Permit ' CITY OF TIGARD ELECTRICAL PERMIT
• A PERMIT #: :00364
DEVELOPMENT SERVICES DATE ISSUED: /8/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136DD-04100
SITE ADDRESS: 11850 SW 67TH AVE ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT : 007 JURISDICTION: TIG
Project Description: Building 1.
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: 95 PER INSPECTION:
201 - 400 amp: 7 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: 1 > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: X CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC NW PROPERTIES CAPITOL ELECTRIC CO INC
ATTN: PAUL GRAM 11401 NE MARX ST
P.O. BOX 2206 PORTLAND, OR 97220 -1041
BEAVERTON, OR 97075
Phone: 503 - 626 -3500 Contact #: PRI 503 - 255 -9488
FAX 503 - 257 -7121
FEES
Description Date Amount Reg #: ELE 26 -496C
[ELPRMT] ELC Permit 9/7/2006 $1,834.35 LIC 48748
[ELPLCK] ELC Pln Rev 9/7/2006 $454.59 SUP 3132S
[TAX] 8% State Surcharge 9/7/2006 $146.75
REQUIRED ITEMS AND REPORTS
Total $2,435.69
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 By: 304 g4d.C4) Permittee Signature: /� )
1
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 Application • FOR OFFICE USE ONLY
City f Tigard REU{ L�` IvE® Received
y g Date/By: r � � PermitNo '1 -'003 / 13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev oC C? lOT Phone: 503.639.4171 Fax: 503.598.1960 JUN 2 6 200 t � ro � ' � I � Date/By: 7
� %10le Other Perini . w
Inspection Line: 503.639.4175 !� ^'' I . Date Ready /By: f // Juris: ® e Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGA a Notified/Method: _� U Supplemental Information
'1l VI?, : _ �� ` �,
�, TY' t, aI r�+ ^y' 6 PLAN REVIEW
New construction ❑ A ddition /alteration replacement P lea check all that apply: # �
❑Demolition ❑Other: ervice over 225 amps, comm'1 ❑Hazardous loca ',
['Service over 320 amps - rating lilguildng over 10,000 sq. ft.,
CATEGO Y OF CONSTRUCTION - of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 - family dwelling Commercial/industrial ❑ Accessory building ['System over 600 volts nominal r� Weeders, s in one structure
El Multi - family ❑Master builder ❑Other: ❑ Building over three stories ceders, 400 amps or more
[Eccupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND ;LOCATION " _ [ gress/lighting plan RV park
El Health-care facility ['Other:
no.: Job site address: // 8s 5". 6 7n t 1,l E Submit 2 sets of plans with any of the above.
City/State/ZIP: /' SRtzt) OIZ 3__ The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name F FEE* SCHEDULE
I I: Li ,-�
N>C t ''• 1 Description 1 Qty. I Fee. 1 Total I **
Cross street/directions to job site A New residential single- or multi - family dwelling unit.
Includes attached garage.
_ t MTh N - 5vJ 6 ET 14 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK - . . . Each manufactured or modular
t dwelling, service and/or feeder 90.90 2
NeDi t��-> i Ca .t�.1 t (ALNci F a- Cf -tAe, SeTtM£
12u Services or feeders installation, alteration, and/or relocation
1
J 200 amps or less 80.30 2
201 amps to 400 amps 7 106.85 14795 2
PROPERTY " OWNER x y .. ❑ `TENANT 401 amps to 600 amps 160.60 2
Name: T ti-cA F 45 4 �� 601 amps to 1,000 amps 240.60 2
Address: 66000 51N 105 /1/4 S 1,r 17S Over I,000 ampsorvolts 1 454.65 ySy.6$ 2
e Reconnect only 66.85 2
City /State/ZIP: N ) `---' R. 17o es Temporary services or feeders installation, alteration, and/or
1,s3) Fax: relocation
Phone: (5
10210 S Soo ( �� to 7 - Dv(
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
`.: "- 0 APPLICANT c_`.1 , ❑ CONTACT ,PERSON- A. Fee for branch circuits with
service or feeder fee, each 95 6.65 631.15 2
Business name: mtc.„1,0.. t 5 / _ -, p branch circuit
fi O" 1 , B. Fee for branch circuits
Contact name:sJ Vet without service or feeder fee, 46.85 2
Address: irst branch circuit
710 !� a � t� 1�L11h1b Si . I Sv 1'r� f ZO Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
1 i.o ! (")IL 4 '7 -7
Phone: (vrc ) 2.4 .4._ - O SSZ [ Fax: : (,4 ) 244_ 04_,-/ Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: DA ( M'DC. PC. • CO Wt Signal circuit(s) or limited-
' ,....,:___LITRACTOR ; - , i s .i - - energy panel, alteration, or
• - extension. Describe: Page 2 2
- Business Name: CAPITOL ELECTRIC CO., INC. .
-
/. . Each additional inspection over allowable in any of the above
Contact name: �
- Per inspection 62.50
---- 6 4 ( Investigation per hour (I hr min) 62.50
- Address: 11401 NE MARX ST. .k� -
Industrial plant per hour 73.75
- City /State /ZIP: PORTLAND, OR 97220 -1041 V" - - -` ELECTRICAL PERMIT FEES*
Subtotal 1 35
Phone: 503- 255 -9488 Fax: 503 - 257 -7121 p
_ _ _ Plan review (25% of permit fee) L, 51 5 t
- CCB Lic.: 48748 lElectricLic.: 26 -496C ISuprv. Lic.: 3132 -S -
State surcharge (8% of permit fee) 1 4 161 5
- Suprv. Electrician signature, required:• tA/lA )1/\ / : I - TOTAL PERMIT FEE 21435. 6
Print Name: DAB ELL MCN Date: 08/31MB This permit application expires if a permit is not obtaintd w3
Authorized signature: j/' /t �s days after it has been accepted as complete
/� v "`- N * Fee methodology set by Tri- County Building Industr."
-
Print Name: DAR MCNEEL - ** Number of inspections per permit allowed.
is \l3udmngvcru. ..L- rcrmnnpp.doc I 03 440 - 461ST( I0 /02/COM/WEB
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELC200&.00:364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8 /2006
Phone: (503) 639 -4171 Aroottp
Inspection Requests (24 Hrs.): (503) 639 -4175 s'_ 11 .I,.
INSPECTION WORKSHEET FOR DATE: 5/2/201;7 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1.
•
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503-626-3500
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503. 255.9486
Inspection Request Scheduled For: Date: 5/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/slab rover 047500 -01 971- 506 -3495 �Y
Corrections /Comments /Instructions:
w `7 ‘i40g. pARY%-it% Lb7 1,70:1,44r,
❑ PASS
A
ARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL . (I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr t 6e Date: 6j 61 Phone #: (503) 718- 2 414
CITY - OF TIGARD
BUILDING DIVISION • PERMIT #: EL.C200S- 00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 918/2006
Phone: (503) 639 -4171 / ,u� 1
Inspection Requests (24 Hrs.): (503) 639 -4175 s': R''�.
•
INSPECTION WORKSHEET FOR DATE: 4/2512007 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE - COMMONS
DESCRIPTION: Building 1.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503-626-3500
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 - 255 -94883
Inspection Request Scheduled For: Date: 4/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/slab cover 047110 -01 971 - 506 -3495 N
Corrections /Comments /Instructions:
Stc<.v � - s, L \ AT; p �� �
•
►11 PARTIAL APPROVA 7 CANCEL f NO ACCESS
[7f FAIL - ' SPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ��. NND ` — Date: 4 Phone #: (503) 718 - 1.41p,
CITY OF TIGARD `='...
BUILDING DIVISION PERMIT #: ELC200G- 00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2016
Phone: (503) 639 -4171 ��� , ... ° �' �'I I et
Inspection Requests (24 Hrs.): (503) 639 -4175 : i
INSPECTION WORKSHEET FOR DATE: 12128/2006 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: :4`
OWNER: PACIFIC NW PROPERTIES, PHONE #: 6036263500
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503255.9488
Inspection Request Scheduled For: Date: 12/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/slab cover 041580 -01 971- 506 - ,Y
PNR
Corrections/Comments/Instructions: eL CtX I 1 C 2
■
2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
N L' ., t,
Inspector: Date: 2' 04) Phone #: (503) 718- �1
CITY OF TIGARD
BUILDING DIVISION • PERMIT #:
ELC2I:IO6-00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2006
Phone: (503) 639 -4171 C
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/20/2006 TIME: 7 :OOAM PAGE: 33
SITE ADDRESS: 1.850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 .
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503- 626.35O()
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 - 255- 94138
Inspection Request Scheduled For: Date: 12/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Undergroundfslab c:over 041324 -01 971- 505.3495 N
Corrections /Comments/ Instructions:
QAlZ a A L U n) fa^ak, 5 LAG Aypps'
fl PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . N 6� t2 Date: r 40.0 Phone #: (503) 718- 2,11410-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 : ' ,
INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:00AM PAGE: 5/
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503-626-3500
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503- 2Ei5.94138
Inspection Request Scheduled For: Date: 8/2412007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054589 -01 971-506-3495 N
Corrections /Comments /Instructions:
sue. N`r J� G�ANfi., 0 J 1:1112 6011 -bl N i 0,1 e f2 6
k:
,PASS I 1 PARTIAL APPROVAL CANCEL fl NO ACCESS
n FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: C Date: g• 2' ' O Phone #: (503) 718- 2,t4j ('
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC2006.00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2006
Phone: (503) 639 -4171 '�L
Inspection Requests (24 Hrs.): (503) 639 -4175 _ -
INSPECTION WORKSHEET FOR DATE: 7/11/2007 TIME: 7:01AM PAGE: 35
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626 - 3500
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 - 255 -9488
Inspection Request Scheduled For: Date: 7/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 051806.01 971 - 506.3496 N
Corrections /Comments /Instructions:
4 4b6v . will.) Q o L. .
zoorv\ of a PE ►L . R
C■ 1 CI ' if• 0 1 To ciskj2?_ .
n PASS yj PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C9' i t Qe Dater 11 I I 01 Phone #: (503) 718 - .1-1-14/Q