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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00784 :•In DEVELOPMENT SERVICES DATE ISSUED: 12/9/2004 II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 2S1 13AA -00400 SITE ADDRESS: 16240 SW 72ND AVE B -02 SUBDIVISION: OREGON BUSINESS PARK I ZONING. I -L BLOCK: LOT : 018 JURISDICTION: TIG Project Description: (1) service. Job # 30495 -4. 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: 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 GREENWAY ELECTRIC COMPANY 15350 SW SEQUOIA PKWY #300 -WMI 9460 SWTIGARD STE. 104 PORTLAND, OR 97224 TIGARD, OR 97223 Phone: Phone: 503 - 620 - 6020 Reg #: LIC 153421 ELE 34 -617C FEES SUP 5025S Description Date Amount Required Inspections [ELPRMT] ELC Permit 12/9/2004 $80.30 [TAX] 8% State Surcharge 12/9/2004 $6.42 Rough - Elect'I Final Total $86.72 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 •regon Utili otification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rul= or , ir'-ct .ues'••ns to • _ - a (503) 246 -6699 or 1 -800- 332 -2344. j Issued By: ,. 2 � � Permit Signature: ro' • OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, leas , 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 Electrical Permit Aaolication r( ) r, c > 1 r 1( i s I 1. (I\ I.1 City of TIgard 13125 SW Hall Blvd, Tigard, OR 97223 Plan Ren Phone: 503.639.4171 Fax: 503.598.1960 Q " „ ' : _r D Other Permit: Inspection Line: 503.639.4175 DEC ©` � I :. Demo Rea RI See Page 2 for Internet www.ci.tigard.or.us 1 r I • F TIGARD Supplemental tidbrmatioa TYPE OF ” PLAN REVIEW Its •: IC 1!VISION Please cbedcall that apply: p New construction 0 Additi ( :. : ❑ Demolition ❑Other ❑Service over 225 amps, comm'I ❑Hazardous location ❑Service over 320 amps — rating ❑Bmldng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential p 1 and 2 family dwelling ® Commercialfmdustrial 0 Accessory building ['System over 600 volts nominal twits in one structure ❑Building over three stories ❑ Feeders, 400 amps or more ❑ Multi 0 Master builds 0 Other ❑Oaa�ant load over 99 persons ❑M structures or JOB SITE INFORMATION AND LOCATION ❑F,gts/lightingPhu RV p Job no.: 30495 - 4 I Job site address: 16240 SW 72nd ❑Health facility ❑der. Submit sets of plans with any of the above. City/State/ZIP: Poland Or The above are not applicable to temporary construction service. FEE SuitelbtdgJapt no.: 1� g, - I Project name: Production Tool • SCHEDULE I_ Qv. I Fee, I Ted I .. Cross street/directions to job site 72 and Boones Ferry Imes atniial single or muttl_8amily dwelling unit. 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax no.: Limited energy, non- residential 75.00 2 DESCRIPTION OF WORK Each cawed or modular Extend Power from existing disconnect to new Masak machine dwelling, service and/or feeder 90.90 _ 2 Services or feeders Installation, alteration, and/or relocation 200 amps or less I 80.30 8639 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reoonnect only 66.85 2 City/StatefZIP: Temporary services or feeders lean, alteration, and/or Phone: ( ) Fax ( ) relO` 0° 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 to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch dseaits — new, alteration, or extension, per panel ® APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: Greenway Electric branch circuit B. Fee for branch circuits Contact name: Byron Hayden without service or feeder fee, each branch circuit 46.85 2 Address: 9460 Tigard St Suite 104 Each add', branch circuit 6.65 2 City / State /ZIP: Tigard Or Miaodlaneons (service or feeder not hrduded) Phone: (503 Fax:: (503 Pump or irrigation circle 53.40 2 signor outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACTOR alteration, or extension. Describe: Page 2 2 Business name: Greenway Electric Address 9460 Tigard St Suite 104 Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: Tigard Or Investigation per hour (l hr min) 62.50 Phone: (503420.6020) I Fax: (503. 6206124) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 153421 I Electrical Lic.: 34 -617C I Suprv. Lic.: 50255 Subtotal 6 Sn1rv. Electrician signature, required /(, Plan review (25% of permit fee) ..� { State surcharge (8% of permit fee) ( a(2 Print name: , lAe.,. ✓ Roo. `t�t2/ TOTAL PERMIT FEE Q' (o .12 Authorized signature: Ttds permit application expires it a permit b not obtained within 180 days after it has been accepted m complete Print naive: I Date: • Fa methodology set by 'hi- County Building Industry Service Board CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVIS,N Business Line: (503) 639 -4171 MST BUP Received Date Requested / 3- - l 6 AM PM BUP / Location r a. 7 �1 /) 7, 4i,l Suite MEC Contact Person Ph ( ) ,..1-N - .}0-ct. PLM Contractor Ph ( ) - C , — M Zd SWR BUILDING Tenant/Owner ELC °A D D 9 -06 761Y Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing E L Insulation Ai 6 h Drywall Nailing Z .� ` ■ j f ` , — A 1 4 U r , ,, • MG Firewall Fire Sprinkler Fire Alarm p 4 3 °I. C Susp'd Ceiling Roof Other: m �^,.� Final COO ?)i Y c--\116h-r\' PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In C (...- - Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: 'N Al Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS P RT FAIL ECTRIC bed e Rough -In UG/Slab Low Voltage Ai. //i_ A Fire Alarm t n 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. A PART FAIL S ❑ Please call for r- inspec ion RE: • Unable to inspect — no access Fire Supply Line / / ADA Date /' A rt. Inspecto % _ Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record fro the Job = Ite. PASS PART FAIL 1