Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00572
�i DEVELOPMENT SERVICES DATE ISSUED: 9/15/03
. '`-� 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 - 4171
PARCEL: 2 S 113AA -00500
SITE ADDRESS: 16100 SW 72ND AVE B -18
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : OOA JURISDICTION: TIG
Project Description: Installation of (8) branch circuits (for relocation and installation of cord drops).
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: 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: 7 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 STONER ELECTRIC
15350 SW SEQUOIA PKWY #300 -WMI 1904 SE OCHOCO STREET
PORTLAND, OR 97224 MILWAUKIE, OR 97222
Phone: Phone: 503 - 462 -6500
Reg #: LIC 44823
SUP 4025S
FEES ELE 26 -122C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/15/03 $93.40
[TAX] 8% State Tax 9/15/03 $7 Rough -in
Elect'I Final
Total $100.87
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 Permit Signature: 0 }: L ! i9-77 o
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: 4A .7° Z--/ « ��� P DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
09/1/03 THU 10:31 FAX 5036594968 THE STONER GROUP 01001
•
Electrical PermitApplication
Date received: Q/iff @.S Permit ne- :ELC�(,10 3 OS7
$ ij i City of Tigar $ . Project/appl. no.: ! Expire date
CiryofTigard Address: 13125 SW a l` r • ' Date issued: By: ‹ n " r Receipt no.:
Phone: (503) 639 -4177 1
Fax: (503) 598 -1960 SEP 1 1 2003 Case tiicno•: Payment type_
Land use approval: 726
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory Commercial/industrial ❑ Multi - family 0 Tenant improvement
O Ncw construction ddition/altcration/replacement C] Other. 0 Partial
JOB SITE INFOR:11ATION
Job address: /L 1 0 0 Sc_e..1 2.n.hi Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot . • '- Block: _ _ Subdivision:
Project name: .. _ - =- = • 4of Dcscnption and location of work on premises: ,eEz ceA- . /mss E.,_
Estimated date of completion/inspection: Ce-Qd 'neoaS
. CONTRACTOR APPLICATION _ ., - _.. . FF SCHEEttilE ..__:_-__ - -:..- - >.-
Job no: ��S CONTRACT - , _ -. Fee Max tNax
Business nine 5 -rbweR - to Nerrredaentbrl- _ I Qty. (es.) Total no. him
Addres ! 9 E ko tin • dodrugrmtt Io attached
City: Nl t L/454f e.)v I State 0 ZIP:972•22 Sermtinduded:
Phone - iJL2r65Gb 1 Fax olli - 04, E 1000 sq. (t. or less a
� �, Z.Z. ` Each additional 500 sq. A. or portion thereof
CCB E
no.: 4. Iec. bus. Iic no: L Lirnited energy. residential _ 2
s z Caty/metro - . no.: 44116p timtted energy, non-residential 2
9 A Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
sup. elect name (pdntx y r - - co s _ license nez 491'..s or feeders-
ti Installation,
alteration or reloca
PROPERTY OWNER 200 amps orless _ 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps . 2
City: State: ZIP: Over 1000 amps or volts • ' . 2
Phone: Fax: E-mail: Recotmectonly _ 1
Owner installation: The installation is being made on property I own Temporary or feeders -
which is not intended for sale, lease, rent, or exchange according to O,orrelotauon.
200 amps or 2
ORS 447. 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGLNEER Brandt circuits - new, Aeration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder tee, cacti branch dtwit 2
City: I State: 1 ZIP: B. Fee for branch circuits without purchase
o service or feeder fee, first branch circuit: 1 , jar 4/4 atS 2
Phone: Fax: E Each additional branch circuit 4.6 4 /(.56
PLAN REVIEW' (Please check all that apply) Misc. (Service orfeedernot
O Service over225 amps-commercial 0 llcalth.earefaciiity Each pump or irrigation circle 2
O Service over 320 amps - rating of 18c2 0 Hazardous location Each signor outline lighting 2
family dwellings 0 Building over 10,000 squwe feet four or Strad dtcait (s)ora limited energy panel.
O System over 600 volts nominal more residential units inane structure alteration, or extension* 2
O Building overdo= stories 0 Feeders. 400 *nips ormow sl tipticn
O Occupant load over 99 persons 0 Mannractured structures or RV park Each additional inspection over the allowable in any oldie above
O> gtess/tightingplan 0 Other. Per inspeAion 1 l 1 T
Submit sets of plans with any of the above. Investigation fee
The above omelet applicable to temporary cosastructiou service. Other
Not all m
ap du cre Fl cwt for mote iafomnaticd Notice: This permit application
Permit fee $ ' .
0 Visa 0 MasterCard expires if a permit is not obtained plan review (at _ %) $
oust number:. _ _/ / within 180 days after it has been State surcharge (8%) $ 7 '
cr -
fi accepted as complete. TOTAL $
Name of madder as drown on mid eard
$
Crrdboldm dgyemro Amomr 4404615 (6100YC0/4)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / — 7 AM PM BUP
Location / !o / 00 7_2" A-v e • Suite MEC
Contact Person 8er e-4' Ph ( ) 7 o Al - '133 -. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner er 3 - 005
7a--
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 1
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
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
SITE ❑ Please call for re'. spection RE: • Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector 711e / — - , Ext
Other:
Final DO NOT REMOVE this Inspection record from the • ' site.
PASS PART FAIL