Permit CITY OF T'IGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98 -0346
t vriOi I '( ( DATE ISSUED: 06/5/98
J10- _ _ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
PARCEL: 1S136DA -00100
SITE ADDRESS••.:11308 SW 68TH PKWY
SUBDIVISION ZONING:MUE
BLOCK • LOT • JURISDICTION: TIG
Pro.j ect Descr : Providence Tigard Data Center
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 1
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)..•: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION : 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR : 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
BENENSON CAPITAL COMPANY type amount by date recpt
708 3RD AVE PRMT $ 40.00 JSD 06/25/98 98- 306844
NEW YORK NY 10017 5PCT $ 2.00 JSD 06/25/98 98- 306844
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 42.00 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'l Service
Phone #: 234 -9900 Wall Cover Elect'l Final
Reg #..: 203
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 folio the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952 -001- 4:7. You may obtain a copy
of these rules or direct questions to '�. by ca,linn 503)246 -1987.
1 ' !// "Si.
Permittee Signature: �,11j /a t, , ,/Li / , ssu ed 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 : DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Chec i
13125 SW HALL BLVD. Rec'd By p
TIGARD OR 97223 Date Rec'd 106, -'Li✓ 5
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST o
Inspection (503) 639 -4175 Print or Type Permit # 1 - C ' ( - V ,
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Tigard Data Center Number of Inspections per permit allowed
Povidence
1
Name (or name of business) Tigard Da Center Service included: Items Cost Sum
Address 11308 SW 68th Pkwy 4a. Residential - per unit
1000 sq. ft. or less $110.00 - 4
City /State/Zip Tigard OR 97223 Each additional 500 sq. ft. or
❑ portion thereof $25.00 1
Commercial 13 Residential -
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Oregon Electric Group Installation, alteration, or relocation
Address 1010 SE 11th Ave.
200 amps or less $60.00 2 -
201 amps to 400 amps $80.00 2
City Port 1 and . State Oregn Zip 97714 401 amps to 600 amps $120.00 2
-
Phone No. 5n3 234 601 amps to 1000 amps $180.00 2
Job No h 01 7 7 Over 1000 amps or volts $340.00 2 -
Elec. Cont. Lice. No. 26 -95C Exp.Date Reconnect only $50.00 2 -
OR State CCB Reg. No. 203 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No 1995 Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
E,d.„AA.,e 2 01 amps to 400 amps $75.00 2
Signature of Supr. Elec n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Xfi 2841S Exp.Date see "b" above.
Phone No. 934 -9900
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
-
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required) :* Signal circuit(s) or a limited energy
panel, alteration or extension 1 $40.00 4n _ on 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ 40.00
5% Surcharge (.05 X total fees) $ 7.00
NOTICE Subtotal $ 42.00
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24- Hour - Inspection Line: 639 -4175 Business Line: 639 -4171
0(DIgg BUP
Date Requested AM PM BLD
/
Location 1 / <3O S 4 Suite MEC
Contact Person Con t s PLM
Contractor Gfe✓ �-lz� , ��U Ph ,23 47- 99,9::; SWR
BUILDIN c� a
/ ELC / 0 ` c) 3 �[ / -�
BUILDING � t/Owner � �)''7
Retaining Wall ELR
Footing
Foundation 5 c , (� � rn _ `n 9 - FPS
Ftg Drain V SGN
Crawl Drain Inspection Notes: f�
Slab a-- 7N9 SIT
Post & Beam / • /
Ext Sheath /Shear J °' i 0 O f 7 Z
Int Sheath/Shear
Framing
Insulation ). r
Drywall Nailing _ � ... i& .i . - .A
Firewall - i
Fire Sprinkler �.� L•f,�'
Fire Alarm
Susp'd Ceiling
Roof
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
PASS PART FAIL
ELECTRICAL
Service
pit
Rough In •
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART 411:0
SITE
BackfilUGrading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other D ate / Z.— 97 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.