Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00745
,, DEVELOPMENT SERVICES 0 DATE ISSUED: 11/19/2004
4J1. 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 - 4171
PARCEL: 2S1 13AA -00500
SITE ADDRESS: 16100 SW 72ND AVE B -18
SUBDIVISION: OREGON BUSINESS PARK I ZONING. I -L
BLOCK: LOT : OOA JURISDICTION: TIG
Project Description: (8) new branch circuits in pharmacy area.
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: 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 3496S
FEES ELE 26 -122C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/19/200' $93.40
[TAX] 8% State Surcharge 11/19/200' $7.47 Rough -
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 Taws.
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: „I 'Zs
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
11/18/2004 THU 15:04 FAX 5036592824 STONER SERVICE Q002
El cal Permit App IV ED FOR OFFICE l - SE ON I.
City of Tigard
8 2 004 R DafrlB y J l' / �' j ' a y `i Permit No.: (�,,.? N y 'Ad
13125 SW Hall Blvd, Tigard, OR 97223 NOV 1. Pim Re view
Li P •���
Phone: 503.639.4171 Fax: 503.598.1%0 �V `" '' 4 t* I ( Date/By:
Inspection line: 503.639.4175 CITY OF TIGA'- - ? - Dam Ready/By: '®` / � IN See Page 2 for
Internet: www.ci.tigardor.� BU�l�IN( DIVISION f - T I V Supplemental lnformatlea
TYPE OF WORK.. . • PLAN REV] EW : .
❑ New construction I' • ddition/alteration/replacement Please check all that apply.
['So over 225 amps, corrsn'I [ ] Hazardous location
❑Demolition U •
['Service over 320 amps - raring C ]Buildng over 10,000 sq. ft.,
OF' CONSTRUCTION . of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2 -family dwelling Cn a � °1 "ommercial/mdustrial ❑ Accessory building ❑ System over 600 volts nominal units in one struatm
Master builder [] Ctther.
['Building over three stories L ] Feeders, 400 amps or more
❑ M ulti- fatilil
Multi-family ❑ ❑ocaipant load over 99 persons [ ]Manufactured structures or
.IOB I*FORMATI.ON'%AND'.:WCATION ❑Egress4rehtingplan RV park
Job no.: g IF 'd 1 Job site address: / OD r� ^7 a d e c ti.Q , ❑Heab�
hne facility C ] .
Submit 2 sets of plans with any ofth : above.
City/State/71P: 1 / / 0 The above lave not applicable to te rary construction service.
Suite/bldg./apt_ no.:T— 1 v Pro name: Al / 4i / L4' FEB' tICl 11IILE ..
�r�} /ICJ ��Wt�.� Desol�0a I Qty. I Fm I Tagil
Cross street/directions to job site: (/ / New residential single- or multi -fan By dwelling unit.
Includes attached garage. _
1,000 sq. !i or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited
energy, non-residential _ 75.00 2
D&9CB1'!?Ol�1bF.V±ORK . : Each manufactured or modular
I/�' t dwelling, service and/or feeder , 90.90 t 2
(� a V sit' &;." -0- ' / K- ®h Servtoa or feeders Instalallon, ante ration, and/or relocation
� 200 amps or less 8030 2
• 201 amps to 400 amps 106.85 2
. : , fl mourn T
401 amps to 600 amps 160.60 2
Name: v) C `, �� I 601 amps to 1,000 amps _ 240.60 2
Address: l Ova 1,000 amps or wits 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders fats Nation, alteration, and/or
Phone: ( ) I Fwc ( ) r'landiDO
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 10030 2
intended for sale, l ease, rent, or exchange, according to ORS 447,449, 670, and 701. 401 to 600 amps 133.75 2
Owner signalize: Date: Branch circuits — new, alteration, o r extension, per pane
1i P1 li : •: ?. A Fee for blanch cira its with
s
Fi ::' +raCr` service or feeder fee, each
Business � branch 6.65 2
B. Fee for titaneh circuits
Contact name: w/tlroert service or feeder fee, I 4615 1.,1 ID , a 2
each branch circuit
Address: Each add'1 branch circuit _ " r 6.65 ' 446 4 5‘ 2
City/State/LIP: Miscellaneous (service or feeder not fnduded)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax : ( ) Sign or outline lighting 53.40 2
E-mail: Signal cirwit(s) or limited -
CONTRACTOR energy panel, alteration, or
•
extension. Describe: 75.00 2
Business name: STt, NER ELEGr i C - -
Address: I qQ 4- SE 0 G O c 0 Each additional inspection over all n►able is any of the above
Per inspection 62.50
City/Stare/VP: M r L 1^/4lJ k I E, o R 9 7Z 2. 2 Investigation per hour (1 hr min) 62.50
Phone: (SS4;13) 4� _. (o SC�
2 o 1 Fax: ($03) ( 5`j- 49' (o S l plant per hour 73.75
ELECTRICAL PERM T FEES*
CCB Lic.: 445 3 I Electrical Lic. :Z( a e 0 1 Suprv. Lic.: 3 4-9 5 Subtotal en !,I CJ
.
Suprv. Electrician signature, required: 06-41",„,„/ Plan review (25% of ) .ermit fee)
��^^ State surcharge (8% of 1 iermit fee) ,r.
Print creme: M 1 KE rt} t_ CO Ni E Date: it I O TOTAL PER MIT FEE , n 0 , g 1
Authorized signature: This permit application expires Ir a per mit 1s not d within 180
days after it has been ace :pied as complete
P name: Date: • Fee methodoloa set by Tn -Cowry Bt ildeng Industry Service Board
CITY OF TIGARD 24 -Hour
BUILDING- Inspection Line:.4503j$39 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /0 J 7 AM PM BUP
Location - 7a ✓ J /�'t � Suite 6-1 " MEC
Contact Person Ph ( ) £ o 2 - — �✓� PLM
Contractor ( 4'r1 ..VA:b) Ph ( ) SWR u _
BUILDING Te nt/Owner ELC �O d / -6 0 7
Footing Pil
Foundation LC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam 0./ 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
L
UG/Slab
Low Voltage �
F ire Alarm
. ASS PART FAIL D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SIT 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector - Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL