Permit CITY OF TIGAR® ELECTRICAL PERMIT
PERMIT #: ELC2004 -00630
x kr DEVELOPMENT SERVICES DATE ISSUED: 10/1/2004
°
�4- , -- ' 1 " 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 - 4171
PARCEL: 2S113AD -01900
SITE ADDRESS: 16600 SW 72ND AVE B -10
SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Replacement of HVAC.
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 10/1/2004 $53.50
jTAX] 8% State Surcharge 10/1/2004 $4.28 Rough -
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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: ':2) Permit Signature: - c_t_,.Q p \p R
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
SEP -30 -04 02:58PM FROM - Oregon Electric Estimating 5032313587 T -582 P.001 /002 F -586
Electrical Permit Application i •
Received ; � t
, City 'of T igard Received //) 1 o' /....0....17..,...., Permilx0•` C>D 63
13125 SW Hall Blvd., Tigard, OR 972 V � Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 r t t, ;t fll'� Date/By: _
Inspection Line: 503.639.4175 ,,,� :_ 1 Date Ready/Ely: Luis: /_ El Sec Pag 2 rot
Internet: www.ci.tigard.or.us " 20 Notified/Method: 1 u Supplemental information — •
' ... . . . , . Ji it: ... .G .i y a 1•l ... .. ... •• • . . , ; PLAN REVIEW •
N ew construction 1 -
❑ ® p ' � Q � � n t Please check all that apply: ['Service over 225 amps, comrn I ❑Hazardous location
❑ Demolition ❑ Other. ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
_'.:.CATEGOXt'V' OF:,CONSTR J CCION • • of 1- and 2- family dwellings 4 or more new residential • ['System over 600 volts nominal units in one Structure
El 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building pguildmg over three stories ['feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other. DOccupant load over 99 persons ❑Manufactured structures or
JOB •SITE INFORMATION:__ANT) LOCATION .. • : ❑Egcss/lighting plan RV park
❑Health -care facility ❑Other:
Job no.: 82184 Job site address: 16600 SW 72nd Ave Submit 2 sets of plans with any of the above.
City /State/ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service.
FEE" SCHEDULE
Suite /bldg. /apt no.: "3-- _ Project name: Rockwell Collins/Flight Dynamics • oe,rrinttott I Q, J low
Cross street/dircctions to job site: Ncw residential single or multi- family dwelling unit.
includes attached garage. _
1,000 sq. II_ or less 145.15 4
Subdivision: Lot no Ea. add'l 500 sq. ft. or portion 33,40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non-residential _ 75.00 2 1
DESCRIPTION .OF' WORK s .. Each manufactured or modular
' dwelling, service and/or feeder _ 90.90 2
emergnecy replacement of RVAC Services or finders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
U .PROPEIt`I'X: 1 OWNER:::. • . I, , „''.;'; , . ; N : " 401 amps to 600 amps 160.60 2
Name: Rockwell Collins/Flight Dynamics 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps o v olts 454.65 2
Reconnect only 66.85 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)743 -3288 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps ro 400 amps 100.30 2
intended for sa1e, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75, _ 2
Owner signature: _ Date: Brooch circuits- new, alteration, or extension, per panel
A. Fee for branch circuits with
D APi'tlCAhiT D. GON[ACi PIItSON service or feeder fce, each
6.65 2
Business name: branch circuit
B. Fcc for branch circuits
Contact name: without service or feeder fee, / 46.85 G c,,,c. 2
each branch circuit
Address Each add'1 branch circuit 1 6.65 O 60S 2
City / Statc/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone. ( ) Fax. -
( ) — Sign or outline lighting 53.40 2 -
E -mail: Signal circuir(s) or limited-
CON fYY,4CTOR .
1 energy panel. alteration, or
extension. Describe: Page 2 2
Business name: Oregon Electric Group
Address: 1010 SE l lth Ave Each additional inspection over allowable In any of the above
Per inspection 62.50
City / State/ZIP: Portland, OR 97214 Investigation per hour (1 br min) 62.50
Phone (503) 535 -2652 Fax: (503) 231 - 3587 Industrial plant per hour 73.75
21i, � ELECTRICAL PERMIT FEES'
CCB Lic.: 203 Electrical Li . /.. = C 1 p. Lic.: 4460S Subtotal S'7 ‘C
Suprv. Electrician signature, required: ■ / Ir >,'_''y•J ,• i Plan review (25% of permit fee)
�e9,r/f vi � ��� V / _ , Date: 97 ,�� State surcharge (8% of permit fee) f '-, 2
Print raarllC: ✓ mss% /'
TOTAL PERMIT PEE _ 7S,
Authorized signatur _ This permit a p pl i catio n uy,ire9 if a permit Is not obtained within 180
_ /�_ / days al er it haB beta accepted at empiric A4/4"4//-
T
Print name: , / � - , �/j//�L ✓ Date: l 2 �� • Fee methodology set by Tri- County Building Industry Service Board
'! •' Nuruber of inspection per permit allowed.
iABuilding1ParniMELC-PermitApp.doc Iv63 440 -06157(10102 /COM/w211
CITY OF TIGARD - 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business.Jitte: :.(503) 639 - 4171
MST
BUP
Received Date Requested _ / 1 1 AM PM BUP
Location 1 cD OL) 7 - 1 ,Q Suite MEC
Contact Person - Ph ( ) PLM
Contractor 7'n- Ph ( ) 4'q 3 SWR
BUILDING Tenant/Owner ELC --Z06 ��� 36
Footing (
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ' ,)
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling r
Roof C f/
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
Q
UG/Slb ^/
Low Voltage 1 /-(1
Fire Alarm
/' a 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS %) PART FAIL
SITE n Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the J ' site.
PASS PART FAIL
i