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Permit A,. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00021 Are; i DEVELOPMENT SERVICES DATE ISSUED: 1/16/04 4� s ..� I ° 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 - 4171 PARCEL: 2S 101 AA- 09100C SITE ADDRESS: 12447 SW 69TH AVE SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE BLOCK: LOT : OOC JURISDICTION: TIG Project Description: 2nd floor remodel, (7) branch circuits and limited energy for fire alarm. Job No. 24 -92 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: 1 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: 6 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: HOUSEHOLD CREDIT SERVICE CAPITOL ELECTRIC CO INC 12447 SW 69TH AVE. 11401 NE MARX ST TIGARD, OR 97223 PORTLAND, OR 97220 -1041 Phone: 503 - 686 -2048 Phone: 255 -9488 Reg #: LIC 048748 SUP 3132S FEES ELE 26 -496C Description Date Amount Required Inspections [ELPRMT] ELC Permit 1/16/04 $161.75 [TAX] 8% State Surcharge 1/16/04 $12.94 Low Voltage Inspection Rough -in Total $174.69 Elect'I Final This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 th. • :e • . . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in ' • R 952 - 001 -'. 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 - 6699 or 1 - 80' 32 - 2344. �• Issu: d By: ! - ! .� r I tw � 4 _ P erm i t • S „..2(124.444...____ 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 I STALLATION ONLY ' / SIGNATURE OF SUPR. ELEC'N: , 41zil'/ „ �'c.1`{ -..-- DATE: LICENSE NO: ag Call 639 -4175 by 7:OOpm for an inspection the next business day Electrical Permit Application OFFICE USE ONLY Date received: /WTI Permit no. _ , • ADO , 1,4 t /appl. no.: C Ex sire date: fi City of Tigard RECEIV �- sued: I / ate. iptno.: CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR 97223 Case file no.: Payment type: Phone: (503) 639 -4171 Fax (503) 598 -1960 JAN 16 20 1. Land use approval: CITY OF TIGARD •r' P E: 3 ❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi - family )4 Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial .1013 SITE INFORMATION Job address: 12447 SW 69 AVE. City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.: Lot: (Block: N/A (Subdivision: Project name HOUSEHOLD (Description and location of work on premises: BLDG. C 2ND FLOOR REMODEL Estimated date of completion /inspection: Job rio: 24 -92 Fee Max. Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. Imp Address: 11401 NE MARX New residential - single or multi family per City: Portland State: OR ZIP: 97220 -1041 dwelling unit. Includes attached garage. Phone: 503- 255 -9488 (Fax: 257 -7121 IE -mail: darrell©cepdx.com Service included: CCB no.: 48748 'Elec. bus. lic.no: 26 -496C 1000 sq, ft, or less $ 145.15 4 City /metro lic.no.: N/A ? Each additional 500 sq. ft. or portion thereof $ 33.40 i/ 1115/04 Limited energy residential $ 75.00 2 Signature of supervising electrician (requir A Date Limited energy, non - residential $ 45.00 2 Sup. elect. name (print): Richard Martin License no.: 2865 -S Each manufactured home or modular dwelling PROPER OWNER Service and/or feeder $ 90.90 2 Name (print): Equity Office Properties Services or feeders - installation, Mailing address: 10260 SW Greenburg Rd alteration or relocation: City: Tigard I State: OR (ZIP: 97223 200 amps or less $ 80.30 2 Phone: 503 -892 -2500 Fax: [E-mail: 201 amps to 400 amps $ 106.85 2 Owner installation: The installation is being made on property 1 own 401 amps to 600 amps $ 160.60 2 which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2 ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2 Owner's signature: Date: Reconnect only $ 66.85 1 ENGINEER Temporary services or feeders - Name: installation, alterations, or relocation: Address: 200 amps or less $ 66.85 2 City: State: ZIP: 201 amps to 400 amps $ 100.30 2 Phone: Fax: E -mail: 401 amps to 600 amps $ 133.75 2 PLAN REVIEW (I'leasc check all that apply) Branch circuits - new, alteration, ❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel: ❑ Service over 320 amps- rating of I &2 ❑ Hazardous location A. Fee for branch circuits with purchase of family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2 ❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase ❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: 1 $ 46.85 46.85 2 ❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: 6 $ 6.65 39.90 ❑ Egress/lighting plan ❑ Other: Misc. (Service or feeder not included): Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2 The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2 Signal circuit(s) or a limited energy panel, alteration, or extension* 1 $ 75.00 75.00 2 *Description: FIRE ALARM Each additional inspectionover th allowable in any of the above: Per inspection I I $ 62.50 I I Investigation fee Other ❑ Visa ❑ MasterCard Permit fee $ 161.75 Credit card number: / / Notice: this permit application Plan review ( ) $ Expires expires if a permit is not obtained State Surcharge 8% ) $ 12.94 Name of cardholder as shown on credit card withing 180 days after it has been i \ $ TOTAL $ 174.69 Cardholder signature Amount accepted as complete. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503 6394175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received , 0 Date Requested Q l''' 9AM PM BUP Location / Z 41-'4' 2 g Suite MEC Contact Person /274"'L Zrd-- Ph ( 5:06 ^ 25 PLM Contractor Ph ( ) SWR • BUILDING Tenant/Owner ' 5 .(1( 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 (- C 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 �' n Smoke Dampers (C LY` 0 39° Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage • -rm Fi Alli PART FAIL 'f Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. � SITE ❑ Please call for reinspection RE: • Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date O Inspecto lAir Other: Final DO NOT REMOVE this Inspection record fro the Job s e. PASS PART FAIL