Permit Xe pri nce +0 Co rre t - / ck r.es • SLA) 5 /two +
ill n CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00142
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007
PARCEL: 2S 103DD - 01201
SITE ADDRESS: 13920 SW PACIFIC HWY ZONING: C -
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT: JURISDICTION: TIG
PROJECT: GOODWILL INDUSTRIES
Project Description: Landscape irrigation control.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: X
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
GOODWILL INDUSTRIES GREEN ART LANDSCAPE & IRRIGATI
1943 SE 6TH AVE BRIAN BYUNG HWA PARK
PORTLAND, OR 97214 8335 NW CORNELIUS PASS RD
HILLSBORO, OR 97124
Phone: Contact #: PRI 503- 617 -9990
FAX 503 -617 -0878
•
Reg #: LIC 157510
FEES
Description Date Amount
[ELPRMT] ELR Permit 5/15/2007 $75.00
[TAX] 8% State Surcha 5/15/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 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: it 50_, i/ % ` Permittee Signature: )g I f ri
n
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.
/'LI'J1e / lb: 11/ blidb1 /eJ Ili laKttN HK I LSNLLHI-'1N F'Atat 1:14/ 17 /
- etrical Permit Application
City of DecreB
Tigard Rciv � ^I Permit No.: eue.2.Q� - 6014'2-
y; cd 5 /15 D �t V
" 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.59x,1960 Date/By: Other Permit; I)/ j`.1 _ 0069 t
1 I l: A ,, Inspection line; 503,639.4175 Date Ready /Hy; hail: 10 See Page 2 for
Internet: www•tigard or gov Notified/Method: Ill" Supplemental information • • TYPE OF WORK ?LAN REVIEW :' .
❑ New construction Addition/alteration /replacement Please check all that apply (submit 2 sem of plans w/nema checked below):
0 Service or feeder 400 amps or more ❑ Building over three stories,
❑ Demolition Other: where the available huh current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
Icm to ground, or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pm+tp • ❑ installation of 75 kvA or
• JOE SITE INFORMATION AND LOCATION C Emergency system. larger separately derived system
❑ Addition of new motor load of ❑ "A "E", ••1- 2 ". "1 -3 ",
siebana.: I y 0 Job site address44886 9 w !! l00ffP or more. elm-money.
_ . L �. ❑ Six or more residential units. ❑ Recreational vehicle parka.
City/State/ZIP: ' / A • ❑ Healthcare facilities. ❑ simply voltage for more than
�' ' ' � J J ❑ Hamtdous locations. 600 volts nominal,
Suite/bldg. /apt no.: I Projec ame: ' po
• C Service or ieedor 600 amps m more.
= t FEE SCHEDULE. •
Cass street/directions to job site:< i . R � i f "�tar.� tkarfition IQs, 1 Fed I row .• .
New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision; I T. no.: 1,000 sq. ft. or Icss 145.15 4
Fa. add'l 500 sq. ft, or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
—
-
k DESCRIPTION OP WORK Swath above R. a.)
75.00 2
Limited energy. multi - family 75,00 2
I I a J. , . / . i,.. ' N. _...- ' residenti tb above so. ft.) ,
. 1 Services or feeders instalJatIon and/or relocation
' 200 amps or loss 80.30 2
-- a PaoPEl1tTY o J CI TENANT 201 amps to 400 amps 106.85 2
NtuneT *- Ei / o ., f C 1 ` I L--11 . J ) 401 amps to 600 amps 160.60 2
Address: .1 it SG �4 mt D ( 601 amps to 1,000 amps 240,60 2
,/i Over 1,000 amps or volts 454.65 2
City /State/ZIP: / 1 ye ni9-N, / le.... 97a/y 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 T own which is not 201 amps to 400 amps 100,30 2
intended for sale. lease, rcnt, or exchange. according to ORS 447. 449. 670. and 701. 401 amps to 599 amps 133.75 2
Owner signature; Data Branch circuits - new, alteration or extension, r panel '
A. Fcc for branch circuits with
APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee.
each branch circuit 6,65 2
Business name: G 4 A . a
B. Fee for branch circuits
—. tr a
.
Contact name: ' 'OF wilhoul
fir service or feeder fee. 46.85 2
g A r • first branch circuit
Address: 40 e r' r '+ , ' ' �� . Each add'I branch circuit 6.65 2
Miscellaneous (service nr feeder not Included) —�
City /State/7TP: i l �L 1 Each manufactured or modular 90.90 2
Phone: 3 ... / , Fax; : (50)/� t,../" dwelling service and/or feeder
l4._ v�� Reconnect only 1 66.85 2
E - mail: ill fail s` 55-6e_ct o )h (65 Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel. alteration, or
Address: .--' ---. extension. Describe: i Page 2 -75 OD 2
City /State /ZIP: 51 t d Eq e (O (/r, G c I O - Eneh additional inspection over allowable in any of the above
Phone: ( ) Per inspection 62,50 • r� Investigation per hour (i la min) 62.50
CC13 Lie.: •I Electrical Lic.: Y " siprv. Lie.: ) Industrial plant per hour 73.75
_ ELECTRICAL PERMIT' FEES
Suprv. Electrician signature. required: Subtotal: I . `DD
Print name: r te , Date: Plan review (25% of permit fee):
L. ( State surcharge (8% of permit fcc): to r ob
Authorised signature: Oft
TOTAL PERMiT FEE: gt,Oo L 4
Print name; It B ate Thb permit application expires Ira permit is ant obtained within 180
S14 1 r. M • days after it In, been accepted as complete.
t:\Butldtn 1 • Number of inspections allowed per permit.
R AnminflELC- PenmttApp.doe osnster 440.41,1. (11'05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00142
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1512007
Phone: (503) 639 -4171 '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/8 /2007 TIME: 7:01AM PAGE: 35
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: Landscape irrigation control.
OWNER; GOODWILL INDUSTRIES, PHONE #:
CONTRACTOR: GREEN ART LANDSCAPE & IRRIGATI PHONE #: 503.617 -9990
Inspection Request Scheduled For: Date: 6/8/2007 Pour Time:
Code # Inspection Description rrm Contact # Message
199 Electrical final 049865 -01 ; 503- 617 -9990 N
Corrections /Comments /Instructions:
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,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6" ►`� LT Date: 2 0] Phone #: (503) 718- 2,414b