Permit CITY TIGARD ELECTRICAL PERMIT
CITY #: ELC2003 -00376
DEVELOPMENT SERVICES DATE ISSUED: 6/23/03
`-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 113A D -01900
SITE ADDRESS: 16600 SW 72ND AVE B -10
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING. I -L
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: JOB NO. 75523
Install two power poles in Bldg 10
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:
PACIFIC REALTY ASSOCIATES OREGON ELECTRIC CONST /GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 503 - 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/23/03 $53.50
[TAX] 8% State Tax 6/23/03 $4.28 Elect'I Service
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. At
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: Permit 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 639 -4175 by 7:OOpm for an inspection the next business day
JUN -21 -03 09:43 FROM T - 257 P.001 /002 F -794
=-••• Electrical Permit App�.i atioi�.
' OFFICE U O NLY
n
1
A City of Tigard Date received: Permit no an -003
: 13125 SW Hall Blvd . � � nt1� Pro'eCt/a• I. no.; Ex•ire date:
l Phone: (503) 639 121; PAX 503`` 5981960 Date issued: MUM Recei•t no.:
Internet address; www.cl.tlgard -or.us ,q Case file no.: 1=Ert
24-Hour Ins •action Re• nest 5034,639-4175
II 182 family dwelling or accessory
• C .9 thniercialtnaustrial • Muld-ramlly 0 Tenant improvement
� ��
CI New construction r\, ,..II
addidonlalteration /replacement Q
3, 0'.,; ,. '2 , 08 S ITE. I NFORMATION '^
Other. partial
� � . €. a I = r , :, ° . � - ,,, r` >' ?p .. r -r . ,.. . z i t v �� � :.
Jab Address: 16600 SW 72nd Ave ?,)'-' Bld.. No.: Suite no.: • Tax ma • lot/account no.:
Lot Block: Su bdivision
Pro ect Name: Fli • ht • namics Descri • :on and location of work on • remises: Install two power poles in Bldg 10
Estimated Date of corn • letion/in • action:
Will • u call for Ins • - lion within 24. hours ?. Yes • No p Project Contact Rob warn!! (503)848 Phone
U
� . UUNTRf.C'IUR'Y•= rLIChTIi)N .. .. ....,. , _._ r, ..
_ f .. ECE S CHEC � CE , ",
Job No.: 75523 Descri Qtr Foe es.) Total v
' . : e • en a -singe •
multi - family per dwelling unit
Business name: Or t on Electric Grou • Includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. 1000 a •. ft or less $ 145.00 $ -
Gi : Portland State: OR Zi • : 87214 Ea adds 500 SF or Portion Ell S 33.40 1. $ -
Phone; 503 234 -9900 Fax: (503) 234 -1001 E -mail: Umnad Enerfri, 1 & 2 Famny III. $ 76.00 ■ $ - II
CCB no.: 203 Elec. • us. tie. no.; 26-95C NREMIREM11111 $ 75.00 . $ - M
:_ •• Each manufactwed home or
and /or feeder. Service -
• , , and/or feeder. " $ 90.90 $
irelArrROPPI - L..� � Service or Feeders -
6@912003
//
5u Elect. Nam= 'MEW' License no: 4460S installation, Alterattonor
RvIOCatien:
, 9 Pr,OPERTYOLMNER 200am•.orless I S 80.30 I $
Name • rint : 2t11amps - 400amps I. $ 106,85 III $ -
Mailing Address: 401amps- 5C0amps 11111 5 160.60 1 $ - M
State: ZI•: 60tam•s- 1000amps II. $ 240,80 11 $ - Ell
Phone: Fax: E-mail Over 1000A or Volta ■. $ 454.65 1 $ -
Owner Installation: The installation is being made on property I own which is Ree 6nn8 t°111Y rc nr .■ - III $ El
not intended for sale. lease, rent, or exchange according to ORS 447, 455. r-oe ders.lnatallatoton,
479, 670, 701. Alteration or Relocation:
Owner's et. nature: Date: 200. • s or leas � II $ 66.85 , $ -
• . ENGINEER` 201amps- 400ampa .II $ 100.30 11 $ - IIII
Name 0vera0la - s- 800amps I. $ 133.75 1 $ -
nc hrtu , - 'ew,
Alteration or Extension Per
Address: Panel: A. Fee for branch
Ci : State: Zi • : circuits with purchase of eetvlce
or feeder fee, each branch
Phone: Fax: E-mail: drwtt iiiiiF
i 8 Fee for branch circuits
, = = Purchase of Service or F - :
P. VIEW
1st aranen Ci ct $ 46.85 $ 46.85
t ' � , PLAN ,E
❑ Service aver 225 amps -Camrr ❑ Health -care facility Earn ad8thnal branch circuit .e $ 6.65 1 $ 6.65 M service over 320 empa -rating of ❑ Hazardous location miscellaneous- (service or
feeder nest Included)
162 family dwellings ❑ Building over 10,000 square feet four or Each . ■ . or lrrf • - :on circle "$ 53.40
❑ System over 600 volts nominal more residential units in one structure Each Signer outfne timing ■M $ 53A0 ■ $ -
0 Building over three stories 0 Feeders, 400 amps or more signal Circuit(s) or Lieniled Energy
Panel Alteration or Exton. on"
❑ Occupant load aver g structures or RV s persons ❑Manufactured s park $ 75.00
❑ Egress/lighting plan ❑ Other: -Description:
Each Additional Inspection over
Me Allowable In any of We
Above. Por inspection
5 62.50 $ -
Submit 2 cote of plats with any of the above Invost+aatien fee: IIIIII
The above are not a ..livable to tem. • a constrvt ion service. Other
Permit Fee $53.50
Notice: This Dental eep tian Plan review 25% $0.00 4.
expires If permit is not State Surdlarge 8% $ 428 •;
obtained within ISO days after It . $57 78
has been accepter as complete. Total
•
CITY OF TIGARD 24- Hour..-
BUILDING Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 AM PM BUP
Location / i co 0 0 7.q ' 9' Suite
��" 6- / 6 MEC
Contact Person - -g:` t?2 - Ph ( ) gT if - 3D PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner � L i 0 ELC 3 - 00.37
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: Z! n L S SIT
Post & Beam 1/
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
--Fire Sprinkler
Fire Alarm
Susp'd Ceiling /
Roof (
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire larm
in Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS PART FAIL
SITE 0 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 7 a Inspector ��-- 'G =' 0 '"7 Ext
Other:
Final DO NOT REMOVE this inspection record from the b site.
PASS PART FAIL