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Permit
C ITY OF T I GAR D ELECTRICAL PERMIT PERMIT #: ELC2005 -00353 ..Ih l DEVELOPMENT SERVICES DATE ISSUED: 7/14/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1 S136DA -00100 SITE ADDRESS: 11308 SW 68TH PKWY 2ND FL ZONING: MUE SUBDIVISION: LOT : JURISDICTION: TIG Project Description: Elec. upgrade east computer room, (1) 1200 amp feeder, plan page no. E7.01. Job No. 13224 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: 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: CLASS AREA/SPEC OCC: Owner: Contractor: BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP KEY LLC, THE 1010 SE 11TH AVE BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214 WORCESTER, MA 01615 Phone: Phone: 503 - 234 -9900 FEES Reg #: LIC 203 SUP 4460S Description Date Amount ELE 26 -95C [ELPRMT] ELC Permit 7/13/2005 $454.65 [ELPLCK] ELC Pin Rev 7/13/2005 $113.66 REQUIRED ITEMS AND REPORTS [TAX] 8% State Surcharge 7/13/2005 $36.37 Total $604.68 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 f re than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules set forth in 952 -001 -0 10 through OAR 952 - 001 -0100. You may obtain copies of thesei{es or direct questions toOUNC at 50 - 246 -6699 or 1 -800 -3 . I ued By: Permittee Signat �-�-� 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: S/e/ 5 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 m� �` FOR OFFICE USE ONLY City of Tigard` d t � L� t / Date/By: a(p � PemtitNo.:C� — Q ® '3J3 13125 SW Hall Blvd., Tigard, OR 9 / 3 � Y Plan Review / j (y 6 2 5 2005 /� x s; d 1 p OS� Other Permit: Phone: 503.639.4171 Fax: 503.59 .19 0 ii�yh' ' i "'I Date/By: Inspection Line: 503.639.4175 i Date Ready/By: L " g Juris: El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notitiied/Method: TI Cl Supplemental Information DUILmp t3i,vi / 4 qi :4tt i /�y�s PLAN REVIEW ❑ New construction ® Addition/alteration/replace e {/'r[ Pl check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'1 El Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY. 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 units in one structure ❑ Multi family ❑ Master builder ❑Other: ['Building over three stories ES/Feeders, 400 amps or more ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: 13224/ I Job site address: 11308 SW 68 Parkway ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City/State /ZIP: Tigard, OR 97224 0-vL w__A�i.-1 dl n The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: 1 Project name: TDC Comp Rm Upgr. Ph 1 &H r,„ FEE* SCHEDULE �Dacript:on I Qty. 1 Fee. I Total I ** Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less J 145.15 4 Subdivision: Lot no.: Ea. add'l 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 Upgrade of East Computer Room le- 6 L l� ‘,": , � pd 4.4N, service and/or feeder 90.90 2 r+^ Services or feeders installation, alteration, and/or relocation 7,0 / ' ', ' / / i 200 amps or less _ 80.30 12 El PROPERTY OWNER I U TENAPi1 1 201 amps to 400 amps 106.85 1 2 401 amps to 600 amps 160.60 2 Name: Providence Health System 601 amps to 1,000 amps 240.60 2 Address: 11308 SW 68 Parkway Over 1,000 amps or volts / 454.65 £, 5 44S 2 Reconnect only 66.85 2 City/State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel 0 APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: Oregon Electric Group branch circuit p B. Fee for branch circuits Contact name: John Vitro re. // 5 0 ;� c 1 .1` q - Z 7 - 6 without service or feeder fee, Address: 1010 SE 11 Ave each branch circuit 46.85 2 Each add'l branch circuit 6.65 , 2 City/State/ZIP: Portland, OR 97214 Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (503) 849 -2787 I Fax: : (503) 234 -1001 Sign or outline lighting 53.40 2 E-mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: Oregon Electric Group Address: 1010 SE 11th 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 hr min) 62.50 , Phone: (503) 234 -9900 I Fax: (503) 535 -2763 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 203 I Electrical Lic.: 26 -95C I Suprv. Lic.: 4818S Subtotal V5 y. y. 6o S Suprv. Electrician signature, required: C i� Plan review (25% of permit fee) / / 3 . /o (O Print name: �f �/ Date: 5/25/05 State surcharge (8% of permit fee) ( 5(p . 37 ' ` a/rt 6 Ue'n p er/C F — TOTAL PERMIT FEE 60 Authorized signature: S / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Adj GI/e7/7,'1P.I1q/ /---- Date: 5/25/05 • Fee methodology set by Tri-County Building Industry Service Board ** Number of inspections per permit allowed. i:\Building\Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB - 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2005 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 111 SITE ADDRESS: 11308 SW 68TH PKWY 2ND FL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PROVIDENCE DATA CENTER DESCRIPTION: Elec. upgrade east computer room, (1) 1200 amp feeder, plan page no. E7.01. Job No. 13224 OWNER: BENENSON 68TH PARKWAY, PHONE #: CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503. 535-2652 Inspection Request Scheduled For: Date: 11/10/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 020634 -02 503 - 849.2787 N Corrections /Comments /Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /1 -S Phone #: (503) 718- r ' CITY OF TIGARD • BUILDING DIVISION = ' PERMIT #: ELC2005 -00353 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2005 Phone: (503) 639- 4171u . Inspection Requests (24 Hrs.): (503) 639 -4175 `�_.. INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 61 SITE ADDRESS: 11308 SW 68TH PKWY 2ND FL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PROVIDENCE DATA CENTER DESCRIPTION: Elec. upgrade east computer room, (1) 1200 amp feeder, plan page no. E7.01. Job No. 13224 OWNER: BENENSON 69TH PARKWAY, PHONE #: CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503-535.2652 Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 018604 -01 503.949 -2787 N Corrections /Comments / Instructions: Li Hic011 SE Cm R -11 4-t `P 1 rA E . �5 - nniNS LAiS GL, rAATI N . CI-AG u NJ Sv ZE" q�� mp .. o - t k ©uGL PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ AL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r l/ ' Date: 16 / Jqar - Phone #: (503) 718- 211q()