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Permit A- CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00431 i DEVELOPMENT SERVICES DATE ISSUED: 7/16/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S136DA -00100 SITE ADDRESS: 11308 SW 68TH PKWY 1ST FL SUBDIVISION: ZONING. MUE BLOCK: LOT : JURISDICTION: TIG Project Description: Upgrade to existing computer room row 2. Job # 18528. 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: SIGNALJPANEL: 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: 7 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 KEY LLC, THE 1010 SE 11TH AVE BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214 WORCESTER, MA 01615 Phone: Phone: 503 - 234 -9900 Reg #: L1C 203 SUP 4460S FEES ELE 26 -95C Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/16/2004 $93.40 [TAX] 8% State Surcharge 7/16/2004 $7.47 Total $100.87 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: T2 f/, Permit Signature: '-e- 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 JUL- 13 -.' 07:36AM FROM - Oregon Electric Estimating 5032313587 T -813 P.001/002 F -788 Electri - ; Permit A t r li p.a `— A R«eired y: -/ —D y ) Permit No.: G c ,� 9t - 6 V3 ) �ardl3 13125 SW all Blvd., Tigard, OR 97223 JUL City t4� � .Bard _ Plan Review Odor Permit: Phone: 503.639.4171 Fax: 503.598.1960 - `' 20 °' ° ' '' , c, 1 .' " i ',' Deem" inspection line: 503.639.4175 "'I ta re Ready/By iwir: H Sec Paee 2 for Internet: www.ei.rigard.or.uS CITY OF TI Nodfied/Method: \ (r Supplemental Information �UlL GAi�n TYPE . • i • :• :. • PLAN REVIEW El New construction ® Addition /alteration/replaccment Please chcck all that apply: ❑Service over 225 amps, comm'1 ❑Hazardous location ❑ Demolition ❑ Other: °Service over 320 amps — rating QBuildng ova 10,000 sq. it., CATEGORY OF CON 1*1JCTI , . . • of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ® Commercial/industrial 0 Accessory building ❑System over 600 volts nominal units in one structure °Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder 0 Other: DQccupant load over 99 persons °Manufactured structures or . i JOB Sgt. INFORMATION ANl) LOCATION: . • • • ❑Egress/]ightingplan RV park I:He alth facility ['Other: Job no.: 18528 _J Job sitc address: 11308 SW 68th Parkway Submit 2 sets of plans with any of the above- City /Statc/ZIP: Tigard, OR 97224 _ The above are not applicable to rcmpotary construction service. FEE* SCHEDULE _ Suitc/bldgiapt. no.: Project name: Providence Tigard Data Center nes I Qa. I Fee. Tie I_ Ci2a5.54TetalreCtiOnS to job Site: Wb — .7— ebilf>"- New residential single - or multi - family dwelling unit. Includes attached garage. A ©e /n 1,000 sq. ft. or less 145.15 4 Subdivision: 1 Lot no.: _ Ea. add'l 500 sq. ft. or portion 33.40 _ 1 _ Limited energy, residential _ 75.00 _ 2 Tax map/parcel no.: Limited energy, non-res 75.00 2 ' : DESCRIPTION OF W ORK' • • . . • , : Each manufactured or modular dwelling, service and/or feeder _ 90.90, 2 Upgrade to existing compter Toone row 2 _ Services or feeders installatiotr, alteration, and /or relocation 200 amps or less 80.30 , 2 • 201 amps to 400 amps 106.85 2 El, PROPERTY..OWNEfr , : ' • `; .I • • .:. '° ?TENANT 401 s to 60O amps 160.60 . amp 2 Name: Providence Health System 601 amps to 1.000 amps 240.60 2 , Address: 1235 NE 47th Over 1,000 amps or volts 454.65 2 y r Rcc.onnect only 66.85 2 City /State/ZTP: Portland, OR 4 9.' / Temporary services or feeders installation, alteration, and/or relocation Phone: (503)215 -4700 Fax: ( ) 200 amps or less 66.85 1 - Owner installation: This installation is being made on property that 1 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. r 401 amps to 600 apps 133.75 2 Owner signature: Date: Breach circuits — new, alteration, or extension, per panel ' r .ApPI.ICAN r ' .. I • • • • Q CONTACT •PERSON .. • A Fen for branch circuits with service or feeder fcc. each 6.65 2 Business name: branch circuit _ _ B. Fee for branch circuits Contact name: without service or feeder fee, 2 46.85 G ./6 2 each branch circuit Address: Each add'l branch circuit 7 6.6S 9( 2 City /Statc/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) ( Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- ;CONTRCTOR r energy panel, alteration. o . � extension. Describe: Page 2 2 Business name: Oregon Electric Group - - Each additional inspection over allowable in any of the above Address: 1010 SE 11th Ave _ Per inspection 62.50 ' ,- City/State/ZIP: Portland, OR 97214 investigation per hour (1 hr min) 62.50 _ Phone (503) 535 -2652 J Fax: (503) 231 -3587 lndusttie' plant per hour .ELECTICAL P 73.75 PERMIT FEES* CCB Lic.: 203 I Electrical Lic -95 Su ic.: 4460S Subtotal / ?, //(, . Suprv. Electrician signature, required: ' Plan review (25% of permit fee) ) Z( ' /i V ■ I -7. State surcharge (S% of permit fen) _ , G/ —7 Print name: �[ am ' � ` TOTA L PERMIT FEE /i f , U Authorized signature: . / ) This permit appilentton expirte if a penult is not ob4tined w[thln 180 / s2 a't I / J d after it has been Building accepted as complete Print name: �'J �T l� �/ Date: ! /Q � • Fee methodology set by'['ri.COUm Buildm y e indu,�ery service Board /, `��f1J •• Number or inspections per permit allowed. Oauiidinewer iC PamirAptl 12/03 440.d6t5rttwou/COrd/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line(503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST x(308 _ BUP Received � ,x Date Requested AM PM BUP 7� Location tS r� � 4 6e L-tySuite MEC Contact_Person a A Jl � Ph ( ) y ? - I ? PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner / 4 -& J . ELC c76 (77— 66 q3( Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors , vJJ Ext Sheath/Shear H ' Int Sheath/Shear Framing Insulation Drywall Nailing Firewall C'>✓�1 f 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 Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line f y d /4 ADA D / I ( 0y Inspector 161M ii/PIZERAY Ext Approach/Sidewalk f Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL