Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00199
>�I11 DEVELOPMENT SERVICES DATE ISSUED: 4/8/03
'___. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1S136DA-00100
SITE ADDRESS: 11308 SW 68TH PKWY
ZONING: MUE
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (44) branch circuits. Job No. 19425 to disconnect and reconnect electric system
furniture, rework circuits, and new power poles.
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: 43 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:
BENSON CAPITAL OREGON ELECTRIC CONST /GROUP
1708 3RD AVENUE 1010 SE 11TH AVE
NEW YORK, NY 10017 PORTLAND, OR 97214
Phone: Phone: 503 - 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 4/8/03 $332.80
[TAX] 8% State Tax 4/8/03 $26.62 Rough -in
Elect'l Final
Total $359.42
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. AV
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:
Z41&.___________
Permit Signature: d/✓ lf—/ev'z_.-/ e- —77
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: fly 4-600, /49-7 N DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
,
-l 16:26 FROM- T -628 P.001 /002 F -785
- I • r • %ow
E Pelrmit Applic - 'o OFFICE USE ONLY
City of Tigard G�� Date received: y y 0.3 - Permit no.:EGC2oo3 — DD /9_,
13125 SW Hall Blvd Re Project/my!. no.. Expi date:
4,1 ?_l.' . Phone: (503) 639-4171. FAX: (503) 598 -1RO� A 'tit \ Date issued: B Receipt no.:
Internet address: www.ci•tigard u 4 Case file no.: ` Payment type:
24 Ins • - ction Re • tie • , :i„' R: 2 ',ADO 3 - / r c.
1' (PL aF FER IT
❑ 182 family dwelling or accessory 0 T r ,-,i, t \, " a 0 Multi-family ❑ Tenant improvement
O New construction • • . !f teratiorrheplacement CI Other, ❑ Partial
JOB SITE INFORMATION
Job Address: 11308 SW 68th P Tit rd Bld • . No.: Suite no.: 125 Tax ma -flax lot/account no.:
Lot Block: Subdivision
Pro ac t Na Description and location of work on premises: disconnect and reconnect elect system furniture.
Estimated Date of co • letion/iins • action: — • 1 i / ! F/V C rework circuits. new • - r • tiles
Will .0 call for Ispeotion within 24 hours? Yes x No
CONTRACTOR APPLICATION r =E S C IEDULc • no.
Job No.: 19425 DeecrlptIon Qq Foe es.) Total rote
- ..hash - •:or
multi-family per dwelling
Business name: Oregon Electric Group unit. Includes attached
garage. Service Included:
Address: 1010 SE 11th Ave. 1000 in ft or loss 5 145.00 $ - 4
Ci : Portland State: OR Z.: 97214 Ea Addl 500 SF or Portion $ 33.40 $
Phone: 503 234 -9900 Fax: , s 234-1 001 E -mail: union Enemy,1 a z Para 5 75.00 $ - 2
CCB no.: 203 Elec. bus. lie. no.: 26-95C united Energy, MA $ 75.00 $ - 2
!s / y= ro Ile. No. Each manufactured home or
( ' ^' , modular dwelling. Service
/ u , : . . .11/ r :, n,, .....^ i ..:: 4/412003 and/or feeder. S 90,90 $ - 2
1 � Service or Feeders •
/ Su .. Elect. ?.u3G WAIIIM License no: 44605 installation, Alteration er
Rah:mark:We
PROPERTY OWNER 200a ..sorte>w 5 60.30 $ - 2
Name (print) 2018mps- 400an1ps 5 105.85 $ - 2
Mailin • Address: 401 • 600amps $ 160.60 $ - 2
City State: Zp: eolamps- 1000amps _ $ 240.80 $ - -
Phone: Fax: E-mail over 1000A or Volo 5 454.85 $ • 2
Owner Installation; The installation is being made on property I own which is Reconnect Only $ 6686 $ T emporary ,
$cM or
not intended for sate. lease, rent. or exchange according to ORS 447, 455. Ponders • Installation,
479, 670, 701. Alteration or Relocation:
Owners sl nature: Date: 200 amps or lees 5 66.85 $ - 2
201amps- 4e0amps $ 100.30 $ - 2
Name: Over 401amps- 800alnps $ 133.75 $ - 2
tlr2Ae11 circuits - New,
Address: Alteration or Extension Per
Panel: A. Foo *branch
St: State: 21.: circuits with purchase of service
or feeder foe. each branch
Phone: Fax: E -nail: circuit 5 6.65 $ -
B. Foo for branch circuits
wiOut Purchase of $ervico or
PLAN REVIEW Feeder. lst Branch Ckt 1 S 45,85 $ 46.85 2
O Service over 225 amps-comm 0 Health -care facility Each additional branch dreutt 43 5 8.65 $ 285.95
0 Service over 320 amps- rating of 0 Hazardous location Mtscallaneou$ - (SOrvlce or
feeder not included)
182 family dwellings 0 Building over 10,000 square Feet four or Each pump orinloalon circle $ 53.40 $ - 2
O System over 600 volts nominal more residential units in one swcture Each Sigh or Outline lighting $ 53.40 $ - 2
0 Building over three stories 0 Feeders. 400 amps or more Signal Cli uLK•) or umlteo Energy
Panel Alteration or Extension -
O Occupant load over 99 parsons 0 Manufactured structures or RV park _ $ _ 2
0 Egress/lighting plan 0 Other: - "Description: -
'� // e rCi Each Addlt ar inspection over
o
�'� �� f L 0,c,16.- r
a r be mewaef � f n an oof the -
/ L� 1/ A _ 5 62.50 5
submit 17 / €e / t s of Plasm with achy Of to above. In"mli0atien f
— The shove are not applicable to temporary construct on service. Other
Notice: This punt* application Permit Fee $332.80
vrphos If permit is not Plan review 25% $0.00 ( f /
obtained within tee days after it State Surcharge 8% 526 62
has been accepted= $25962
coorpfete. Total
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 •
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 1 7 / ' /O AM PM BUP
Location / 1 3 O 6 g- Suite MEC
Contact Person s' -1-1( ) Fe-1-5-.01-7g7 PLM
.—
Contractor ' Ph ( ) $�'"I �-(37 SWR
BUILDING Tenant/Owner ELC 3 -131 d (
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fi : Alarm
'yam Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'A PART FAIL
SITE Please call for reinsp . ction RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / a Insp Ext
Final D ' OT REMOVE this inspection record from the site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requeste - 7 /D AM PM BUP
Location 1 30 p � " "'" C VA..) Suite MEC
Contact Person Ph ) 34- Al g7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 00 I 9
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer ,k (,Q. o f " j ) ,
Rain Drains �'
Catch Basin / Manhole f � I 4 l f e d o CO ''1 h er
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fir: • .rm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'PASS . ART FAIL
Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date 7 — � 0 — d3 I ns p e ctor ? Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL