Permit G-; CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00496
COMMUNITY DEVELOPMENT DATE ISSUED: 8/29/2008
.T I GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 420 ZONING: C - G
SUBDIVISION: ONE EMBASSY CENTER LOT : JURISDICTION: TIG
PROJECT: ASSOCIATION FIELD SERVICE
Project Description: (4) branch circuits for light fixtures.
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: 3 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:
PORTLAND OFFICE ASSOCIATES RC COSTELLO ELECTRICAL CONTRATING
BY TC PORTLAND, INC PO BOX 336
8930 SW GEMINI DR AURORA, OR 97002
BEAVERTON, OR 97008
Phone: Contact #: PRI 503 - 982 - 7400
FAX 503 - 982 -7401
FEES
Description Date Amount Reg #: ELE 3344C
[ELPRMT] ELC Permit 8/29/2008 $66.80 LIC 87402
[TAX] 12% State Surchar 8/29/2008 $8.02 SUP 3934S
Total $74.82 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 B Permittee Signature:
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.
Electrical Permit Applicati0 �o FOR OFFICE USE ONLY
5 p
City of Tigard ` DateB : O Permit No.: _
Received
. $- `'" •
• ; q 13125 SW Hall Blvd., Ti: 1 AI r,. 3
^0 Plan Review
Phone: 503.639.4171 F. ' : 13.598.1960 1• O�
III
Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 \,\ �'� Oa* Date Ready /By: luris: ® See Page 2 for
Internet: www.tigard - or.gov ; �'c` �� Notified Method: — 7 T [J Supplemental Information
TYPE 1,..` � �w PLAN REVIEW
en /replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Additio
❑ 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 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. A
❑ Addition of new motor load of ❑ "A ", "E ". "I -2 ", "I -3 ",
( j I OOHP or more. occupancy.
Job no.: Job site address: 90 2 0 S l J (J A S i'1 .15t3 Va t P Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Z JJ LL ❑ Health -care facilities. ❑ Supply voltage for more than
1 17 r O J ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 1 Project name: ( � cor (�4 11J, Feld, SQl U t(4 ❑ Service or feeder 600 amps or more.
A FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 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.)
(� k 1 Limited energy, multi - family 75.00 2
1 r (A (1(, k CI f C, / 14 s j re �(XG�1 t? + y �I residential (with above sq. 0.)
r Services or feeders installation, alteration, and/or relocation
- 4 t K 1 1 I ure"S 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ 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 /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or Tess 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 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, er panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 y6 gS 2
first branch circuit
Address: Each add'I branch circuit 6.65 IC.q S 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 9090 2
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:
C C osfe. I I 0 E leC I r a COk I Cont. —L "C^ energy panel, alteration, or
Address: -p Q "33 extension. Describe: Page 2 2
City/State /ZIP: Al v C J I op 2 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (So3) 9 '3Z - `l L d,J Fax: (30 3) GI 6,2_. 1 Li 0 1 Investigation per hour (1 hr min) 62.50
CCB Lic.: 89 L.I 0 L Electrical Lic.: 3 - 34 ( Suprv. Lic.: 3C1 N . 5 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: <o6 • BU
/4_... Date: 8 I I i U Plan review (25 %of permit fee):
Print name: OGQ1 G CU5' - k w I State surcharge (12% of permit fee): b
Authorized signature: TOTAL PERMIT FEE: 9 4 . 8\
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I: \ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL,WORKONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
'`.COMMERCIAL WORK 'ONLY:,
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 : \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
C:l_C2pt)i:3� Ut'"k1g�;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8129/2008 C
Phone: (503) 639 -4171 ^ ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 �. ' -
INSPECTION WORKSHEET FOR DATE: 9/25/2008 TIME: 7:0OAM PAGE: 32
SITE ADDRESS: 09020 SW WASHINGTON IINGTON SQUARE_ RD 420 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE: z
PROJECT NAME: A!;SOCIATION I =IELD S
DESCRIPTION: (4) branch circuits for light fixtures.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: RC COSTELLO ELECTRICAL CONTRATING PHONE #: 1;03,982 -7400
Inspection Request Scheduled For: Date: 9/25/:008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 075913-02 503- 504 -675 N
Corrections /Comments /Instructions:
•
<PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9 -2.5- -P Phone #: (503) 718-
. • .
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
ELC2008•00496
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
W29/20013
Phone: (503) 639-4171
, 1.1 1 1
Inspection Requests (24 Hrs.): (503) 639-4175 ,._... 1,
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/25/2008 7:00AM 33
SITE ADDRESS: CLASS OF WORK:
09020 SW WASHINGTON SQUARE RD ile8 #:
SUBDIVISION: TYPE OF USE:
ONE EMBASSY CENTER
PROJECT NAME: • -
ASSOCIATION I= I ELI) SER VI GE
DESCRIPTION:
0) brailc:h circuits for light fixtures.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: PHONE # . • 503_982-7400
RC COSTELLO ELECTRICAL CONTRATING
Inspection Request Scheduled For: Date: Pour Time:
9/250008
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 075913-01 503-504-6757 N
Corrections/Comments/ Instructions:
• ,
,,, Li PARTIAL APPROVAL 0 CANCEL NO ACCESS
n FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: -2 Date: 92 5c9 Phone #: (503) 718-
CITY OF TIGARD ..
BUILDING DIVISION PERMIT #:
DATE ISSUED: El_C2003.004%
13125 SW Hall Blvd., Tigard, OR 97223 8/29/2008
Phone: (503) 639-4171 ,4:'''''At
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/24/2008 7:OOAM 21
SITE ADDRESS: CLASS OF WORK:
09020 SW WASHINGTON SQUARE RD /le& #:
SUBDIVISION: ONE EMBASSY CENTER TYPE OF USE:
PROJECT NAME: --, , - -
A: FIELD SERVICE
DESCRIPTION: (4) branc:h circuits for light fixtures.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
. CONTRACTOR: RC COSTELLO ELECTRICAL CONTRATING PHONE #: 503-982-7400
Inspection Request Scheduled For: Date: 9/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final / 075850-02 503-504-6757 N
)
Corrections/Comments/Instructions:
il\t 61 WOksel 1
•
I PASS ri PARTIAL APPROVAL ACANCEL I I NO ACCESS
1 I FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: GM NOG Li ---- Date: 51 Phone #: (503) 718- IA%
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL C2006-00.496
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 8/23/2008
Phone: (503) 639 -4171 '�L
Inspection Requests (24 Hrs.): (503) 639-4175 �._ : _.
INSPECTION WORKSHEET FOR DATE: 0 }2417008 TIME: 7:(10ANi PAGE: 22
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 09020 SW WASHINGTON SQUARE RD 420
ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: A FIELD SERVICE
DESCRIPTION: (4) branch circuits for light fixtures.
OWNER: PORTLAND OFFICE ASSOCIATES,
PHONE #:
CONTRACTOR: RC COSTELLO ELECTRICAL CONTRATING PHONE #: 503.982 -7400
Inspection Request Scheduled For: Date: 924l2Q08 Pour Time:
Code # Inspection Description Confirm Contact # Message
130 Ceiling cover 0756 �t 1 01 ‘ , 503 - 604.6757 N
Corrections/Comments/Instructions: /
i
4 v RE19#(4 U
U
PASS ❑ PARTIAL APPROVAL ACANCEL NO ACCESS
FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: G ---1 -- 2- b
` NOB Date: 1 Phone #: (503) 718- �7 /'D
/ ^ .
CITY OF '
��mm m m�'n� TIGARD .ro -
BUILDING DIVISION ^ ' '
~°~°"~~~°""°~" ~~"°"~,"~~"° PERMIT #: E]-C20080O496
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 Arid..
INSPECTION WORKSHEET FOR DATE: 9/2/2000 TIME: 7:01AM PAGE: 7
SITE ADDRESS: OSD2O WASHINGTON SQUARE RD420 CLASS OF WORK:
SUBDIVISION: ONE EMFJASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: ASG0C|AO0N FIELD SERV/CE
DESCRIPTION: (4) branch circuits for light Mures.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #: | |
CONTRACTOR: RCC0GTELL0 ELECTRICAL C0N7RATNG PHONE ft: 503
.
lnspection Request Scheduled For: 89/2/2008 | 92OOD Pour Time: |
|
Code # Inspection Description Contact # Message |
125 Wall cover 503- 504-6750 N I
/ Corrections/Comments/Instructions:
.2 '
PARTIAL APPROVAL �� CANCEL fl NO ACCESS
' | |
FAIL ri CALL FOR INSPECTION | 1 ADDITIONAL FEES ASSESSED
/
Inspector: G� 1 ( q 2- 1 1d
•