Permit •
CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00649
41?'. DEVELOPMENT SERVICES DATE ISSUED: 11/01/1999
— - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DA -00100
SITE ADDRESS: 11308 SW 68TH PKWY
SUBDIVISION: ZONING: MUE
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Install 2 branch circuits in existing commercial building.
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:
BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP
KEYLLC,THE
1010 SE 11TH AVE
BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214
WORCESTER, MA 01615
Phone: Phone: 234 -9900 •
Reg #: LIC 203 ORIGINAL
SUP 1302S -
ELE 26 -95C •
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT KJP 11/01/1995 $42.85 99- 319446 Elect'I Final
5PCT KJP 11/01/199£ $3.43 99- 319446
Total $46.28
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE `�yt G � ISSUED BY:
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: Oti`' DATE:/// /9,9
LICENSE NO: .2.3
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application
PlanChedc#
13125 -SW HALL BLVD. Rec'd By
TIGARD OR 97223 RECOVE0 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304
Date to DST
Inspection (503) 639 -4175 0C , T 2 81999 Print of Type Perms �L L. /y 5 - oa�1f
Fax (503) 598 -19 60 Called
� MM � N1 1 Y Do EIA iplete or illegible will not be accepted
1. Job Address: / /2 q41 4. Complete Fee Schedule Below:
Name of Development_ Tigard Data Center Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum 4 '
Address 11308 S W 68th Parkway 4a. Residential - per unit
City /State/Zip Tigard, Or 97223 woo sq. ft. orless $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial ® Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
- -(Prior to permit issuance, applicants must provide contractor license- - 4b. Services -or Feeders - - - -- -
information for COT data base). Installation, alteration, or relocation
Electrical Contractor Oregon Electric Group 200 amps or less $ 64.25 2
Address 1 01 0 sr. 1 1 t h A VP 201 amps to 400 amps $ 85.50 2
City Portland State OR Zip 9 7214 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. 234-9900 Over 1000 amps or volts $ 363.75 2
Job No. 831.3 9 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 2 6- 9 5 C Exp.Date I0/ / I 4c. Temporary Services or Feeders
OR State CCB Reg. No. 2 03 Exp.Date 7 1/ Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n /�; " /7' 401 amps to 600 amps $ 107.00 2 ,0.9 1
Over 600 amps to 1000 volts,
License No. 2841 S Exp.Date /eh /1.200/ see °b" above.
Phone No. 234- 9 9 0 0 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase ofservlce
City State • Zip or feeder fee.
Phone No. First branch circuit $ 37.50 3 7.5 0
f
Each additional branch circuit $ 5.35 b • -5 5
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
panel, alteration or extension $ 60.00
3. Plan Review section (if required):* Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Per inspection $ 50.00
Service and feeder 225 amps or more Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 4 2 . 8 5
* Submit 2 sets of plans with application where any of the above apply. 8%1% Surcharge (.09X total fees) $ 3 - 4 3
Not required for temporary construction services. Subtotal $
Sb. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 4. (0.2$
1: \dsts \forms \electric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 6394175 Business Line: 639 -4171
BUP
Date Requested � AM PM BLD
Location 1319e £W Suite sI MEC
Contact Person Ph ew �a `f7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC /99 '"" 1Dee<i -I
Retaining Wall ELR
Footing Access:
Foundation i' FPS
Ftg Drain
SGN
Crawl Drain Inspection Notes:
-
Slab ` SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall ./4tiC- /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
CC)
Roof Q
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PAS T FAIL
ECTRICAY
Rough In
UG /Slab
Low Voltage
Fire Alarm
A S PART FAIL
E
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other D ate ?-0 / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.