Permit CITY OF TIGAR® ELECTRICAL PERMIT IN ° PERMIT #: ELC2008 -00556
COMMUNITY DEVELOPMENT D ATE ISSUED: 10/1/2008
,T1GARIJ. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102C B - 03200
SITE ADDRESS: 09975 SW FREWING ST i:e616t£4 ZONING: C -G
SUBDIVISION: MASSIH OFFICE BLDG LOT : 021 JURISDICTION: TIG
PROJECT: MASSIH OFFICE BUILDING
Project Description: (4) branch circuits for 1st and 2nd floor lobby areas.
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:
MASSIH LLC TIMBERLINE ELECTRICAL CONTRACTORS
PO BOX 108 PO BOX 918
BEAVERTON, OR 97075 LAKE OSWEGO, OR 97034
Phone: 503 -544 -9944 Contact #: PRI 503 - 459 -4089
FAX 503 - 254 -4227
FEES
Description Date Amount Reg #: ELE 26 -121IC
IELPRMT] ELC Permit 10/1/2008 $66.80 LIC 160037
[TAX] 12% State Surchar 10/1/2008 $8.01 SUP 4957S
Total $74.81 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 ; :. - A . A TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cente Those rules are set forth in
OAR 9 - 001 -0010 thro = • • 95 - 001 -0100. You may obtain copies of these rules or direct questions to OU ∎ - : t .246.6699 or 1.800.332.2344.
i /
Issu: d By: , 4 : _,!) /`. _I i Permittee Signature: ICON& .i
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: \ .r!/ !� '� ., �" /�/ DATE:
i
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 Applica' 'r - - 0, lOR (rl:lc l: I S►: 0\1.1
Of Tigard Rece ived
City 'A ,�
IN tY /o / g Date/By:
D f Pit N �a"C_ �g-wuS
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
. 1 c; A it i) Inspection Line: 503.639.4175 r , r ' u .; �� - y ri t ; ,� , (, Date Ready/13y: lof ® See Page 2 for
U
Internet: www.tigard- or.gov J` d ' » a Ulf LUi Notified/Method: / f Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Tess to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling �Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
El Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: q q 1 75 50 [Polio? 100HP or more. occupancy.
❑
/ ❑Six or more residential units. Recreational vehicle parks.
/ !
City /State/ZIP: o � . 77223 ❑ Health -care facilities. El Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: Lpt,hif !j Project name: 0 AI !a/Dit..- 4.15 21,(5 ❑ Service or feeder 600 amps or more.
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
D
Limited energy, multi - family ON OF WORK (with above sq. ft.)
// i
SCUPTI
L 64/T/CQ ,0764s'1e - ti ei / - gl l residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
•
200 amps or less 80.30 2
..7PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
i / 401 amps to 600 amps 160.60 2
Name: L- 601 amps to 1,000 amps 240.60 2
Address:- Po boy 1 Q Over 1,000 amps or volts 454.65 2
City / State/ZIP: b i. 9.-7 6 75 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (50 5 Li LI - ss yi 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 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, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT I 0 CONTACT PERSON above service or feeder fee, 6.65 2
Business n e p � � � 'w /n� / each branch circuit
�� X11.2, 91.. � �A�. I.0 n , B. Fee for branch circuits �Q/��
Contact name: without service or feeder fee, ) 46.85 '� 8.5 2
first branch circuit
Address: Each add'l branch circuit 3 6.65 j . 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 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
•
Business name: 1 4.9_, 2'5 C ' , "`"'vvv • i r a d Signal circuit(s) or limited -
rrr tt' energy panel, alteration, or
Address: Pd t W g extension. Describe: Page 2 2
City/State/ZIP: C w �- D / b' 7 74 t3 V Each additional inspection over allowable in any of the above
5 - lid eq Fax: 5 3 / � 5 _ 4227 Per inspection 62.50
Phone: (
�J U J 4'tJ � � Inve per hour (1 hr min) 62.50
CCB Lic.: 16603-7 Electrical Lic.: - Y• , d, Suprv. Lic.: i.(G) g . 7 s) Industrial plant per hour 73.75 _
Suprv. Electrician signature, required: f I I ELECTRICAL PERMIT FEES 1 /
Subtotal: et r se
Print name: ' L1, 1 (� i� d u Plan review (25% of permit fee):
Date: `� 3 - . O V
State surcharge (12% of permit fee): X .0 1
Authorized signature: 57 TOTAL PERMIT FEE: fl ", g/
�a u L S: Date: /�
Print name: h it, This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
CI „.-- ARD
BUILDING DIVISION PERMIT #: ELC200300666
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1/200tf
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'. 1. L
INSPECTION WORKSHEET FOR DATE: 1/7/2009 TIME: 7.01AM PAGE: 27
SITE ADDRESS: 09975 SW FREW ST LOBBIES CLASS OF WORK:
SUBDIVISION: MASSIH OFFICE BLDG LOT #: 021 TYPE OF USE:
PROJECT NAME: MASSIH OFFICE BUILDING
DESCRIPTION: (4) branch circuits for 1st and 2nd floor lobby areat...
OWNER: M ASSIH LLC, PHONE #: 503 -644 -9914
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 's0 - 469.4089
Inspection Request Scheduled For: Date: •1/7/20()9 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 079451 - 01 603.313 -0331 N
Corrections /Comments /Instructions:
\ ----___J
\
\\
\ /
Ut r
/V \
ASS ❑ PARTIAL APPROVAL ❑ CANCEL . ❑ NO ACCESS
AIL C ALL FOR INSPECTION ADD FEES ASSESSED
n ❑ i
Inspector: Cr u V 6 6 I.e Date: Phone #: (503) 718- a-4 (41
CITY OF TIGARD
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BUILDING DIVISION
Oh" PERMIT #: ELC2008-00556
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1/2008
Phone: (503) 639-4171 „ii_alit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/612008 7:OOAM 29
SITE ADDRESS: 099 SW FREWING ST LOBBIES CLASS OF WORK:
SUBDIVISION: MAS111 OFFICE BLDG LOT #: 021 TYPE OF USE:
PROJECT NAME: MASSIll OFFICE BUILDING
DESCRIPTION: (4) branch circuits for 1st and 2nd floor lobby areas.
OWNER: MASSIH LLC, PHONE #: 503-5149944
CONTRACTOR: TIMBERLINE ELECTRICAL. CONTRACTORS PHONE #: 503
Inspection Request Scheduled For: Date: 1O/&2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 El ect rival rough-in 076318-01 --' 503-849-8804 N
Corrections/Comments/Instructions:
---__
. _
PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
0 FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G 1\10Q, (....e Date: 11)1 6ii• Phone #: (503) 718_1046