Permit CITY Y OF TIGARD PERMIT
PERMIT #: ELC2003 -00415
` Avi/ DEVELOPMENT SERVICES DATE ISSUED: 7/8/03
'=-- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
PARCEL: 25101 DC -00200
SITE ADDRESS: 13535 SW 72ND AVE 150
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (4) branch circuits for tenant improvement.
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: 3 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:
PACIFIC NW PROPERTIES LTD PTNSHP R C COSTELLO ELECTRICAL
9665 SW ALLEN BLVD STE 115 ROGER COSTELLO
BEAVERTON, OR 97005 1439 SE 17TH LOOP
CANBY, OR 97013
Phone: Phone: 263 - 2385 FAX
Reg #: 238 -8483 3834S
LIC 87402
FEES ELE 3 -344C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/8/03 $66.80
[TAX] 8% State Tax 7/8/03 $5.35 Rough -
Elect'I Final
Total $72.15
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- 800-33 -2344
lss @d By: k , p;„-,_ - � . � 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: X -' DATE: x ///
LICENSE NO: 313 /4-
Call 639 - 4175 by 7:OOpm for an inspection the next business day
_. ,
Electrical Permit Applicatioirk
Date received: i i c) 3 Permit no.:
• r"M;;,.*e.' '-- - - •--- -,
_.:_aN..1)1 r City of 11 ugard Project/appl.r.o.: Expire date:
Addle's: 11125 SA' Hall Blvd. Tigard, OR 97223 f
c,t,,,,fri Date issued: By . , Receipt no.:
Phone f 503 619 :4 i 71 1
Fax. 1503) 598-1960 Case file no.: Payment type:
I and ti approval: b /9) 5 - a 9 c/
1141 01r'p1'iti■lit
D I & 2 1.rmily ,tv.elliny or accessory _ ommercial/industrial 0 Nlulti-family enant improvement
I
J Ne1A .o J Addition/alteration/replacement 11 Other: L.) Partial
JOB StITINVOIRIVIIii(iN
,.., . ... . .. .. -..
L lob addiess: PP _ Bldg. no.: 1Suite no.: I co Tax map/tax lot/account no.:
- r-
Lot: i Block ' Subdivision:
_
• Proj,-et natr•e: g S ett lio ; Descnprion and location of vs ork on premises: is ,t-P4,,,,,---, 77
EstitiLded Lc,: di e..
f litikitrAtiON -. FEE :SCilli?Oill f" --.• -1– ... r. ' -
. ,. _.., ,
• . -
Job no. Fee Max
. - i Description family per Total no. (Asp
Busint ,-s • .•:. ••.'? :- 11 . ;i0 _s_ i e c 4 ( ic. o . 1 7,i ,
Nen midential - single or multi- I
dwelling imitincludes attached garage.
,- - - - -
'• ' AL. r 1 sta 1 ZIP: ci - )00'2_ S luded
1.. l. 0 ...1 enice inc:
I ' 1000 sq. ft. or :ess 1
f ; ,:it. . t; • ; - a" -- 7 1 1 / J/ 1E-mail: 4 1
- L
-
- -- -- -- --- - - )-;,;:tt Iddj■joi; il SOC
1 ' - Ce . •-/ ' E . l :
lec. busie. no - 3 - .3,.--iLiC) . __
, Limited energy. res.Jer.ti al I 2 1
--, -
11 Ti II- LI , I irn;:ed enet nui itsidel.t.,1 , 2
. ?C .. ...... -...
home .;
nr ,
' . .. • . , : > `‘.7 • :It.' feeder
,-
- - -- -- -- -- --- -7.7 ' -T1 r Sert Ices or feeden.- nisrAlAiii3O
xi. t .....t r: , . at . ,),... 9
- ' - -.
i t , C . • i ... - - h:e1 '1° .. . alteration or relorarimc
- :-..' ""-- .• - 0 • r 7 ..
1 eR P It
".-. 'il: - i - :;::. :: ...,..-...,- ,.. 1 :-: - . • - -: ' 1 • - --
-00 ampt ot les_
2
Nar /p 201 amps to 400 amps i [
rie rint) f- j
l •_,..J ----'-. ,
_ . Ll
......... .. — 401 amps a: r■00 arm s 1
1-- - -
N.u:2 AtI. c , .- (-1 ,S j -jilul v .te, 1 1
, 601 amps to 1600 amps . - 1 - 1 b Zi i 2
__
1 IFax E R
1 12 ! 1- ...-■ _ St P. 9 - 1QD5 Over : 000 amps o- v ,■:::., 2 ,
- 1 _ 1
1 1, It' 1 ecoiniect only - 1
. —
I - - - ----- ------ ---- Temporary services or feeticrs - 1
..; , Y1. 'il.' 1 , 1q a1 1.itilin tS e:ng made Jr. property I own •
installation, alteratioa, or relocation. 1 1
A 111Ch
•s UN , :u ti.l....I lot salt, le.o,e rent. or exchange according to
200 amps or less 2
• 1 ...: 44 4‘...). - 4 - 1 '/ 6711 ;till
20: xrups tu 400 amp:. 4 2
CA% tier's ;ig:A..r Date. _ 40! to 600 .ini s 2
,..:. 7 r _f■it
C, ! ,.,A- . •••-•-• -
•• .., ,. - - . • - ..- :. . • : • -• . ..-- Branch circuits - new. alteration,
,....(1: , 44 ',.: .;a1.,2„ ...1 mliir .. . . :, ,. ,. ,
or extension per panel: ,
Name:
_ A. Fee for ttancit ci rt..aits , ..,!:11 part:11,1st ,,f
Address: service or feeder ter tun bra.n circuit 1 2
r --- . --- — - - - -- - --- --
"State: I ZIP. B. Fer: for branch circuits •.vitttoi,t purchase - 1 - '
1 /4'
---- of service or feeder fee, l■r s t hi noti ,trcu t .
Pholte: 1 Fax: 7 E-mail: -- — '
.. ',
Each add:nom.] branch cir - to. 3
'''''""ki■Tit i-viliv Oka 4 . cliZ.i.'k' all: that in' PIO' . .':.: :- -
KJ . ', • a -• : - - - . Misc. (Service or feeder not included). 1
0 Ser.:cc over 225 ornr .• •,rnmero:.•. J Health-rare facility Earn rump or irngauoil cir,.:le t
2
OV. r 4 ■0 .. o r.01,1 ..i 1 -.., 2 j Hielardoils locatonn Each sign or OJT il ne light 2 :it;
...._
1 dwe'ling; LI Budding over 10,000 ..+Let. Ice: f■.ur ...:.r Signal circJit(s) or dimmed .Y.e: ,2■ pa:.'
Li s Imo cver boo , ..d. i.,f Lil ■ 1111lIC les...rent:di units': one ,IIIILLI:e alteration, rn extension* --1_ 2
13 lit.id,linr o‘er ,l.r..t •',. rt., ...) Rieder", 4/0 arrq.s or clime *Destrimion• _ _ _
C.1 :.k:up.tntit ,-)•; pets its .3 Manufautired stracturo el kV park Each additional inspection o'er the allowable In any of the above:
CJ Lismas/lighongchui Li Other: Per inspection FM 1 ! .
Submit._ _ sets of plans vvith any of the above. Investigation fee
1 _ l'he above are not applicable to temporary construction service. Other
6 g'C)
Not jurisdictions accept cnulit cards pleiase call jurisdiction for moire nth:inflation.' Notice: This permit application Permit fee $ & 19
Visa 0 MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card flambe': .____ _ _____ ______ ___/____ /____ within 180 days after it has been State surcharge (8%) .... $ . 3 <
Expires TOTAL $ 7A‘ i 6-
accepted as complete.
Name of cardholder as shown on credit card $
Cardholder signature Amount i 440-4615 (6/00/COM)
CITY OF TIGARD 24 -Hour '
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested - 7 — I l e AM PM BUP
Location / 3 3S 7 Suite / S MEC
Contact Person 161)A- Ph ( ) � � 1 7 ,c7 PLM
Contractor Ph ( ) SWR ' L r
BUILDING Tenant/Owner ELC 3 d `� �J
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
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
F Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 77-‘ - ` Ins , Ext
Other:
Final DO NOT REMOVE this Inspection record om the j ' ' 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 Requested S AM PM BUP
Location / 3 5 3 -rt4 Suite /SD MEC
Contact Person C_f.c.a Ph ( ) .D L t- 407,5K PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 "60 ( 1 I5"
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 t\10 W lO 1 1
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 /2/O C
Fire Alarm
* Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
i PART FAIL
SI 0 Please call for reinsp-ction RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA r'
Approach/Sidewalk Date ! U Inspector
Other:
Final DO NOT REMOVE this inspection record fr the J site.
PASS PART FAIL