Permit C ITY OF TIGARD ELECTRICAL PERMIT
-- PERMIT #: ELC2003 -00394
T�
� DEVELOPMENT SERVICES DATE ISSUED: 6/30/03
" 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 113AD -01900
SITE ADDRESS: 16600 SW 72ND AVE B -10
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Installation of (2) power poles and (1) outlet onto steel column in Building L.
Job No. 75589
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 6/30/03 $53.50
[TAX] 8% State Tax 6/30/03 $4 Rough -
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. 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 OA: - •1 1 -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- . -2344. r
Issu ; d By: � ' : I , , . Signature: /_%_/
% �
Permit Si nature:
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: X-7°, DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
JUN -24 -03 12:52 FROM- T -299 P.0031004 F -913
, e''' i —
llCat1OU r r cs
' ET ical ]Permit App w _ � t pFFICE SE ONLY Wt CAY 4
A ' City of Tigard' 0 Date received:( ? /3 Permit no.:fl.CJao3— ao3Y7
13125 SW HaII Blvd 1 Projectlappl. no.: Expire date:
u O By: Receipt no.:
� I 1 f i -1� Phone: (503) 639 -4171, FAX: (503) 59&10 Date issued:
Internet address: www.ci• u s\� ,�S \ „,,,,‘„...\ Case file no.: I Palrment type:
24 -Hour Inspection Re • uest 5 03.639 -4175 U Multi-family 0 Tenant improvement
_ -
❑ 1&2 family dwelling or accessory G\ Gimmerdal/Industriat
❑ New construction � p� 'adoitIONelteratiONrePlacement ❑ Other, ❑ Partial
j } , Ali: F3 ;fi^r ;lf.€ " t ' JOB' SITE'INFORMATION �t .:1r1 r,}'� '+ +z , ��r� :;:, '' r '! ii
Job Address: 16600 SW 72nd Ave Bld•. No - Suite no.: -' ft) Tax map /tax lot/account no.: -
Lot Block: Subdivision -
Pro ect Name: Flight Dynamics Description and location of work on premises: instal' Ho power poles nd one outlet on to steel
Estimated Date of cam• letionllns•ection: columr 4/......1
Will au call for ins. otlon within 24 hours? Yes ❑ No ❑ Project Contact Stave Ho • be (503 535 -2631 Phone
r : r 7 :IFEE SCHEDULE"' ' rY h - - ;'''J w: i "� =
��. � _.: ..:,. L.C)NTRACYURfAPPLICATION ; :f4 + ., ,_:: .: - . - - 13; _ _. ... - - .
' aM m.
J ob No.: 75589 Deecriptlon Qty Fee (ea.) Total Lrzp
'ew row •• ta - singuar
mult144mily per dwelling unit -
Business name: Or - ton Electric Grou • includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. 1000 R or less 3 145.00 $ - 4
City: PortIandjStete: OR Zip: 97214 Ea Addl 500 SF or Portion $ 33,40 $ -
Phone: 03) 234 -9900 Fax: (503) 234 -1001 E -mail: Limned En • r , 1 8,2 Family $ 75.00 $ - 2
COB no.: 203 El. c. bus. no.: 26 - 95C Llmi1ed energy, Multi 5 76.00 $ - 2
CItY /metro - • End, manutactured home or
1 /� i modu6sr dwelling. Service
51.nanerp ,,, - ( t ' 2003 anchor feedor. S 90,90 $ 2
service or Feeders -
Su Elect Name •lint � rcense no 44605 Installation, Alteration or
s..: J a y n ni 4 , f Jr: u, k -' Retocatton:
l - i k•�• - 200 am•s or less S 50.30 $ 2
.�' � - _ , . . I I?QPERTY., OWNER ;:� _ .._
201amps- 400amps $ 106.85 $ - 2
Name (print): - -
Malinq Address: 401amps S00amps ,$ 160 $ - 2
CI State: Zi•: 6o10 • s- 1000amps $ 240.80 $ - 2
Phone: Fax: E - mail Over 1000A or Volts 5 464.65 $ - 2
R erxmnnectOnlY 5 66.85 $ = 1
Owner Installation: The installation is being made on property I own which is Tempor Servlcbs or
not Intended for sale, lease, rent, or exchange according to ORS 447, 455, Feeders - InstaOauon•
479, 670, 701. Alteration or Relocation:
Owners s nature Date 200 am. s or MSS $ 65.85 $ - 2
ENGINEER + ,, i 2013 •a- 400amps $ 100.30 $ - 2
Name:
Over401 .s 50Damps $ 133.75 $ - 2
; rang crew — . 1 ere.
Alteration or Extension Per
Address: Panel: A. Fee for branch
City: State: Zip: cim,Irswilh purchase ofservlCa
or feeder fee, oxen branch
Phone Fax E circuit s cos $ - 2
T r 8. Fee for broneh einwlta W /Qut
.. � W ,. i kf - , " Pursh=e of Service or Feeder,
;,PLAN REVIEW 4 lsteranchGR 1 $ 46,85 $ 46.85 z
❑ Service over 225 amps -comrr O Health -care facility Each additional branch circuit 1 $ 6.65 $ _ 6.65
❑ Service over 320 amps -rating of ❑ Hazardous location Miscellaneous • (s6MCO or
reader not Included)
1&2 family dwellings ❑ Building over 10,000 square feet four or Each pump or irrigation clrcte s 53.40 $ - 2
❑ System over 600 volts nominal more residential units in one structure Each Sign orOutilne Lighting $ 53.40 $ - - 2
❑ Building over three stories 0 Feeders. 400 amps or more signal , um It(s) or Li Energy
Extension
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park $ 7 8- 0 ° $ - 2
❑ Egress/ lighting plan 0 Other: I ` •Desaiptwn: -
Each Additional inspection over
me Allowable In any of the
Above. Por inspection
5 62.50 $ -
_
Submit 2 sofa of plans with any of tho above InveSOgatlon fee:
The above are not applicable b temporary construction service. outer
Permit Fee 553.50
Notice: This permit application Plan review 25% SO.oO 4.
expires If permit is not State Surcharge 8% 54.28 9
obtained within 980 days after ir $57.78
has been accepted as complofo- Total
CITY OF TIGA 24 -Hour
BUILDING' Inspection Line: (503) 639 -4175
INSPECTION DIVISION - Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested 2' 7 AM PM BUP
Location /44 t) 0 ' U) 72/4 Suite MEC
Contact Person j�t.� -� Ph ( ) 5 5 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 'Pi) m ELC 3 2 23
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: e-- >v o-�r_ 6 be-5 SIT
Post & Beam �� '� ��
Shear Anchors
Ext Sheath/Shear ° A C,�L,G, n---
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
�CTRI AL
Service
Rough -In
UG/Slab ; / 3.e() =
Low Voltage
Fi - • farm
4V* ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
eb PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / -3 Insect . Ext
Approach /Sidewalk Date P -
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL