Permit tr, •
A, ELECTRICAL PERMIT
CITY OF TIGARD PERMIT #: ELC2005 -00932
'W DEVELOPMENT SERVICES DATE ISSUED: 12/5/2005
''� �► 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2 S 110AA -00700
SITE ADDRESS: 14030 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Temporary service and (2) branch circuits for remediation pump. Job No. 01 2234
• RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: W /SERVICE OR FEEDER: 2 PER INSPECTION:
201 - 400 amp: 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:
TOSCO CORPORATION BOYLES ELECTRIC, INC.
PO BOX 52085 P.O. BOX 1227
PHOENIX, AZ 85072 BORING, OR 97009
Phone: Phone: 503 - 668 - 7440
•
FEES Reg #: LIC 137002
ELE 3 -465C
Description Date Amount SUP 3404S
[ELPRMT] ELC Permit 12/5/2005 $80.15
[TAX] 8% State Surcharge 12/5/2005 $6.41 REQUIRED ITEMS AND REPORTS
Total $86.56
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
suspende fnr m e than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules set forth in 95 - 01 -0010 through OAR 952 - 001 -0100. You may obtain copies of these r _ . or direct questions to OUNC at
50 46 -6699 or 1 -800 -3 -2
Is ued By: L �yw Permittee Sign . ure: , „ 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:
ONTRACTOR INSTALLATION ONLY
i
SIGNATURE OF SUPR. EL - 'N: 2 " / fi r DATE:
LICENSE NO: /D �S
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 FOR OFFICE USE ONLY
Permit Application Received '/ Electrical �1� Q2
1 Date/By: / .' d Permit No.: g'Le -- / J
/i". �1 , ' � V7 \O Planning App .val Sign
City of Tigard � , ' -� ; , � / Date/By: PennitNo.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 `k,'1';' Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post Review Land Use
/ir,,, I ' 4111
?�
Internet: www.ci.tigard.or.us : a ` _ Date/By: Case No.:
—
i Contact JyaseN (� See Page 2 for
24 -hour Inspection Request :C8 14 i - 1,4:., ,
, 1,1 ' "- ' Name/Method: #(p • Supplemental Information.
+-', •w ..> • - s,. ... L•��ct.'�-•• � ' t<=MJ..._+.57?.kakVii.777:23a,:.::E4ri - :f+'? "t'iti 4� : p . ; �acesaitaraftw° �'ai^`.ea°m
❑ New construction • Demolition • Service over 225 amps- • Health -care facility
commercial El ®.Addition/alteration/r- •lacement El over 320 amps -rating of ❑ Building o ver Other: Hazardous 0on
,� , • _ „s,3.. , � V:t <! ;& - _�� V- over 1 1
� _ �_ 'fir 10,000 square feet,
.. t 1??f�'` `1 d • !a,g;� t I & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling a Multi-Family ❑ System over 600 volts nominal one structure
CCCSSO ❑ Building over three stories ❑ Feeders, 400 amps or more
ry Building y ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
r r :,-- y am, J, , 17:: , ..r ao- . Submit _ sets of plans with any of the above.
The above are not ap livable to tem ora construction , service.
Job site address: 1 4030 u PAC F' I t 1• f .-t - -- �,� , ;'
-- p _ a�,, • � ' s .,,- �,,..... _
I �c r ^°� s ir "ale' — .. ._- - �.
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: (.4 wJaGaL. Description Qty Fee (ea.) Total 1
Cross street/Directions to job site: New residential- single or multi - family per
D dwelling unit. Includes attached garage.
'L
Co(Lf•dc 04.L. p c Q h , 4 [ AC Service Included:
1000 sq. R or less 145.15 4
- 7 6 §ArS s* nr +r ,,. Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: I Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax ma • / • arcel #: Each manufactured home or modular dwelling
__ , ' a '3K ci 3 • -9 �� ` J;• ! if t - service and/or feeder 90.90 2
�_. +- "'F. . �.., ��. - '� tiro .,.
N - re l P
Services alteration or feeders t Installation,
Se. 2v I `CQ rd it— alteration or relocation:
RMeae /'4tar� e wP - I 20 amps to or 400 80.30 2
-� 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
t - ' Rb _ 5 2- '�',;? ,__..� I _'sue_ 6 amps to 1000 amps 240.60 2
�° Over 1000 amps or volts 454.65 2
Name: Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation: /
City /State /Zip: 200 amps or less / 66.85 6 b — I
Phone: �: Fax: 201 amps to 400 amps 100.30 2
e . ` 11' t L; st ` -+ Branch c cults - new alteration, or 133.75 2
Name: extension per panel:
A . Fee for branch circuits with purchase of qq 3U
Address:
service or feeder fee, each branch circuit tl 6.65 (3 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: r Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
r. , + , � , ,regT , C ,�, l . W . r, a r. Each pump or irrigation circle 53.40 2
1. � -A:_ Each signor outline lighting 53.40 2
Job No: C) A 3 y Signal circuit(s) or a limited energy panel,
Business Name: [So Les I C flA I p,L Description:
or extension Page 2 2
Description:
Address: P O RR ho - a �1
City/State/Zip: Go 21 0 ( � C 7 0 G Each additional inspection over the allowable in any of the above:
`J I) / / Per inspection per hour (min 1 how) 62.50
.563 66
Phone:303 .662r 7 y y o Fax:
a3 - t 7b 1, ' Investigation fee:
CCB Lic. #: 1'3706 0.... Lie. #: 3 - 4 6s C other:
. ;µ, _ 7.ia
, i$x r - fT.;; ; -', --
Supervising electrician Subtotal $ O l
signature required: Plan Review (25% of Permit Fee) $
Print Name: - 1 0 1,.,.. e" , to g I Lic. : 3 y 0 Y 5 State Surcharge (8% of Permit Fee) $ 6 4 I
TOTAL PERMIT FEE $ S` r S 6
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set.by Tri -County Building Industry Service Board.
(Please print name)
is \Dsts \Permit Forms\ ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems
Burglar Alarm
Garage Door Opener
Heating, Ventilation and Air Conditioning Sys t• . *
0 Vacuum Systems •
ED Other •
COMMERCIAL WORK ONLY:
Fee for each system. $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
Audio and Stereo Systems
❑ Boiler Controls •
El Clock Systems
El Data Telecommunication Installation .
•
El Fire Alarm Installation
HVAC
El instrumentation
El Intercom and Paging Systems
Landscape irrigation Control
Medical
Nurse Calls
0 Outdoor Landscape Lighting
El Protective Signaling
El Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i: \Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
CITY ARD F TI
O G
BUILDING DIVISION PERMIT #: F[ 02006.00)3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12I i200f,
Phone: (503) 639 -4171 �-d ; to
Inspection Re nests (24 Hrs.): (503) 639 -4175 -W'
INSPECTION WOR HEET FOR DATE: 1/75/2006 TIME: 7:03AM PAGE: or)
SITE ADDRESS: 1403 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: UJNOCAI..
DESCRIPTION: T etnporarys and (2) branch circuits for remediation pump. Job No. 01 2234
OWNER: TOSCO CORPORATION, PHONE #:
CONTRACTOR: f3OYLES ELECTRIC, INC. PHONE #: 503- 660M10
Inspection Request Scheduled For: Date: 1/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 02564E41 503. 6611744() Y
Corrections /Comments /Instructions:
C.'3.6.
A ASS 111 PARTIAL APPROVAL 11 CANCEL 111 NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ��� . Date: I 6 Phone #: (503) 718- VILA
r^
C I T Y OF TIGARD , ,f
BUILDING DIVISION PERMIT #: ELC2005 -00932
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/5/2005
Phone: (503) 639 - 4171x. E1
Inspection Requests (24 Hrs.): (503) 639 -4175 "__.,
INSPECTION WORKSHEET FOR DATE: 12/22/2005 TIME: 7:03AM PAGE: 58
•
SITE ADDRESS: 14030 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: UNOCAL
DESCRIPTION: Temporary service and (2) branch circuits for remediation pump. Job No. CI 2234
OWNER: TOSCO CORPORATION, PHONE #:
CONTRACTOR: BOYLES ELECTRIC, INC. PHONE #: 503 - 668-7440
Inspection Request Scheduled For: Date: 12/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 023874 -01 503 -668 -7440 N
Corrections /Comments /Instructions:
S S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FA L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /452—fr61 Date: / Z r Vi- Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELC2005-00932
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/52005
Phone: (503) 639 -4171 dry� i � l ?
Inspection Requests (24 Hrs.): (503) 639 -4175 :�- `__..
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 83
1 4030 SW PACIFIC HWY t M lb
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: UNOCAL
DESCRIPTION: Temporary service and (2) branch circuits for remediation pump. Job No. 01 2234
OWNER: TOSCO CORPORATION, PHONE #:
CONTRACTOR: BOYLES ELECTRIC, INC. PHONE #: 503 - 668
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Unaergroundlslab cover 023580-01 503- 668 -7440 N
Corrections /Comments/ Instructions:
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ L OR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
ar Inspector: Date: 1 2 1 17 I 06 Phone #: (503) 718- SI