Permit _ j - - - " ,, t -' E LEC TRICAL PERMIT
A CI F TIGA 1 'r
PERMIT #: ELC2004 -00132
j .` i DEVELOPMENT SERVICES DATE ISSUED: 3/19/2004
` ` - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 25101 DD -00800
SITE ADDRESS: 14020 SW 72ND AVE
SUBDIVISION: ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI, (1) new service and (1) branch circuit for new batch plant.
5/17/2004 Addition oDrench circuit for total of (2).
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: 1 W /SERVICE OR FEEDER: 411. PER INSPECTION:
201 - 400 amp: 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:
IS PROPERTIES LP ALLEN JOHNSON ELECTRIC
PO BOX 87908 P O BOX 411
VANCOUVER, WA 98687 AURORA, OR 97002
Phone: Phone: 651 - 3101
Reg #: LIC 34879
SUP 2602s
FEES ELE 24 -142c
Description Date Amount
Required Inspections
[TAX] 8% State Surcharge 3/19/2004 $6.96
[ ELPRMT] ELC Permit 3/19/2004 $86.95 Underground Cover
[ELPRMT] ELC Permit 5/17/2004 $6.65 Elect'I Service
(additional fees not listed here) Elect'I Final
Total $101.10
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 -000- 332 -2344. /
Issued By: / i L am , _ . / . _ _ _ 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
57 7 O ' 7 / G """r M EL ECT RICA L PERMIT �9 ;
. CI F TIGARD 1
� 4: DEVELOPMENT SERVICES PERMIT #: ELC2004 -00132
r� �1 DATE ISSUED: 3/19/2004
" 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171
PARCEL: 25101 DD -00800
SITE ADDRESS: 14020 SW 72ND AVE
SUBDIVISION: ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI, (1) new service and (1) branch circuit for new batch plant.
5/17/2004 Addition of�ranch circuit for total of (2).
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: 1 W /SERVICE OR FEEDER: 411111. PER INSPECTION:
201 - 400 amp: 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:
IS PROPERTIES LP ALLEN JOHNSON ELECTRIC
PO BOX 87908 POBOX411
VANCOUVER, WA 98687 AURORA, OR 97002
Phone: Phone: 651 - 3101
Reg #: LIC 34879
FEES SUP 2602s
ELE 24 -142c
Description Date Amount
Required Inspections
[TAX] 8% State Surcharge 3/19/2004 $6.96
[ELPRMT] ELC Permit 3/19/2004 $86.95 Underground Cover
[ELPRMT] ELC Permit 5/17/2004 $6.65 Elect'I Service
(additional fees not listed here) Elect'I Final
Total $101.10
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 -0699 or 1 -800- 332 -2344. /
Issued By: Z / _ t 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
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00132
DEVELOPMENT SERVICES DATE ISSUED: 3/19/04
13125 SW Hall Blvd., Tigard. OR 97223 (503) 6394171 PARCEL: 2S101 DD - 00800
SITE ADDRESS: 14020 SW 72ND AVE
SUBDIVISION: ZONING: I -
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI, (1) new service and (1) branch circuit for new batch plant.
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 HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 1 PER INSPECTION:
201 - 400 amp: 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:
I S PROPERTIES LP ALLEN JOHNSON ELECTRIC
PO BOX 87908 P O BOX 411
VANCOUVER, WA 98687 AURORA, OR 97002
Phone: Phone: 651 - 3101
Reg #: LIC 34879
SUP 2602s
FEES ELE 24 -142c
Description Date Amount
Required Inspections
[TAX] 8% State Surcharge 3/19/04 $6.96
[ELPRMT] ELC Permit 3/19/04 $86.95 Elect'I Service
Elect'I Final
Total $93.91
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 O; ' ' =! -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 2 -2344.
Is ued By: Ce /_ Permit Signature: �( � 1.
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 STALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: &lfro. v DATE:
LICENSE NO: Ave
Call 639 -4175 by 7:OOpm for an inspection the next business day
Electrica1Ptrmit Application FOR OFFICE USE ONLY
City - Received W Ha I Blvd '4, Tigar OR 97223 Plan ReviewA/ � // �� Phone: 503.639.4171 Fax: 503.598.1960 2 � , , Date/B : Other Permit:
Inspection Line: 503.639.4175 Id _ �' _.. Date Ready/By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TAE OF WORK PLAN REVIEW
❑ New construction 2 . dddition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling �ommercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑Other: ❑ Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park
Job no.: Job site address: / 1 20 S tit/ ? Zw� ❑Health -care facility DOther:
Submit 2 sets of plans with any of the above.
City/State /ZIP: / ,- / U7/4 9? L Zcy The above are not applicable to temporary construction service.
//���,��� ,, J FEE* SCHEDULE •
1j
Suite/bldg. /apt. no.: Project name: 1_/ _/ / / //G 55 • Description 1 Qty. I Fee. I Tatul I ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: • Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/14/1 // , r ! ` /' _ 57,002‘..--; S erv ic es service an ins a eeder 90.90 2
7 ✓ 7 z..... �'� GG�" - 4-7 - 1 --- Services or feeders installation, alterati and/or relocation
A l 4 y ,j,,.._ f - 200 amps or less � 80.30 10,3 2
• ' 0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 1
Owner installation: This installation is being made.on property that I 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. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each V/ 6.65 6 3 2
Business name: j _ 4. -- `. _� branch circuit 6
�/ L OL B. Fee for branch circuits
Contact name:
/'T' .�-j .� without service or feeder fee, 46.85 2
,c4 r-7- 4"'
each a d'I branch ch c i t
Address:
Each add'1 branch circuit 6.65 2
City/State/ZIP: ,iGf sLGjLj0 ,or Miscellaneous (service or feeder not included)
Phone: (i "3 ) Z� - - 39 Fax:: (S v3) 6 5 %- i / G • Pump or irrigation circle 53.40 2
l Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: J ff>_ .* _ c�
Address: ��i ,r3 / �� Each additional inspection over allowable in any of the above
>/ Per inspection 62.50
City/State /ZIP: /4.0 A-2 !j/Z.-C 92 vv - Investigation per hour (1 hr min) 62.50
Phone: ( „ j) zy - _ i 93 z , L ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES* •
CCB Lic.: 3 L(l j 5 Electrical Lic.: / a L Suprv. Lic.: Z 6 or 2-S Subtotal g� y •
Suprv. Electrician signature, required: 71�il/✓� -4 P lan review (25% of permit fee)
Print name: C. Date: j /I --of State surcharge (8% of permit fee) 6, q 96
TOTAL PERMIT FEE 93 • / /
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: �} ! (t a.-- /), ,,i_/, Date: 3 — /9 O • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Pennits\ELC•PermitApp.doc 12/03 440- 4615T(I0 /02/COM/WEB
Electrical Permit Application - City of Tigard !. _ .
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
•• RESIDENTIAL WORK ONLY: • .
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\ Building \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Liner (503)
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 7= 4 A Date Requested S 23 O AM PM BUP
Location /40 2 -0 7 2- /C�-CJ Suite MEC
Contact Person GZza -fit Ph ( ) Q':3 - 2 P'V3 PLM
Contractor Ph ( ) SWR ten,/
BUILDING Tenant/Owner ELC CrY - / 3 a
Footing
Foundation ELC
Access:
Ftg Drain 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
rm
PASS PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line c� �J
ADA
Approach/Sidewalk Date 1 6--2-j7- ' ° L Inspector ��� �.� ` Ent
Other:
Final DO NOT REMOVE thls Inspection record from the job site.
PASS PART FAIL