Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00144
mo DEVELOPMENT SERVICES DATE ISSUED: 4/3/02
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S1 13AA -00600
SITE ADDRESS: 16140 SW 72ND AVE B -01
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : OOB JURISDICTION: TIG
Project Description: New service and machinery connections - Job No.67548
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: 32 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:
PACIFIC REALTY ASSOCIATES TUALATIN ELECTRIC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 655
PORTLAND, OR 97224 WILSONVILLE, OR 97070
Phone: Phone: 682 -2955
Reg #: LIC 00065650
SUP 3483S
ELE 3 -268C
FEES Required Inspections
Type By Date Amount Receipt Elect! Service
PRMT CTR 4/3/02 $293.10 2720020000( Elect'I Final
5PCT CTR 4/3/02 $23.44 2720020000(
Total $316.54
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1-800- 332 -2344.
Permit Signature: AP / Issued By:
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
A 503- 678 -7763 p.2
Apr 01 02 01 :19p
Electrical Permit Application
•
Date received: - 1- 0 Permit no
�{ i.CL Zvo2 - ao/y1 1
•
i,l' 41 City of Tigard Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 pate issued:
Phone: (503) 639 -4171 By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
•
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory t_d Commercial/industrial 0 Multi- family 0 Tenant improvement
O New construction 0 Addition/alteration/replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: \ (lj ,\_.. - la n` Rvc_ Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot Block: i (Subdivision: B a t \ '. t5C,,.a. qua`",
Project name: \)tlic,,^Q.(_r I Description and location of work on premises: '
rl
Estimated date of comp etion/inspection: Of'
Job no: L"1 &k-kCse
Fee Max
Business name: a r c cote r,
Description . Qty. (ea.) Total no. Imp
Address: e„( (. .., s --- Newresidauial -singleormttftl- Gmilyper
dwei ngttnitIncludesattachedgarage.
City: \x..‘... \ C. 1 State:pR I ZIP: `1 0- Seniceincluded:
Phone: bY) a- a \5s Fax: ize l9pt1 E -mail: 1000 sq. ft or less 4
CCB no.: v = . bus. lie. no: aai,e6 Each additional 500 sq. ft or portion there
bS Limited energy, residential 2
City/metro C. n0.: Limited energy, non- residential 2
" " (/ , y- 1-. p. Each manufactured home or modular dwelling
Signature of supervising - ectrician (required) Date Service and/or feeder 2
Sup. elect. name (print): V c Civt„. -Qe,_1(1 License no: $5.5 Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 1 aC^,.3* ap,'� 2
(p ) ' 201 amps to 400 amps
Name rin[ : qL �.. kek Pr. w 4nc.,� 2
C 401 amps to 600 amps 2
Mailing address: IS M ` J' N...3 ate. o, 4•04a.14 - " 6 -A 601 amps to 1000 amps 2
City: - V ; w � I State: '"' '1 Z \ ZIP: <In 4 Over 1(x10 amps or volts 2
Phone:t z a 178'1 I Fax: 1E-mail: Reconnect only 1 •
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocatlon
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps • 2
Owner's signature: Date: 40110600 . .s 2
ENGINEER Branch circuits - new. alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 5 i„,,,5 o7 ta, el) 2
City: I State: - I ZIP: 8. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit: ,
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
0 Service over 225 amps- commercial O Healthcare facility Each pump or irrigation circle 2
0 Service over 320 amps-rating of Ita2 0 Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over600 volts nominal more residential units in one structure alteration. or extension* 2
0 Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
0 Egress/lightingplan 0 Other.
Submit sets of laps with any of the above. Per inspection 1 [ I 1
— P Y Investigation fee
The above are not applicable to temporary construction service. Other
t
Not all jurisdictions accept credit cards, please call jurisdiction for ore Information. Notice: This permit application Permit fee $ act . l O
more
0 visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $
Credit cad number / / _ within 180 days after it has been State surcharge (8%) .... $ (a3, '44
Expires accepted as complete. TOTAL $ 3164
Nate of cardholder as shown on credit card
Cardholder signature Amount
440-4615 (6/0O/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 te a- '1 AM PM BUP
Location / L I V d 7 -i')d 4- ' --- suite MEC
Contact Person FL Ph ( ) !o Fc?- S S ' PLM
Contractor Ph ( ) x 1 SWR
BUILDING Tenant/Owner ELC 'OD- 60 / ' 4 (
Footing ELC
Foundation
Ftg Drain Access: ELR %y
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
D r on
Drywall Nailing \ ' WS'al
Firewall � ■K,lAa"` �l
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
*Im • ART FAIL
0 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 oo11
Approach/Sidewalk
Other: Date 9 �� b Inspector A ►.. �..rc_ Ext
I
Final DO NOT REMOVE this inspection record from he job ite.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
Inspection Line: (503) 639 -4175
BUILDING -- MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested q—/ AM PM BUP
Location / (o l 7 v 7 a 7 )a 4t' Suite �i MEC
Contact Person Ph ( ) 6 0 °Z a--5, -,-C PLM
Contractor Ph ( if\ X SWR l
BUILDING Tenant/Owner ELC l Tq
Footing �l ELC
Foundation Access: tr ()' Ftg Drai
Crawl Drain
Slab
Inspection Notes: SIT
Post & Beam
Shear Anchors y
Ext Sheath/Shear
Int Sheath/Shear v t
Framing
Insulation ( � C-, - , u : % A ; r
Drywall Nailing �` ` -
Firewall i)Lt�' lT T o _ 0
Fire Sprinkler \r 1 l �lJ 69)-)110--t , y �
Fire Alarm a � b • \n!'f L� � ici f� � � o � Olt
Susp'd Ceiling
Roof i \ i � ! AO
Other:
Final . . So htV . W fil LL 1 rl 5T»1.L 91,1A !Iry S
PASS PART FAIL
PLUMBING o C � GO& 5 N LOW
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fnal PART FAIL \[ 00410A LL,�'�Q!C1�}' Tb wqL� ` �� 3 wok``
MECHANICAL 'N1v` f !61' ck. oP\) t-/ - -0) O (1.. 9 1o/, "fn1 t1l� D
Post & I Beam
n
Rouugh h -In � P t L - i O' 63 1� W ) LL, till )1 LIB ) » v &) i4\ 2 a— / g Ain
T
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PAR
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
AppP roach/Sidewalk Date Inspector�� Eat
P
Other:
Final DO NOT REMOVE this inspection record from a job site.
PASS PART FAIL
I