
Phone: (5 by 3 S k' I Fax: (S (3) tD4R 3 - ' 3 �1 Investigation per hour (I hr min) 62.50
CCB Lie.: ' 4-2 I.P I I Electrical L : 2 , - , ri e _Suprv. Lie.: 476" 5 Industrial plant per hour _ 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: -
r s 2 i !is /,
� � Date: V
3 _ i S � c� Plan review (25% of permit fee): --
Pei �1
State surcharge (8% of permrmit lee): �,
i -.r
A horized signatur , _�ra�� ■ TOTAL PERMIT FEE: (p 1 f , 9 I
F' , This permit application expires if a permit is not obtained within 1
Prl t name: L o L. Z- Date: 3 - 1 S •- 0 days after it has been accepted as complete. ( )0 •
I
(51 o2 t `01 •
/ i/ 01
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•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00165
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/19/2007
Phone: (503) 639 -4171*�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 12950 SW PACIFIC HWY 275 CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 021 TYPE OF USE:
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: 3 branch circuits.
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: ORIENT ELECTRIC INC. PHONE #: 503-663-5881
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm #N, Contact # Message
199 Electrical final 046694 -01 s \ , 503. 663 -5881 Y _
,) yvvACkl
Corrections /Comments /Instructions:
)//)
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ' Date: Vitt cl Phone #: (503) 718- 2*k
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00165
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/19/2007
Phone: (503) 639- 4171w°GI��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/20/2007 TIME: 7:00AM PAGE: 54
•
SITE ADDRESS: 1 2950 SW PACIFIC HWY 275 CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 021 TYPE OF USE: •
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: 3 branch circuits.
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: ORIENT ELECTRIC INC. PHONE #: 503. 663.5881
Inspection Request Scheduled For: Date: 3/20/2007 Pour Time:
Code # Inspection Description • • :, • - Contact # Message
125 Wall cover 0450730 503-663-58131 Y
Corrections /Comments /Instructions:
N NIA (R\\ ALLowsD IN
baopraD oRt 6 u5 pet.%)'ND C ,E %L4
X12/ 33L1• tQ-
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: T' N Q- L Date: 3( Phone #: (503) 718- 2 Ab'