Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2009 -00021
- COMMUNITY DEVELOPMENT DATE ISSUED: 1/15/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DC
SITE ADDRESS: 15705 SW 72ND AVE ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK III LOT : 002 JURISDICTION: TIG
PROJECT: NIKE GOLF MANUFACTURING
Project Description: (1) branch circuit.
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: 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 REALTY ASSOCIATES CAPITOL ELECTRIC CO INC
15350 SW SEQUOIA PKWY #300 -WMI 11401 NE MARX ST
PORTLAND, OR 97224 PORTLAND, OR 97220 -1041
Phone: Contact #: PRI 503 - 255 -9488
FAX 503 - 257 -7121
FEES
Description Date Amount Reg #: ELE 26 -496C
IELPRMT] ELC Permit 1/15/2009 $46.85 LIC 48748
[TAXI 12 %State Surchar 1/15/2009 $5.62 SUP 3132S
Total $52.47 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: qcit et /; n A V4 ) ( Liz Permittee Signature: A l op ( CO - ' f ovi
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Elect-rical Permit Application
RECEIVE • GOI: u1 F1('1? USE UY1.1'
A 1'.I • ., , ecervo • Pesalit no.: • 0002
City of Tigard 1 `J 1' `I Date./By: •1 •p• • C 1C.200R
AI i • 13125 SW Hall Blvd., Tigard, OR 97224,, Plan Review Other Permit:
0 . ' Phone: 503.639.4171 Pax: 503 : OF TIGARb Ewe"' D
T I G A R D inspection Lint: 503.639.1175 0 I J fl h IVG DIVISION D ate ltealfy /By:
Notified/Method: Sou Nu 2 rut
Internet: WW.G$SCd- or.$OV fied/Method: S uylrlwu jd11Ini' uutiwl
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sai:>. Y,,. o..> , > :i >. > :i�f.l.a9k3� :aliYw`:: :a . >. >. ,•...u���,.,.�X+9k,`k`k 8;ffi4 :.�..$. #..v.�.r u..3 , . �F��:SU�Y ?3£ :t.: :FSi > :i :i�ta<�� : za<�;� c < :_e >i.�`f : : : : :5r > : :s ,
■ New construction 122 .Additiunlatteratiudmplaeement Please check all that apply (submit 9 sets of plans wfitcros checked below):
❑ Demolition ❑ Other: !, El Ml So o ar feeder 400 amps cr more ❑ 6ullding over three stories
: :ii.: > '. y %'..iMii;f<:l
ai : a�? •401 :v: 'i?.M 8 " ..ie7:411G� u�l` ' k'N',GESSEitai where the available fault Current El Marinas and boatyards
• 1. and 2- fiaaily dwelling Cii Commercial/industrial • Accessory building exc6'edS 10,000 amps et 150 volts or Floating buildings
❑ !gold-family ❑ Master Builder ❑ Other Teas to ground, or exceeds 14,000 Commercial•use agricultural
..A:_£,:6 ':>, ` >i . 4 i $'1 'alp'` "'`> °' `« IT' •s e£>°. ' MONA S r amps for all otter installations. El buildings
Job no.; 290251 Jub it addnst: 15705 SW 72nd Ave ❑ Flre Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State/ZIP: Tigard, Or ❑ Addition of new motor load of ❑ °a" ^E° "� -2' "13°
1001.-IP or more. ❑ occupancy
S a:¢ J >•.,'g Iept.: t .: 'Project name! Nike Golf ❑ Six or more residential unite ❑ Recreational vehicle parks.
❑ Health-care iimilitics ❑ Supply voltage for more than
Cruse Streetaircctiuns to job site: ❑ Hazardous locations ❑ 600 volts nominaL
❑ Slavic: or feeder 600 an, s or more
Subdivision: 1 j. no.:
#" ea .'" �3 ` i i a :ei'd $ +sr� V :
I Lot
D Pee. 'ruwl ^ Description Qty.
Tas n•• • reel no. g� : ��{tt>>A?y�;p , y ' ;x New residential - single or multi-family dwelling unit.
'•'t i tt 1.•ti{i'3< ., i:e.'"'i:.r'3'. Kr t`rst �z'i wl to. aiggri,L'�8wa$ , :3 >i �> A., ,. :. *0r :;lil�i `:ii `.,. ; l Included attached garage.
Added Degating /viacljine 1000 so. ft. ur lows _ $ 145.15 a
Ea. Add'1 500 sq. It or portion S 33.40 1
>'.11' :> r IL: >' 1 A1'7:s�'P'i°irt'?°;r s >f. ; A4Riiu,ob" . Rm: ,::a°,.3 =< l•R' •: : :•.0t' Lucite, ener rcaidcntial
Nance. (with slave y.
,. ft.) $ 75 00 2
Limited enurtsy, multi- family
residential (with above ay. it) 5 75 00 2
Address: Service or feeders installation, uh11.YAtiu0, and /or relocation
200 amp's or less $ 10.30 ^^
City/State/ZIP:
201 amps to 400 amps $ I 06.s5 2
Phone: r' 401 amps to 600 amps S 160.60 2
601 amps W 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 454,65 _ 2
intended tar sale, loose, rent or exchange, according to ORS 447. 449.670, And 701 Temporary terncet or feeders installation, alteration, and/or
Owner signature: Date: relocation _
200 amps or teas S 66.55 1
:Y .3 tg „sat ov .a m ntam .0.la,7`.3 �'K :>rb �r ; -x : .i 201 atop, to 400 amps 3 100.30 2
Business Name: CAPITOL ELECTRIC CO., INC. 40 t amps to 600 cups S 133.75 2
Branch circuits • new, Aeration, or extension, per p:ulel
Contact name: Jim Eddington A Fee for branch circuits with
service or feeder ice, each
branch circuit 5 4.45 2
Address:
B. Fee for branch circuits
City /StatlJZ1P: without service or feeder fcc,
first branch circuit 1 5 45.95 48.65
Phone: 971.6064888 Fax: 608457.7121 Each additional branch circuit: $ 6.65 2
Miscellaneous (service or reedrr nut included)
E-mail: .. 1 ! ,'' e . a • Each manufactun:d or modular
a MP y > {f s <o " .: `4n �p , e:r ,r,r s . s : . r:
:;ii :i ����� ,�; •{,', �a. ' • : :%�� •:x� ' izz :�it : = i i c . :.t dwelling, duviec cold or feeder 5 90.90 2
Rudntcss Nance: CAPITOL ELECTRIC CO., INC. 1Lw onnrcl only 5 66.95
Pump or iaiglltion circle 3 53.40 2
Silii or outline lighting . $ 53.40 2
Contact Rome;
Sigel! circuit(s) or limited-
Address; 11401 NE MARX ST. orgy panel, niterotions, or .
extension. Describe; Page 2 2
City /Si:ow/ZIP; PORTLAND, OR 97220.1041 - -
Racli additional inapeitiun over allowable m any of tile above
Phone: 603.2654486 Fax: 608. 267 -7121 Per inspection S 62.50
htvcstigation per hour (1 hr min) S 62.50
CCB Lie.: 4874B !B1ectrical�l. 'c.: 26 -496C ISuprv. Lic.: 3132 -S Industrial laru •• hour $ 73.75
� � j 1 A TIVUti fiE a'.' I `"';<< A:, :`I i ! ::t ii liF :x . tll> > iidiftii :eiii ;i6t:• ''3 : :7ii; � }°ti.
Suprv. Electrician signature, required; .4 L/1r 1
�i Subtotal $ 46.86
Prim Nance: *ARE I. MCt Date: 01 06! 9 Plan review (25% of permit Ice)
Authorized 5'L,italw7:' ��/ State surcharge ( 12% of peitnit feu) $ 5.62
[2. �9 4$4 . TOTAL PERMIT FEE $ 62.47
Print Name; DARRELL MCNEEL - This permit sppncaUon expires IN perms lx not ourulued wtwtn eau
d,yf drier it IWa Dec, eeeopled er .omple,e.
' Number of inspections pc penait allowed.
Z0 39dd 01=110313 101Idti0 ZZILLSZE05 ZE :ET 600Z/51/10
CITY OF TIGARD
• WILDING DIVISION
PERMIT #: ac2009_00021
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111612009
Phone: (503) 639-4171 ,,._attr-V
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1123/2009 TIME: 7•00AM PAGE: 11
SITE ADDRESS: i5705 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: ORFGON BUSINESS PARK III LOT #: 00 TYPE OF USE:
PROJECT NAME: NIKE GOLF MANUFACTURING
DESCRIPTION: (1) branch circuit.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 603
Inspection Request Scheduled For: Date: 1/23/2009 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
199 Electrical final 079966.01 971 N
Corrections /Comments/ Instructions:
\ ,
\
N:1 PASS D PARTIAL APPROVAL fl CANCEL El NO ACCESS
fl FAIL 0 CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: ,"---\ N G L) Date: I- 23 Phone #: (503) 718- 7-,W4
CJTY OF TIGARD .
4.
BUILDING DIVISION A ..
. PERMIT #: 8.U:4)09-00021 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ii•j09
Phone: (503) 639-4171 *WO
Inspection Requests (24 Hrs.): (503) 639-4175 . Altsl- A i
INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 1 PAGE: 42
. SITE ADDRESS: 15705 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON 13USINESS PARK III LOT #: 002 TYPE OF USE:
PROJECT NAME: NIKE GOLF MANUFACT( RING
DESCRIPTION: ()) branch circuit.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/20/200,9 Pour Time:
Code # Inspection Description •,. - ' al # Contact # Message
199 Electrical final 079823-01 971-506-3076 Y
, A i r
Corrections/Comments/Instructions: b L
<0 6 Or 41) G A Lvniv. R oX 1 / 4 )6e0
L k 2 3
0 PASS Ill PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
•
XAIL
' CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
I
Inspector: C.4. 1 0 I gi k-k Date: 1 ,-10- 9 Phone #: (503) 718- 344