Permit CITY OF TIGARD ELECTRICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT D: 5800246
DATE ISSUED: 5/12008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 113AA -00500
SITE ADDRESS: 16100 SW 72ND AVE B18 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT : OOA JURISDICTION: TIG
PROJECT: INSTITUTIONAL PHARMACY
Project Description: Installing (10) branch circuits for new fixtures and work stations
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 HMI SVCI 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: 9 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: Contact #: FAX 503 - 659 - 4968
PRI 503 - 462 -6500
FEES
Description Date Amount Reg #: ELE 26 - 122C
[ELPRMT] ELC Permit 5/1/2008 $106.70 L1C 44823
[TAX] 12% State Surchar 5/1/2008 $12.80 SUP 3496S
Total $119.50 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.
4 11IP
Issued By: != Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property 1 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.
Apr. 30. 2008 10:46AM Stoner Electric Group No, 3217 P. 1
Electrical Permit Application IoI: nri.If. l: l •a: ONI.
City of Tigard ES3/7111 6 g Pewit No,: 4 _J, — GCle ,
• 13125 SW Hall Dlvd, Tigard, 0497223_ (::,r i. r� Plan Review
• ' ' Phone: 503.639,4171 Fax: 5 0 3 ,,591. 1 1960 /:-
03 598_1960 s� V � f Date/8 . Other Permit;
Inspection Line: 503.639.4175 C ,� Date R ems:
T I G A P D Pam �S �Y See Page 2 for
Internet: www.ligard-OtgOV pp,, Noliliied/Method: Supplemental Information
. • .PI OF WORK c.1 L U U 6 PLAN REVIEW
❑ New construction I Addition/aiteration/replacement Please ',beck all that apply (submit 2 sets of plans w/items checked below).
L, d i / a S' l i 1,2 A r. Li ❑ service or fccder 400 amps or more D Building over three stories.
❑ Demolition 0 Other: a7 r, o ° , - , . --,;infiartNe where the available fault current ❑ Marinas and boatyards.
CATEGO OF CONSTRUCTION ! ' ' r: r v exceeds 10,000 amps of 150 volts or D floating buildings.
less to ground, ur exceed% 14,000 ❑ Corm :Mai -use agricultural
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building arms for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
El Emergency
on ofne m "A", r, "1- separately
". "1 system.
JOB SITE INFORMATION AND LOCATION
El Addition of new motor load of 0 "A ", "E", °I -2' >, "I -3"„
no.: Job site a ddress' 10014P or more. occupancy. no.
:5 ' : 11 100 Stir 72 wo_.. A .%) ['Six or more residential units, ❑ Recreational vehicle parks.
City/Slate/ZIP: -r t� � /L D Health-we l cats n s . ❑ Supply voltage for more than
I+r 13 Haaardooa locations. 600 volts nominal.
Suite/bldgJapt. no.: Project name: IN 41 T Pr DM Ai 1144044tit D Sery oo or feeder 600 amps err more.
FEE SCHEDULE
Cross street/directions to job site: anniptiaa 1 Qty. 1 Fee 1 Total I •
New residential single- or multi family dwelling unit
Includes attached garage.
Subdivision: I I.ot no.: I,000 sq. R or less _ 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. II. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. D)
q � r Limited energy, multi - family 75.00 2
2 0.0 k e , Akio tnki i u RM • $ -A residential (with abovo sq. R.) - - ,
} �*et t Services or feeders installation, alteration, and/or relocation
7 s Lo a Fwroc . I LI W Au HIOWIae" 200 amps or less 80.30 2
❑ PROPERTY OWNER J • 0 TENANT 201 amps to 400 amps 106.85 2
Name: P � e l 7 , C /l � l �' J� 40I maps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: I c3 J v ( 5 . J s � 4J/4 o vl 7 ) ? 4t r-1c Over 1,000 amps or volts 454.65 2
Clry /State/ZIP: e� 9'� ?-041 Temporary services or fecdcrn installation, alteration, and/or iCi
relocation
Phonc: ( ) 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 t0 ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or ex tension, per panel
Owner signature: _ Date: A. Fee for branch circuits with
: APPLICANT I . ❑ CONTACT PERSON above service or feeler fee, 6.65 • 2
each branch circuit
Business name: B. Fee for branch circuit.;
Contact name: without service or feeder fee, 1 46.85 46,86 2
first branch circuit
Address: Each add'I branch circuit q 6.65 5q. fpe5 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder •
Phone: ( ) I Fax: : ( ) Reconnect v 66.85 2
E - mail: pump or irrigation circle 53.40 2
• CONTRACTOR • Sign or outline lighting 53.40 2
Signal p a nel. (s) or limited-
Business name: STONER ELECTRIC
energy panel alteration, or
Address: 1904 SE OCHOCO extension. Describe: Page 2 2
City /State/ZLP: MILWAUKIE, OR 97222 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 462-6500 I Fax: (503) 659-4968 Investigation per hour (I hr min) 62.50
CCB Lic.: 44823 I Electrical Lic.: 26 -122C I Suprv, Lic_: 3496S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES -
Suprv. Electrician signature, required: M:e l+d4 e Subtotal: 1 ( , ID
Print name: MICHAEL FALCONER I Date: 4./0/e) S Plan review (25% of permit fee):
State surcharge (12% of permit fee): 1 t se)
Authorized signature: TOTAL PERMIT FIE: 1 i of-50
Print name: Thin permit application expires if a permit is not obtained within 190
Date: �..- _ _�,
CITY OF TIGARD
BUILDING' DIVISION PERMIT #: ELC2008- 00246
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/2000
Phone: (503) 639 -4171 Avuaf„oit
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/20/2008 TIME: 6:59AM PAGE: 26
SITE ADDRESS: 16100 SW 72ND AVE B18 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK 1 LOT #: OOA TYPE OF USE:
PROJECT NAME: PAYLESS
DESCRIPTION: Installing (10) branch circuits for new fixtures and work stations
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 503 -462- 6500
Inspection Request Scheduled For: Date: 5/20/2008 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 070149 -01 503806 -0761 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: $ vv tsA L-6 Date: 61 tt)A Phone #: (503) 718- ti A
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008.00246
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/2008 •
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 . ° L .
INSPECTION WORKSHEET FOR DATE: 5/13/2008 TIME: 7:02AM PAGE: 18
SITE ADDRESS: 16100 SW 72ND AVE 1318 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 00A TYPE OF USE:
PROJECT NAME: INSTITUTIONAL PHARMACY
DESCRIPTION: Installing (10) branch circuits for new fixtures and work stations
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 503-462-6500 —
Inspection Request Scheduled For: Date: 5/13/2008 Pour Time:
Code # Inspection Description 'onfirm # Contact # Message
195 Misc. inspection 069801-01 503-806-0761 Y
Corrections /Comments /Instructions: P \
❑ PASS F./ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ���+��■ • • ' - ON ❑ ADDITIONAL FEES ASSESSED
Inspector: G- tt66 Le
Date: Gil I 61 Phone #: (503) 718 - 1144t