Permit - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00633
l
e l DEVELOPMENT SERVICES DATE ISSUED: 10/15/03
� 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: JOB NO. 19615 Work is located in the mail room
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: 24 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 10/15/03 $206.45
[TAX] 8% State Tax 10/15/03 $16.52 Wall Cover
Elect'I Service
Total $222.97 Elect'I Final
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: ���-7nj _ Permit Signature:
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:OOpm for an inspection the next business day
OCT -02 -03 07 :34AM FROM-Ore .a- ,r• l; -.•I• 5032313587 T-868 P.001 /002 F -674
N. Electrical • - • • Or anion OFFICE USE ONLY
City of Tigard G fl 2 2003 Date received: Permit no.:Ekatoy2,- ct• 3
13125 SW Hail Blvd Prolect/appl. no.: Expire date:
. _.,J.,.;- i .j!!,1 Phone: (503) 639 -4171, My ‘ -p tam bate issued: By: iReceipt no.:
Internet address: ' - . 5mneulm Case file no.: Payment type: ___
24 -Hour Inspectio - 75
D 182 family dwelling or accessory IA Commerdal/Industrial u Multi-family 0 Tenant improvement
❑ New construction O addition/alteration/ :cement 0 Other . ❑ Partial
JOB SITE INFORMATION
Job Address: 11308 SW 6801 Parkwa Bid No.: Suite no. �, Tax map/tax lot/account no.:
Lot: Block: Subdivision Yl aft ((c, -l''
Pro ect Name: 71: and Data Center Des - - • tion and location of work on • remises: Mail room rem IS Staffing expansion
Estimated Date of corm • letion/ins • action: _
Wrtl ou call for ins. - ction within 24 Figure? Yes • No O ProJea Contact John Vitro 503 849 - 2787 Phone
CONTRACTOR APPLI:;ATION FEE SCHEDULE
,. x no.
Job No.: 19615 Description Qty Fee tea) Toni Ircp
NOW resIOaM -24ngle or -
Business name; Oreoon Electric Group lncma� chchedgar unit,
Service Included:
Address: 1010 SE 11th Ave. - 100o 5 ft. o, less $ 145.15 $ • 4
City: PortlandrState: OR Zip: 97214 Ea AddI500 SF or Portion s 59.40 5 - 1
Phone: (503) 234.9900 Fax (50 294 -1001 1E-mail: _ Limited Enemy. 1 a 2 FaMiy s 75.00 $ • 2
CCB no.: 203 Elec. bus. lie, no.: 26-95C umuod Enmpy, r,aed -Earner 5 >5,00 $ s
City/metro tie. NO.: 1
Each manufactured home or
/ modular dwelling. Service
,A>•norr, ,/ . •r / �"
. '•. •.4 n, Pit - . 0/212003 .andror toodor, 5 90.90 5 - 2
■ 4 Service or Feeders
Su.. - ct. Name :y t :M rk Kenne .- , -- nse no: 4460S Installation, Alteration Or
Raldeation:
PR•P =,w r" •WNER 200 amps orreas 5 60.90 $ - 2
Name (pllnt): 201ampa- 400ampa S 106,65 5 - 2
Mailin, Address: 40lamps Maws S 160.60 $ - 2
Coil . State: ZI • : 6olamps 1000amps _ S 240.60 S - 2
Phone: Fax: E over 10o0A or Volts S 454.65 $ - 2
Oniy
Owner Installation: The installation is being made on property I own which is T R mporary se rvloes or S 56 $ - 1
e
not intended for sale, lease, rent, or exchange according to ORS 447, 455, Feedsera _ i nsu g a d on.
479, 670, 701. Alteration or Relocation:
Owner's signature: __ __ Oaten . ZOO •aor1oss $ was $ - 2
ENGINEER 2olamps- 400amps E 100ao S - 2
Name: ever 401ernps- 600amps S 133.75 , $ - 2
Branch Circuits - New,
Address: Alteration or Extension Per
Parrot A. Fee for branch
City: State: Zip: drwlta with purttass of service
or feeder Poo. each branch
Phone: Fax: E -mail: circuit 6.65 $ - 2
B. Fee for branch circuits W/Out
Porch= or Service or Feeder.
P R VIEW 1st Branch Ca 1 S 46.35 $ 46.85 2
0 Service over 225 amps -comer ❑ Health -lore facility Each additional Wendt circuit 24 5 6.65 $ 159.60
O Service over 52c amps-rating of 0 Hazardous location miscellaneous - (service or
feeder not Included)
1812 family dwellings 0 Building over 10,000 square feat four or Each pump orirricedon circle S 6340 S - 2
o System over 600 volts nominal more residential units in one struCture Each Stan or Outline UOhtinO 5 53.40 S - 2
0 Building over three stories O Feeders, 400 amps or more Signal CZtarit(s)orLimited Energy
Panel Alteration re Extension*
la Occupant bad ovc r 99 person:. O MSnufecNned structures or RV park _ S 75,00 S • 2
0 Egress/lighting plan 0 Other. •Desertpenn:
Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. Each Additional Inspoctfon over
the Altowabto in onyoe
Nodes: WA pone! applleanon
Above. Per Inspect ti .
amass lra permit is not S 6250 $ -
06tslned within •/ao days auror lnva 6 Izon roe
has boon ecc prod as template. 'Other
Permit Fee $206A5
Plan review 25% $0,00 i
State Surcharge 8% 516.52 N
Total 5222.97
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ Zli //5 BUP
Received 040' Date Requested AM PM BUP
Location / / 3 o F Lp Suite , / 7 6 MEC
Contact Person ✓ — ' ' Ph ( f 0)) f� l_ 2 787 PLM
Contractor ✓� Ph SWR
BUILDING Tenant/Owner �i - a ✓L /di 4.4a 4013 - DO& 3 3
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire wall
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
Firm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI 0 Please call for einsp • ction RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date / / 4 _ Inspector ■ .���••• Ext
Other:
Final DO NOT REMOVE this inspection record from the ' b site.
PASS PART FAIL