Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00501
ley DEVELOPMENT SERVICES DATE ISSUED: 10/16/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AA -00500
SITE ADDRESS: 16112 SW 72ND AVE B -18
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : OOA JURISDICTION: TIG
Proiect Description: Installation of (2) service /feeders (200amp /less) and (8) branch circuits.
Job #4178.
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: 2 W /SERVICE OR FEEDER: 8 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 ELECTRICAL DIMENSIONS INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 12146
PORTLAND, OR 97224 3961 N WILLAMS AVE
PORTLAND, OR 97212
Phone: Phone: 282 -7255
Reg #: LIC 44008
SUP 2964S
ELE 26 -432C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 10/16/01 $213.20 2720010000( Wall Cover
Elect'l Service
5PCT CTR 10/16/01 $17.05 2720010000(
Total $230.25
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 dired questions to
Permit Signature: Issued By: 4 0 / A
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: i ' ` : „ / DATE:
LICENSE NO: )-� 4 S
Call 639 -4175 by 7:OOpm for an inspection the next business day
i
dr 5 r
;., A Electrical Permit Application
w s 4W Datereceived: I it /D i Pemritno.:) _e 1-a5D1
u. I'I`I" City of Tigal CE�� P�1�, Projectlappl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, T OR Date issued: By: g� I Receipt no.:
Phone: (503) 639 -4171 O ] J
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: C%D? OF TIGAR
TYPE OF PERMIT
0 I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family XTenant improvement
O New construction 0 Addition/alteration/replacement 0 Othen 0 Partial
JOB SITE INFORMATION
Job address: /. /r'2. c , 4) 70, i ' A. I✓ Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot I Block: 1Subdivision: N C I
Project name: 1 Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR `,APPLICATION" - -.. d,.. - __ FEE SCHEDULE_
'
Job not - 41 78 F Mast
.. D aaipdon Qty. (ea.) Total no. hasp
Business name: I' e eri2tu ,1 1lo
�l. LJ 1 .NS18 ?N
W5 C- Ne,ns9dential- s� G
eormuld- �lyper
Address:)
ddress:)Ja OX 1 Z 1 4 deellIngunit. Incbdesattached games -
City: ' ...... b State I ZIP: Q 7 2 / z2, Serviceinchaskth sq. R or less 4
Phone:2A.. e7 Fax: - 14 �' { E - mail: 100 s q . 1. or l sa • tt or portion thereof
CCB no.: 44/) r' ec. bus. lic. no: ka--4 2 -
1,;,,ucedmergy, residential 2
City /me t no.: I 4 0 v ( FPM. Limitedenergy, non- residential 2
' i /. ■ _./ Il /J ■ / f1 -i ..,011.1 eC.g Each manufactured home or modular dwelling •
S' of supervising electrician ( -, • - .) Date ,' - - Service and/or feeder 2
- Service orfeeders- installation, - 2- (( ) / ()
Sup. elect. name (print): a , - • . • •
Limns nix .�. - al(onortsloradae J /C i
PROPERTY OWNER 200 amps or less - 4-76 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: • 601 amps to 1000 amps 2
City: I State: 'ZIP: ' Over 1000 amps or volts 2
Phone: I Fax: I E-mail: ttecaaaea°oty _
Owner installation: The installation is being made on property I own Tempatatyeervias' f eed ' s —. • -
which is not intended for sale; lease..rent. or exchange alcantding to oe,a on ortdodatde - t
_
ORS 447, 455, 479, 670, 701. 200 amps or less 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 .2
. Brandh circuits - new,alteraaloo, . •
or extension perpas*.
. Name:. .. - a Fee for brands circuits with pmtbase of
Addte: • service or feeder a each branch circuit a 6,4,5"51 2
C isal Q Ma S B of service feeder fee. fun branch circuit: 2
Phone: Fax: E Each additional brands circuit
PAN REVIEW (Please check all that apply) Mkc.(Senkeorfeedernot�x 2
Each pump or imgadon circle a S amaoamas terC�td eagrs�oommarial• Q Health�eefaaliry ote' and:ci suits g 2
Q Serviceover320am�ps- rating of 182 Q Haadonsiocatian or ali h iingmetgylmnd.
familydwelings QBm'>dmg over i0000sq� feet fourer oratre (s)or 2
Q. System ova 600 volts nominal more residential mmsin one &encore {
Q Feedes.400 amps arm •
Q. Oc upanttoadover99persons Q Manufa�red moms or RVpark Each dInspection owxthe allowable inaatyof the abovr !
0 l gp� Q Other. Perimpeedon 1 I I I
Submit sdsofpfam• with say ofthes� Investigation fee
The abo are not applicable to temporarf coasizadloa sttxride. Other / , . I : t
P+amitfee s Na all jurisdictions accept credit duds. plate ad *acacia!' mom dumb= Nod= This permit application Plan review (at - ?)...4- s-
• expires if a pan& is not obtained has been Stale (84b) $ ` d �
/. / within 180 days after withoteputchase
Condit and aomb + as
- s '
Noma( ordb .Lt . a.shown m aedu s ippp���� pp � 7
Expist
Cardboldes *maim Ameoot _ o � ' , 3 `- : L -1) 4404615 (6000Cem
4.
,
Electrical Permit Fees::. Limited Energy Fees: 4
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY 7s.00
Complete Fee Schedule Below: Restricted Energy Fee .._........
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit 4 ❑ Audio and Stereo Systems
1000 sq. ft or less $145.15
Each additional 500 sq. ft. or
portion thereof $33.40 1 1:1 Burglar Alarm
Limited Energy - • $75.00
Each Maned Home or Modular - ❑ Garage Door Opener'
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation . • .. .
200 amps or less S80.30 / r 2 ❑ Vacuum Systems
201 amps to 400 amps S106.85 2
401 amps to 600 amps 8160.60 2 ❑ Other
601 amps to 1000 amps 5240.60
Over 1000 amps or volts $454.65 2
Reconnect ony $66.85 _ 2
TYPE. OF WORK INVOLVED - COMMERCIAL ONLY �� •
Temporary Services or Feeders Fee for each $$steer.....- .--- -..:.- --»- -"
Installation, alteration, or relocation (SEE OAR 918-260 -260)
200 amps or less $66.85---
• .. _.
201 amps to 400 amps $100.30 2 Check Type of Wont Involved: 401 amps to 600 amps 51 33.75
Over 600 amps to 1000 volts, • ❑ Audio and Stereo Systems -
see "b" above.
Branch Clrcuits. _ _ ❑ Boiler Controls - - .
New. alteration or extension per panel -- _- - .: - - -
a) The fee for branch circuits ❑ Clock Systems
with purchase ofservlce or . .. • _ _ -
finder fee. •
Each brandy circuit _ $6.65 2 ❑ Data Telecommunication Installation • :. e. _ •
-
b) The fee for branch circuits -. _ • without purchase of service ❑. _ _ Fre Alarm Installation: _. . _
or fe
eder fee- - _fi. - ... •.:Y.- „ ..::i- • - •
First branch drarit . _ ”. . . -. " . $46.85 .. -.� E2 HVAC
Each additional brandy circuit ? $6•� -:� -tea- -w
... .. Instrumentation .
Miscellaneous -. , .. _ _ =
(Service or feeder not inducted) --. _.,.7.: -- .. - - .
Each pump-or irrigation circle - .- ._ - _ - $53.40 - - ❑ Intercom and Paging Systems_ -
Each sign oroutline lighting � — _ . _ .. -- -
Signal dreuit(s) or a limited energy - • " En Landscape Irrigation Corytivf . . . .. -
panel. att> tian areorterysion, $75,00 •
Minor Labels (10) . _.- $125.00' - . - .. ❑ Medical •
Each additional Inspection over -` :_ -- - :- •_ _ - - . '
-.: NyuseCatis
the allowable in any of the ove 56250 =— .. .: .
Per inspection $82.50• • • . ❑
Outdoor landscape Lighting'" In Plana _ . . _ -
J " 0 2 1 - 3 7-9- - -- ❑ Protective Signaling - -- •
Enter total of above fees. .. S l g 40 . ❑ Other
8% State Surcharge / -1 r 0 .: _ $ i'1 ° ` 7 Number of Systems.
25% Plan Review Fee 1 ` No licenses are required Licenses are required for ell otlrerhnstallafions
See 'Plan Review section on .
front ofappficatian. _ _.. . -. Fees: .__
Total Balance-Due. . n
3C, . 7 _. Enter total of abovefees. . s`
a TrustAaoouMfA , 5% state Surcharge -- -- -S
T otal Balance Due _ . - . V - '
. .
is dstslforrnldc- fees.doc• 10/09/00. .. -- - -- -- ____ _..- ! -
•- " ' CITY OF TIGARD BUII DING INSPECTION DIVISION /
24 -Hour Inspection Line: 63: ,75 Business Line: 639-4 T
6...-
Date Requested /d - Z- AM PM BLD
Location 1 / (Z - 7 d .-' 72d -2_ Suite ,t3 / g MEC
Contact Person — L fll U j Ph , o q - 7 / 9 PLM
Contractor ° ' Ph SWR
BUILDING Tenant/Owner d j ELC D 7 / 0 0.x/
Retaining Wall ELR
Footing E C CeSS J
Foundation FPS
ARP Ftg Drain �` t
i
Slab es �� } SGN
Crawl Drain Insp ion No . �� �, ;
Post & Beam 11 ! � .SIT
Ext Sheath /Shear 7 _ --f---- � r' /J/ f _ _ /� __ _ ,
Int Sheath /Shear 96
6 /',, i ^ • 99
Framing >< 0 D/l,C L! E O cd/iQ //t
Insulation
Drywall Nailing 60 /p/ �f
/pi ( pAL --lam — -.1--4.
Fire wall n_ /� c
Fire Sprinkler / ��`�"/ / o e � ��►- /�
Fire Alarm ,/
Susp'd Ceiling L _ �� - / ��% �' �/• � - �
Roof �IYYrr7 EX� 5
Misc: .,, .� sr_ L —
�` a
PASS PART FAIL
Final �� a <Z
57' dj' Q/2 / D�1^'� � Q�
PLUMBING roof-- 9 Sb(7 /e d .
Post & Beam f
Under Slab /J _ 77- 74/✓ 4A — 4 i / e U. jQ j
Top Out /
Water Service ■ Jvti c fj C» b /7X /17-. b51 J '��2TY+-1
Sanitary Sewer
Rain Drains ��,e 7r1e1 -76n / F DA - -1 (p r .5SOf cp i
Final
PASS PART FAIL 40 se _ .L • _ , 4 _ p ( _
MECHANICAL
Post & Beam l c -DtV Cf ice 'rn l'a ,1v; A d-)6Jr„ 1 )23 ti 1
Rough In
Gas Line 4- OX CrY /o ID y' C- o e--D, /
Smoke Dampers k1 'nn 1 •1-/_ r C )> 71- el,--)5 ,5-f pr
Final I I (`'1
PASS PART FAIL .5(-,;+C-1. .5(-,;+C-1. C / i 4i C Lac / 1
- C i --1 rj tc C'�
ELECTRICAL J
Service ` 4) { U./ier/ 6 4 7 i IA / /.. . / ( -- '7 ')
Rough In
UG /Slab . 41 1 .011_40!:‘ r AO Z' . C _ ,
Low Voltage
Fire Alarm .' a. ' _ b∎ P 0 i _ . -1 .. ., I
r ( 1 `� PART FAIL )3r1C77�7) i L' -L ticti /-;/7 b�17/ .2 4.)n IL-
E
Backfill /Grading c , y r y `/ d < ! kvl iv
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA 1 /�'
Approach /Sidewalk Date ( e �3 / 0 i Inspector ` ' N 6&, . �(� Ext
Other T + 1J
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.