Permit CITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2007 - 00766 •
COMMUNITY DEVELOPMENT DATE ISSUED: 11/14/2007
' TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 DD -00400
SITE ADDRESS: 06825 SW SANDBURG ST ZONING: C -P
SUBDIVISION: SALEM FREEWAY SUBDIVISION LOT : 001 JURISDICTION: TIG
PROJECT: TOC
Project Description: 1 branch circuit: Refeed existing light pole circuit.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st WIO SRVC OR FDR: 1 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:
TOC MANAGEMENT SERVICES INC ATLAS ELECTRICAL CONTRACTORS
6825 SW SANDBERG ST 4403 SE ROETHE RD
TIGARD, OR 97223 MILWAUKIE, OR 97267
Phone: Contact #: FAX 659 -4944
PRI 659 -2212
FEES
Description Date Amount Reg #: ELE 3 -2C
[ELPRMT] ELC Permit 11/14/200' $46.85 LIC 1532
[TAX] 8% State Surcharge 11/14/200' $3.75 SUP 50095
Total $50.60 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: s e _ J 4 4 Permittee Signature: a�� C�
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.
.0- . if ATLAS ELECTR I CAL Fag :503 594944 Nov 14 2007 8:20 P. 02
Electrical Permit Application FOR o FF 1 t: F. l i S L O N I.1
City o j CEIVED Tig ' i H
Ptratit - D D 710.(.
7, 13125 SW flan B)<'d, Tigard, OR Pbn Review Cies=Pemat
Phone: 503. 639.4171 Fax: 503_598.1M 1 4 L U U I Date/3 . ®. see Page z Tor
n ; 1
Inspection Line: 503.639 -4115 >3a l yBr
t . I �, t- npD ed/Dtcthad S�plemenW leforma6on
interact: www.ngard- or.gov 01 l - ,� .
.. , _ ,..,,: _ .: ,� - � : c• :...� •:, " : : :- ---.-� � :. ^ 12 .. , , ;i.:.. •- �i;1': Irk =" ' - - - =-
Il :,_ , 'r- ..; JAI![-. 7 .n�.u�, :�� ,�,�ytf _ "" 44! y u ` : „ � r
1`v T �I �klr 'r r'^'" � ' y r� mi :: i , . r 1' 0 I 1 a It L . ill'ijry r � Ai� , , a�1 �, ur I -
' I li :
e ;t' -,i1 . .1211, I k!,,2 i a :1 •._ , ,}I. :III 7!ar4 , ,iU s:, tuts ..ouelwt �si,tll�Ht...f t t 1 :' u I r ' l
l i'•'', �,9 a.wn.� al ., _ir. : Please check all that app (submit 2 sets apt= w/items checked below):
❑ New construction i� Addititm/etltet ation/replacemeAt ❑ Service or feeder 400i pa or more ❑ awl a ding over three scoria.
❑ Demolition i 0 Other. where the available filth current ❑ Marinas and boatyards.
ilaT '� ten ,:,ryr;
�, �t^-1- ;,tmnmFlr•^ Char: �- nv7t � ^i -�,I
f ��` "3'�.�)il� ,,;�� vad �1f � .C� t . exceeds 10,000 aoopsi a t 150 volts or ❑ Floating buildtagbuildings. a, _ 11 .t !iir.3a t:-.'6 j' flig i�ii - b. " u.,i :cn �u r I sf ik - :.. Iw t' F�: my t; liferY,:i r-/i rasi t,:'tJ n `! �i less to ground, or exceds' 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling j ® CommercialTmdasttilal ❑ Accessory building anqui for all other installations. b uldinga
CI Multi - family ❑ Master builder ❑ Other: ❑ Fire pump.
. ,_ : I :., ?r; a. " >_ ! r�s r ; :[It;e c_ :r; :,,, c: "- r,. , ? :rlar;. = f(o` 1' " " : :, f = '^ _, ❑> system ❑ Installation o 7s or
larger separately derived system
1 a i , 1 i , il; , t C i : ;' ! : `, G ' !' " t' :, . [ ,z t�!✓ Fif!Ik r;f A ofoaw motor load of ❑ "A", "B' "1-2 ", de r "
ft l •;,hG ti ? Nd:ly . ! :_7 �: ; I f .- _ :..`•i_ i ! r _. err thiT tt 1J .
.F u , >, t i: a�tirir.: !•uls� i: a . ;. t3lr'L.
occapasaY.
Job no.: 16893 Job site �•_,:.al. n:, _. � .., ..,., 100 or more.
address: ' ` - Street ❑ Six or more residential units. ❑ Recreational vehicle parks
City/StateJZIP;
❑ Health-care thcrlities ❑ Supply voltage Or more than
Oregon ' ❑ Hazardous locations.: i 600 volts nomloal.
Management ❑ Service or feeder 600 amps or more.
r . - f � •= I ' h� : ail ric=.` 1 " r:; ,,a.,,..__. ? , .j� . ..< j�l ,t�krri ,���'- .T rk
Cross street/directions to job' site: . _ -, :.. ! . • , . re, Total
New residential single -or multi-fly dwelling unit-
Includes attached garage. '
•
Subdivision: Lot no.: 1,000 sq. ft. or less ; 145.15 4
Ea. add'1500 sq. ft. or portion
Tax map/parcel no,: :..4000 1
ru � �5I[h 7!'r, -r; unpA ",7 , • �,c-i;a ^„ � ^.; 'L 1T . , jN. t�_ r I - . - +i.�
Limited energy, r esidential 2 •
�usse�� 2, - { iViL 1 ..t � e _' Y I G rb �,-Z ` , rf ' w I ,n :.. above sq" ft)
i Fsutl ""rl i ,a " I is 1,3 I ti!' �!i -t ! :n== :3� laf(�l� - ; -; a „rl� 4 '!,Ilf�{ i
:f- ."i fl�fl �{� ''i (with abo
limited energy, mold- family 75.00 2
: i _ pole ' not ' ' residential (with a ere sq. R)
Services or feeders installation, alteration and/or relocatio
200 amps or less ' : 80.30 2
- : IF--` 7 E: .' ••3e r it F� _gipncP l .l • ., a lii " ",;• -,_G: p; 341 u. 106 2
.�` -�gt h �r �yy,y1 rt5 } ' - %T: - ItJ !r :11 :. tI , I ' 20 1 amps 400amps e ° i ; / m 9 r a I l lf Ali hipp t 17nti 17 I F si f' ; 7 ' amp mP
@li a•�"i�i'�!- �,; :,� :_�rL•:.� , t L 9a �;i Lo I P.,_ -J,.. I G� t t 1113e. •
401 amps to 600 amps 160.60 2
i V ./_ . I 4 .4 ' - I ''_.411 - 601 amps to 1,000 amps 240.60 2
Address: to w 2 LO . - 41 r 4 - £ ,r ea. A Over 1,000 amps or volts 454.65 2
Ci /State/ZIP: Temporary services or feeders installation, alteration, and/or
t)' / f • :� relocation
Phone: 6 Q a I 1 Fax' ( ) 200 amps or less t 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps : 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps : 133.75 2
I Branch circuits - n >tI
new; alteration, or extension, r panel '
Owner signature: Date: A. Fee for branch circuits with
,,1.���4�'1(1�:7 a .: 7.7a:.rk: =rer . un, l:: -11 I . - 3FTr I" r'ra': t . hlr ,. ; , _, i 7F "•-:-r_r�tt :.4''' •o
lfigi.. :' .t2.,4N1 mm3 k n y .. t _ty ' l iitN, 1 �,r��, I �Irlt.s'i ...... i� 7 kfIt Ti?� 1�u.�i.•I...a :irl.�n� kr. . � L,f I I above ser�'ihc or feeder fee, 6.65 2
i ,•. each branch eirctiit .
Business name: ! B. Fee for branch circuits
j - • without service feeder fee I 46.25 46.85 2
Contact name: first branch circuit .
-
Address: • Eachadd'1 branch tirctiit 6.65 2
Mlscellaueous (service or feeder not included)
City/State/ZIP: Each manufactured or Modular ' 90.90 2
dwcllin , service arid/or feeder
Phone: ( ) I Fax:: ( ) • Reconnect only ! 66.85 2
"
E- tnaiL• I Pump or irrigation circle 5140 2
to err n?I!it: �. :_�� t ' L+ ,I. .I i! =�--., u eli 53.40 2
_
1 � � t ;f t•, !h r: ! r i i ai I , F�'' Si tlin lighting 'hT7' ��i '"�'•'s 1 °. : �i� � Sh�l2�ll��l
: :,. G, ,. I I, I , �!I�, s: 3! � � ! t f�. 1� or 0
., g zt.'
�nl,:'�.R i, n _,..: �hf a�B,Ct iu':_ .;.4 Id ]I. _ ' - r. . � : .. : ..il l .0 �EI:
Signal circuit(s) or limited-
Business name: Atlas Electrical Contractors, Inc. energy panel, alteration, or
Address: 4403 SE Roethe toad extension. Deacnb �: ? I Page 2 2
i _
City/State/ZIP: Mllwaulde, Oregon 97267 Each additional Inspection over allowable in any of the above
Far inspection I : 62.50
Phone: (503) 659 -2212 � Fax: (503) 6594944 / 0 Investigation per hour (1 hr min) 62.50
CCB Lie.: 1532 i Electrical Lie.: 3 -2C Suprv. Lie.: -'109S Industrial plant pet' hour 73.75 p
h' + r oil 2 f l J l l r t '. II l I 't '' .j .c N1I r!.•
Suprv. Electrician signature, required: , ,/ Subtotal: 46.85
D
1 Date: I I pate: 1/13/07 Plans review (25% of permit fee):
print name: Ty Shepetslcy
State surcharge (8 % of permit fee): 3.75
Authorized signature: ` . `' ..),,,ii. r • 'DOTAL PERMIT FEE: 50.60
jj Tcati
rats Permit appon expires if a pen,* is out obtained within 180
Print name: Ty Shepersk 1 , Date: 11/13/01 days after it bas been accepted as complete.
. • Number of inspections allowed per permit.
• L1 u s t U n g i P e n m e s t E t c - P e r r itApadoe i 0 5 / 2 3 t 06 . . . . . . .. .. 440-4615,r(l llo5/COVWFB . . ' i
• i
•
CITY OF TIGARD
BUILDING DIVISION • .• PERMIT #: ELC2007-00766
13125 SW Halt Blvd., Tigard, OR 97223 DATE ISSUED: 11/ l4/2007
Phone: (503) 639-4171 .":011111t
Inspection Requests (24 Hrs.): (503) 639-41,75 L.
INSPECTION WORKSHEET FOR. DATE: 12J312007 TIME 7:00AM PAGE: 59
SITE ADDRESS: 06925 SW SANDBURG ST CLASS OF WORK:
SUBDIVISION: SALEM FREEWAY SUBDIVISION LOT #: 001 TYPE OF USE:
PROJECT NAME: Toc.
DESCRIPTION: 1 branch circuit: Refeed existing light pole circuit.
OWNER: TOC MANAGEMENT SERVICES INC, PHONE #:
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 6592212
Inspection Request Scheduled For: Date: 12/3/2007 Pour Time:
Code # Inspection Description Confirrrl'#, Contact # Message
199 Electrical final 060611-01 503-901-9343
Corrections/Comments/Instructions:
\\,
\\\\
PASS PARTIAL APPROVAL n CANCEL fl NO ACCESS
pi FAIL El CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Cr Nbe Date: 1 Phone #: (503) 718- 1-11