Permit . CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00722
• COMMUNITY DEVELOPMENT DATE ISSUED: 10/22/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S115AB-01900
SITE ADDRESS: 16200 SW PACIFIC HWY B2 ZONING: C -G
SUBDIVISION: TIGARD TONE SQUARE LOT : JURISDICTION: TIG
W
PROJECT: HEAVENLY PETS
Project Description: (stalling lights and outlets, adding a low voltage phone line.
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: 1
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:
BIT HOLDINGS LTD PARTNERSHIP NELSON ELECTRIC LLC
BY FORUM PROPERTIES INC 1745 4TH AVE
FIVE CENTERPOINTE DR STE 290 WEST LINN, OR 97068
LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 503 - 267 - 8529
FAX 503 - 237 -6472
FEES
Description Date Amount Reg #: ELE C123
[ELPRMT1 ELC. Permit 10/22/200' $128.50 LIC 168080
)TAX] 8% State Surcharge 10/22/200' $10.28 SUP 3506S
Total $138.78 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 thro , • R 952 - 001 -01 ' : You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
I
Issued B J L f /// Permittee Signature: � 4§10//rA691
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.
•
i +��Electrical Permit Application City of Tigard OCT 2 2 20 RECEIV kt�lt UI l.':�(f >a,�)
Date By d , . •: .. 1)tiI
Jtetetve „ Z2
i llig ° 13125 SW Hall Blvd.. Tigard, OR 97223 •Ian Review
/ I 2Z/ d 51.4J Permit No /
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
-
CITY OF 1164 t ate /B,
1 l(, A R O { Inspection Line: 503.639.4175 AN , Ready ®See !'age 2 for
....;_,e. Internet: www.tigard- or.gov BUiLDINGDIVI VWittiedi:vtetliod. Supplemental Information
•
TYPE OF WORK PLAN REVIEW
❑ New construction -. Addition /alteration/replacement
Please check all that apply (submit sets of platy wiitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO 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 uthci 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
) - 't) 100HP et more. occupancy.
(4 Job no.: - Job site address: i Si4 p 1 I G _ Six or more residential units. ❑ Recreational vehicle parks.
Citti' /State/L1 P: � 04 • q`� Health
azard us locations. ❑ Supply voltage for more than
�(( � ❑ Hazarous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: /�� �� .2 ❑ Sertice or feeder 600 amps or more.
— - u.�� FEE SCHEDULE
Cross street /directions to job Site: Description I Qty. I Fee. I total I
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
F.a. 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. tt.)
/1 ``��gg J� �� energy, multi - family 7 -
4 1 1 tn 4 , ,5 , Limited ener
// 9'' % ! % � residential (with above sq Ii.) X 00 2
���� Services or feeders installation, alteration, and/or relocation
.1 4 4��I /' a. /_ • r 200 amps or less I 80.30 I 2
❑ PROP TY a WNER ❑ TENANT 201 amps to 400 amps • 106.85 2
Name: 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/%1P: Temporary services or feeders installation, alteration, and/o
relocation
Phone: ( ) Fax: ( ) 200 amps or Tess 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
Branch circuits- new, alteration, or extension, per panel
Owner signature: Date: A. Fee 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
without service or feeder fee. y6 2
Contact name:
first branch circuit
Address: Each add'I branch circuit / I 6.65 6,4 I 2
Miscellaneous (service or feeder not included)
City /State /'LIP: Each manufactured or modular
90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( 1 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name:,AJ r e`/,14 -r/6.- Signal circuit(s) or limited -
energy panel. alteration, or • ,
Address: /f94' 9 /-n lfe exictlslt 1,5.0G- Describe: l Page 2 2
City /State /ZIP: V✓ 24 /? Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone:) 2o 7, %p_,..,1 F ` �, �y 17` '
.5 `x /` °or�' `G , Investigation per hour (t hr min) 62.50
CCB Lie.: l a/60go Electrical Lie.: c/ zg Suprv. Lic.:,/,...067.5 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: /Obi 10 Subtotal: 0 5 (, �e (0
Print name: /4IC�� 6� e Date �- --O.-7 Plan review (25°0 of permit fee):
l State surcharge (8% of permit fee): A), 2 '
Authorized signature:
( • "�� . s —" 50 5 TOTAL PERMIT FEE: /34 /.7 Print name; This permit application expires if a permit is not obtained within 80
Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
IABuildingiernits\l:L(:- PemitApp due 05113/00 440- 4615T(I I/05 /COMIWEI
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00722
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 'I0/22/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1 L
INSPECTION WORKSHEET FOR DATE: 10/23/2007 TIME: 7 :00AM PAGE: 73
SITE ADDRESS: 16200 SW PACIFIC HWY B2 CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: HEAVENLY PETS
DESCRIPTION: (stalling lights and outlets, adding a low voltage phone line.
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: NELSON ELECTRIC LLC . � 1 � � PHONE #: 503-267 -8573
Inspection Request Scheduled For: Date: 10/23/2007 Pour Time:
Code # Inspection Description • rte-#— Contact # Message
125 Wall cover 058077 -01 503 267 -8529 Y
Corrections /Comments / Instructions:
(14"110 a- AN at �. A�2•
4 e1.4_ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' - 1 v �4 L Date: iO 7. 310 Phone #: (503) 718- VILA)