Permit CITY OF T ELECTRICAL PERMIT
TIGARD PERMIT #: ELC2005 -00938
DEVELOPMENT SERVICES DATE ISSUED: 12/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112AA -00900
SITE ADDRESS: 14160 SW 72ND AVE 110 ZONING: I -H
SUBDIVISION: NELSON BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: (7) branch circuits.
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: 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:
SPIEKER PROPERTIES LP ROBERTS ELECTRIC INC
4380 SW MACADAM AVE STE 100 5759 SW 48TH AVE
PORTLAND, OR 97201 PORTLAND, OR 97221
Phone: Contact #: FAX 503 - 244 - 0560
PRI 503- 244 -7754
FEES
Description Date Amount Reg #: SUP 3886S
[ELPRMT] ELC Permit 12/6/2005 $86.75 LIE 9388
[TAX] 8% State Surcharge 12/6/2005 $6.94 ELE 34 -23C
Total $93.69 REQUIRED ITEMS AND REPORTS
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:) - Permittee 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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
ti
- `Electrical Permit Appl 'C:114 r()Ii (>l� ri i sl•: (
City of Tigard i : Received . / -- d Permit No. 'G . /, c'() N
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 [ (` ''" 'r . .f= ` i '' Date/B .
Inspection Line: 503.639.4175 DEC 0 1 • 'I Other Permit:
l Date Ready/By: RI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPFeR WORK ISIO ! PLAN REVIEW
❑ New construction ', Ad r�l l pace e Please check all that apply:
❑ Demolition ❑Other; ['Service over 225 amps, comm'I ['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
❑ I and 2 family dwelling ® Commercial/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 4 (( 0 S . w_ Z 2 El Health-care facility ❑der
n Submit 2 sets of plans with any of the above.
City/ State/ZIP: �' The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: / / O Project name: e...47,14 FEE* SCHEDULE
Description I Qty. I Fee. I Total 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'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Aft-, dwelling, service and/or feeder 90.90 2
/�-, -) Q -A Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER 1 ❑ 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
Phone: ( ) Fax: ( ) relocation
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. 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 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit I 46.85 5/6:53'5
Address: Each add'l branch circuit 4: 6.65 3q.91 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
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: go g S ��� Le x A3 C
Address: 5 5 5 S _ W . c.cg'l Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: p p ' Ol r - ? ZZ ( Investigation per hour (1 hr min) 62.50
Phone: ( - o ) 0 c( t4 X75 c.( I Fax: ( 503) 0 2 vc.(- 7? .54 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 430K Electrical Lic.:3 Lf 23 G. Suprv. Lic.: 3f, S Subtotal (c, 75
Suprv. Electrician signature, required: �� Plan review (25% of permit fee)
Print name: Y�-o ig—ezz p yl/l.CCu A t 13 Date: / 2_14, ( s State surcharge (8% of pertnit fee) 9 y
TOTAL PERMIT FEE 4'T 6 9
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
•• Number of inspections per permit allowed
i:\ Building \Pernits\ELC- PcmitApp.doc 12/03 440.4615T(10'02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
L ITED ENERGY PERMIT FEES:
PREM rriAL WORK ONLY: _ ___ - - --
Fee for a esidential systems combined .. $75.00
Check Type o Work Involved:
❑ Audio and ereo Systems*
❑ Burglar Alarm
❑
•
Garage Door Opener
❑ Heatin:., Ventilation and Conditioning
System*
❑ Vacuum Sy ms*
❑ Other:
PCOMIVIERCIAL WORK ONL . — —
Fee for each commercial system... • $75.00
(SEE OAR 918 260 - 260)
Check Type of Work Involved:
• ❑ Audio and Stereo System
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommu cation Installation
❑ Fire Alarm In e Ilation
El HVAC
❑ Ins u entation
❑ tercom and Paging Systems
•
IN Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
•
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
iABuildingWennits \ELC- PennitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Ll_C2.200 -009313
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6;/2 )O ,
Phone: (503) 639 -4171 knun po l
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 1/11/2006 TIME: 7 :01AM PAGE: 811
SITE ADDRESS: 14160 SW 72ND AVE 110 CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONTRACT FURNISHINGS
DESCRIPTION: (7) branch circuits.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 503.244_774
Inspection Request Scheduled For: Date: 111.2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 024698 503 N
Corrections /Comments/ Instructions:
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Pkavt0 w6x44iis kit? 1'1-Z) N
Irf 6G- CIS._. v.. ■L Q,01. J, _
G *. 10 Fes`!' fV4D
3 . � -�+�. L
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ AIL ❑ CALL FOR INSPE TION El ADDITIONAL FEES ASSESSED
Inspector: Date: ' 1 0 -4 Phone #: (503) 718- 2.-1/1/4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 00938
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/200;i
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: 1/9/2006 TIME: 7:01AM PAGE: 47
SITE ADDRESS: 14160 SW 72ND AVE 110 CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONTRACT FURNISHINGS
DESCRIPTION: (7) branch circuits.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: fiO3 244.7J':1
Inspection Request Scheduled For: Date: 1/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 024561 -01 503 - 572 -79€ N
Corrections /Comments/ Instructions:
o (WibL—E7c �? i Raty AA) cAU- f�(
eittAL
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
,;4 FAIL L FOR INSPECT ON ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: ` 9 0 Phone #: (503) 718- 2 6
CITY OF TIGARD
BUILDING DIVISION PERMIT #: LI-C7005- 00030
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 1/6/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/5/2006 TIME: 7:OOAM PAGE: 61
SITE ADDRESS: 14160 SW 72ND AVE 110 CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONTRACT FURNISHINGS
DESCRIPTION: (7) branch circuits.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 603244 -77fel
Inspection Request Scheduled For: Date: 1/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
109 Electrical final 024413-01 603-572-7905 N
Corrections /Comments / Instructions:
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C) i Pd `(►')
NCC-SA c
1
❑ PASS [ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � Date: /T Phone #: (503) 718 -02- -V
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC20o5.00 9;38
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12.0200:
Phone: (503) 639- 4171 n ud hh�6�l�1�
Inspection Requests (24 Hrs.): (503) 639 -4175 :..
INSPECTION WORKSHEET FOR DATE: 12123/2005 TIME: 7:02AM PAGE: 21
SITE ADDRESS: 14160 SW 72ND AVE_ 110 CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONTRACT FURNISHINGS
DESCRIPTION: (7) branch circuits.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 503 - 244 -7754
Inspection Request Scheduled For: Date: 12/23/2005 Pour Time:
Code # Inspe • - : - • stion Confirm # Contact # Message
130 e icing cove 023985.01 50•572 -7985 Y
Corrections /Comments /Instructions: 3S9c1Ce s /..
SS ❑ PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0(7
4 Date: /L 2 . -I° Phone #: (503) 718 -
CITY OF TIGARD ._
BUILDING DIVISION s PERMIT #: ELC2005 -00938
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2005
Phone: (503) 639 -4171 iu -e ��n� � 1I
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: /2113/2005 TIME: 7:02AM PAGE: 67
SITE ADDRESS: 14160 SW 72ND AVE 110 CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CONTRACT FURNISHINGS
DESCRIPTION: (7) branch circuits.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: ROBERTS ELECTRIC INC PHONE #: 503 2447754
Inspection Request Scheduled For: Date: 12/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 023364 -01 503-572 -3232 N
Corrections /Comments / Instructions:
• -- ■ c ` - - 11Z - VA8LC
."11.111P111.1.1 11111.,
L CAov V --. A016S _
21 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL C L FOR S r i TION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: G / 3 arPhone #: (503) 718 - 1 f / 4