Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00542
ti DEVELOPMENT SERVICES DATE ISSUED: 8/29/03
F I I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171
PARCEL: 1 S136DA -00101
SITE ADDRESS: 11410 SW 68TH PKWY ZONING: MUE
SUBDIVISION: PERS SITE
BLOCK: LOT : JURISDICTION: TIG
Project Description: JOB NO 21 -633 Tenant Improvement in computer 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: SIGNAUPANEL:
MANF HMI SVCI FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 25 PER INSPECTION:
201 - 400 amp: 1 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: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
OREGON, STATE OF PUBLIC 3D ELECTRICAL SERVICES INC
EMPLOYEES' RETIREMENT FUND PO BOX 173
11410 SW 68TH PKWY OREGON CITY, OR 97045
TIGARD, OR 97223
Phone: Phone: 503 - 657 - 9173
Reg #: ELE 3-460C
LIC 135234
FEES SUP 4478S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 8/29/03 $353.40
[TAX] 8% State Tax 8/29/03 $28.27 Rough -in
Elect! Final
Total $381.67
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 wil 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: 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
11UU L.CLUU.I ttf,I/ U:1. UU L1e1 f. UU1/ UU1
•
A Electrical Permit Application
►► '
. Damsel 1, ' Para act _ I -as ,
•
_.11 , jj City of Tigard NED > date.
Ciey tt{71gavd Addreae:13125 SW Hall B1Vc��'� Dale issued: • By: • 1=
• Phone: (303) 639.4171
Fax: (503) 598 -1960 • �� • 2 a 1003 fllono.: Paynunttype:
Land use approval: • , ._....... A .:: • . . ' •
018 family dwelling or accessory . ,,Commercla1induatrial : O Multi- family • 0 Tenant improvement •
O New consultation 44‘..- 0 AdditionIalterationheplacmnent 0 Oiher: • 0 Partial • . • :
Job address: 1 14 lo 5 t L.klMN4y Bldg. no.: Suite no» Tax map /tax lot/aocount no.:
Lot: 1 Block: Subdivision: •
project names Description and location of wait on • .... . f �;.._ a• e, r� L: : . • dpi
Estimated date of co .. .' eti ." don:
,( :UNs it:\('t Olt ,\I'l'1.I(;\ l IOiN. . . .. i ! 1 . Y :.l l l f•.
. l)l?1 :
Job not ° d1- -33 • 1M Marc
Deoatptlon Qty. (ea) Total maw
Badness mesas: "'3 (cA� .-- - C,t✓S Novm ldeted- tmieerowln-thadly per
Addrel* K. ,,. dea06egrnlLladadeltdbiebedgarage. .
a s . s AMT .. e 'a. tienloetedsded:
Phone: Brmail: loot ... a. whim 4
COI no.: • 2.3 EIec. bus. lies no: •- • c. "�� deaW a
a „ • - , , ' 3'4 \ umnodmom aoa.ie�oociet r-
i// / J Er
WAmmmfammed ham armodulardweling . • ,
8wtssmdforfeeder 2
eup. elect nans4dat): ,e _ • . - •, T>i'eA1 llomss not I! • • m thadta- e.
•
altendon orrolemtlom c • , .��0
viii ri :et i 1' MI NIlt 100 or has DO• :3U ' _ • �'- ;a ' • 2
WI to. ! _ CI r:'A%- .
r . amps to I stripes • 2
Mks address: • 601 amps to 1000 amps • 2
City: State: 1Zlp: • Ow 1000 our or rolte 2 '
Phone: I Fax: 1 Reatomeat ath► I •
°woes budaiation: T iasttlladon le being made on property i own Than raglereieesorlams- . • •
whih is not intended for sale, lease, rent, or exchange according to 0°
c
ORS 447, 453, 479, 670, 701. Zoo amps colas • 2
201 imps to 400 amps 2 '
Owner's Ili • An to on ■ 2
orMendeapesp e /64 • .XS
Nemec /
Address: A. = vicear feeda foe, each branch c1rcuk� 25. e lia+I 2 •
�: 1 Ste>te • 1 ___ . 11. Pastor blanch tames without purchase
Phon Fax: B-maii :. dunks or feeder 0soiftatb chdrmib . 2
llooti additional brooch draft .
or not )_
0 Seevios over 22i ampoemoutunalal • 0 Besids- ausTOUlty Sash or Girths 2
a Itervme over 320anl nantagortara 0liataedoaeleeedon • ' Each lighting 2
fhmfly4 eUinpe . O BaUdimg over 10,000 aguatefeet foto or S ) or a Molted emu panel.
0 System over6o0 vain aoudad mom eepldasUal%mitain=simonize eltantloa.oretetessionn 2
0 BuUding over thaeestories 0 paedeee,400 amps ormom • aDrrcilptiom ,
0 Occupant load tl0 pemmaa 0 Menuuflsoturs4 sansit e. or RV w Usk addUtoaeal inspection worths allowable rimy ( tyre about
ogt�tt tw
o ,eR 1 1
• submit _ �s ofpi�nsMae anyelft 1retabotes 1n adonf
'Mashie!. are not appilmbletotemtporary oenitte leases v lee. Other
Not all ivateaosos• aeon ft ar t midi. pass call pobdlstlw tar mina , . • . Notke: This pm* application Permit the $ J� *.'
• - Was O MaetatCatd ' ' expires ifs penult is not obtained Plan'leview (at — 96) $ •
• cad m o m - - r - coils 4,7-11 r , within 180 days after it has boon State eurchatgo (896) $ it Z7
- ..yy • _ � accepted ■a oomph:t .
T'r ` TOTAL $ '
rte j� t 1 . . S r
___ - -•∎ ; . ^ .a, - 1 ......_.r., ._ ... .......... . ..........._._................ _ . __..... _ itb4its1'NOQIWMI...
:.ITY OF Ti UARD z4 -nour
BUILDING Inspection Line: (50) 6394175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
J BUP
ieceived VP( -3 2 2-'ate • = . uesstted /1/1 ? AM PM BUP
.ovation ` 4 11 0 P6,01 Suite MEC
;ontact Person p &t wei 1 Ph (- )`7 7/ 5Ob t.%2:0LM
:ontractor Ph ( ) SWR
BUILDING Tenant/Owner /2 x,12 S ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: v /A.� Q SIT
Post & Beam fR
Sr Anchors a
Ext
Ext Sheath/Shear
th//Shh d.L�
ear
Int Sheath/Shear /
Framing J
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final
--- 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
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please • = I for r: inspection RE: fl Unable to inspect — no access
Fire Supply Line -
Approach/Sidewalk Date 1 / IExt
Other:
Final • DO NOT REMOVE this inspection record m th job site.
PASS PART FAIL