Permit '''' � ` CITY OF TIGARD ... -1 ELECTRICAL PERMIT
7 ,,,
r ° PERMIT #: ELC2007 -00581
COMMUNITY DEVELOPMENT DATE ISSUED: 8/20/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AD - 00900
SITE ADDRESS: 14800 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: HOME DEPOT
Project Description: Relocate 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: 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 W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
HD DEVELOPMENT OF MARYLAND, INC TIMBERLINE ELECTRICAL CONTRACTORS
POBOX 105842 PO BOX 918
ATLANTA, GA 30348 LAKE OSWEGO, OR 97034
Phone: Contact #: PRI 503 - 459 -4089
FAX 503 -254 -4227
FEES
Description Date Amount Reg #: ELE 26 -1211C
[ELPRMT] ELC Permit 8/20/2007 $53.50 LIC 160037
[TAX] 8% State Surcharge 8/20/2007 $4.28 SUP 4957S •
Total $57.78 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: PO \
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.
Rug ' 20 ' 0'7 08:27a Timberline Electrical 5032544227 p.2
I�
Elect liCatlOII GE \ � ` �
rical Permit App , FOR OFFICE USE ONLY
City of Tigard DateDate/By �e
Receive• P ermit �,/
o l o �g ' ' 7 ._ 775
13125 SW Hall Blvd., Tigard, OR 97223 % ® Luv PlanR ew
/ Other Permit:
11 Phone: 503.639.4171 Fax: 503.598.196(Q U Date/By:
Inspection Line: 503.639 4175 Y p� 1GARD 1 Date Ready/By: r See Page 2 for
TtGA2D Internet: www.tigard -ocgov C lJt Notified/Method: I li, Supplemental Information .
TYPE OF WC 1 � t �
'11C PLAN REVIEW
❑ New construction
Please check all that apply (submit 2 sets of plans w /ites checked below):
• Addition /alteration /replacement m Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION cxeeeds 10,000 amps at 150 volts or ❑ Floating buildings. •
less 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 pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - "1 - 3",
{� �, 100Fi? or more. occupancy.
Job no.: I� t?, Job site address: /�tC�/ ut%I �}" f [
❑ Six or more residential units. ❑ Recreational vehicle parks.
�:_�� a — ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous lo cations.
city /State/zIP : lit t' 17 t—' 7 l z re 600 volts nominal.
Suite/bldg./apt t no.: Project name: '� ❑ Service or feeder 600 amps or more.
g P f' - FEE SCHEDULE
Cross street/directions to job site: uescription I Qty. I Fee. I Total 1 • '
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft_ or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2 •
DESCRIPTION OF WORK (with above sq. ft.)
((11 ?-0)41-1(5' ` / Limited energy, multi - family 75 00 2 • � (t 1, / -C1 L residential (with above sq. ft.) _
Services or feeders instrll =tioa, alteration, r r6Ior reloca?l
200 amps or less 80.30 I
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name:
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 I 66.85 I 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according.to ORS 447, 449, 670, and 701. Branch circuits - new. alteration, or ex tension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I 1:1 CONTACT PERSON above service or feeder fee, 1 6.65 h ( L
: 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 1 46.85 ' /6. 2
Contact name: first branch circuit /
Each add'( branch circuit 6.65 2
Address:
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) • Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
•
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: ii / J1t ki i'1. 1 360 (C _ C_1 c7 r5 energy panel, alteration, or •
Address: L
QQ Gx Cj/ '`f extension. Describe: Page 2 2
City/State/ZIP: 7�' Each additional inspection over allowable in any of the above
ty 1rJ c; C A - ( 51 1
_ Per inspectio 62.50
Phone: (50 ) I5 j 4C6 ' e Fax: (325 ) 'i y Z Z7 Investigation per hour (1 hr min) 1 62.50
CCB Lic.: ii8c3 7 1 Electrical Li .: - /i prv. Lic.: `f'C Industrial plant per hour 73.75
I
ELECTRICAL ICAL PERMIT i EES
Suprv. Electrician signature, required: c 1 Subtotal: I J %5
•
t t ( / i ,` Plan review (25% of permit fee):
Print name :T ...--s- Ai G te: C' 7C1� State surcharge (8% of permit fee): 4t 1
Authorized signature: TOTAL PERMIT FEE: ,C 9' c+,
Thi s permit application expires if a permit is not obtained wi ISO
Print name: Date: days after it has been accepted as complete.
t • Number of inspections allowed per permit.
I :\ Building \Pcrmi'slE.C- PermitApp.doe 05/21/06 440- 4615T(1:105/COMM'IB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00GB1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/20 /2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/21 /2007 TIME: 7:00AM PAGE: 35
SITE ADDRESS: 14800 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOME DEPOT
DESCRIPTION: Relocate branch circuits.
OWNER: HD DEVELOPMENT OF MARYLAND, INC, PHONE #:
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503 4159.4089
Inspection Request Scheduled For: Date: 8/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 054388^01 603-313-0331 Y
ections /C mm structions: c>o55
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ST 11 C.KIr(L ® e&og LO-.1 13■(1h►CrA'2.1(4W
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N. PASS El PARTIAL APPROVAL El CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 1 1 Date:
1
Phone #: (503) 718 - MIA