Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00182
DEVELOPMENT SERVICES DATE ISSUED: 04/09/2001
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171
PARCEL: 2S 113AA -00700
SITE ADDRESS: 16416 SW 72ND AVE B -05
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : OOD JURISDICTION: TIG
Project Description: Installation of wiring for (3) dedicated copier circuits: (2) in training room and (1) in repair area. Job
#99.4990
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: SIGNALIPANEL:
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: 2 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 TICE ELECTRIC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 15009
PORTLAND, OR 97224 2139 SE BELMONT ST
PORTLAND, OR 97293 -5009
Phone: Phone: 233 -8801
Reg #: LIC 166
SUP 2586S
ELE 26 -126C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 04/09/2001 $60.15 2720010000( Elect'I Final
5PCT CTR 04/09/2001 $4.81 2720010000(
Total $64.96
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 direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE � p& /76)1 ISSUED BY / , Alf
OWNER TALLATION 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:
Cali 639 -4175 by 7:OOpm for an inspection the next business day
04/09/2001 08:16 503 - 872 -8290 TICE ELECT.SERV.DEPT PAGE 02
10/10/00 TUE 09 ;00 FAX 503'508 1880 CITY OF TIGARD % Zoo :•
Electrica P mitApplication
WIttelivoil I- ° I ?oath% wilt . •wl- .
,_ 1E;i'i? City of Tigard . ,, pp •
Pro' a 1.[b. 8cpiredate:
cioenlgard Address: 13173 SW Hell Blvd, Tigard, OR 97223 Data Issued: By: j Receipt no.;
Phone: (303) 639 -4171
Fare: (503) 598 -1960 • Caw Mc no.: Payment type:
Land use approval: .
. l Yi'l? OF 1'i.itl11T
1 01 & 2 family dwelling or accessory Q(Commecoinl/industrial 0 Multi - family CI Teoant improvement
O New construction ' 64.1 6 Qpldditictdaltmetlon/rsplaamrnt 0 Other , • •O Partial
.loll SI IF INI (11t.11A'17(bN '
Job address: 164116 SW 72nd Bldg, no.: Suite no. :. 05 ex law= lofleecouat co.:
Lot: BlocIC _I Subdivision:
Project name: 1114 Bu- fines .1,.,• • • • •n and location of wock on prentlaaa: ._ . . =• - .
Estimated •date.oi corn .letiaviinspection: 4 13 s 1 ci R its "s ' • ' •,t ...r h .�•:..
(:u \' i lt,%(u(/lt Al'1'1.l( ION 1.14. S('ll1:IttU.1: •
Job no: 99.4990 btu name: _ — _ ._ ' : . oo, Imp
'
Address: rs l- sioglsorsaitl•faany II son rtevK 15png d>'el adbledo8ar'e rodsedprose.
City: .. ., - , - State: ,,. TIP: a : Se.leeledoded:
,_ Phone: s _ . , s - . • s le" . a. orless a
CCII no.: , . Elec. bus. lie no: ,_ '� nddUottall00 • ,Rol asthma
City /tn •lie. no.: 2014 • ted .• . ,��� MM./ MI=
[.incited , I essooddeatid 1♦1OMIIMMO
. • ' N t 4/09/01 t0 RAN -: Mil bqractur r ' q •. Arm
Sign . re of p rvlelnj electrician ry iuired) . Dora &voloehnalar feeder 11111111. 2
Sup • °L.l000.ro: -a tlotvarreedar- •4oaralla4oa,
u
p Jo u,, . • ,. : ► • • al4ntioaorr+eloconces
L'Ittll't:lt I'1 us111 ' . • . Wasp orIse
Name (plat): Northwest Business Systems 201 .• aeon
Mailing address: 1 amps to 600 AT 1009 AMP
City: State: ZIP: Our 1 � � 000 or solo
Phoae: Pax: 134t1411: fwmeneawnl
Owner installation: The installation is being made on property I own , ay • ert°v3os
which is not intended for sale, lease, rent. ar axehange aceordtng to k oOr an OC
ORS 447, 455, 479. 670, 701. 200 amps °f 11O 2
201 amp to 400 dye
Owners al'. :... ..' - - Date: .........._ .... set to 600am. a
ENG1. kilt • . Winch dtetdte-new. ' • -
erouraloa per p 1
Name: • A. Etc for bunch dtadu purctsaseot IIIIII -
Addreas: sa l norfeecerfoe. a obbrand chant 2
City: Star: 21p: iiiii*Fill111111111
• Phone: Fax: E-mail: , - C'__=1111M
1'I.AN ItL:vii:w(1'Ira +. .hack all rh:,t:,I,plyl - R per 1St.. '•)t
O Serer= over 223 entpa eom,naly al Q Hedtbcar. fsdlhy Iisehpump or MVO= circle 2
Service over 320amprrstingof lea 0 HQardnrubeedoa Bub (IgnorauInee , 2
rani Iy dwellings 0 Building over 10.0rnaqusse feet karat Slptdeirwst (s)ur►Umlud sewn Pena.
O Syaem ever 602v1 4nemfaal Mom resldandsl oohs laoae Mimeo ellaatlon,wattaaaioa• I 2
I O B wadies e'crMemo= 0 Paccias,400 woo arras *Penal , doe:
0 t S • c rpuu loodovu 09 perm 0 Mawt.mwW 41166Wrw or ZV p.i t Baal .. , , • • one the alembic le may ashy alma,
I 7 esraanirhtinedsa O Mac - Pella • - ..
Saba& _ ones of plats with ai of the abo re. . evestitadeafee =MIME _
-Tie above are not applicable to temporary ens uaedoa motes Wet
r Na al Milani= seep credit cosh, peace an ke dtmaa tQ ohm latarwdz. Notice: This permit application Permit fee $ .-44.4-5—
I ■:1 Yin 0 MasterCard expires if a permit Is not obtained Plan tavtew (at %) S
sea„ and notate . ---/ within 180 days after It has•beee State surcbtuge (8%) ,... $ 4.81
end
F d araaeldar w skew va endit accepted re complete. •TOTAL S 9 F
Trust Acct 166 .
Cadtmlda ait7�a • . 4464615 , RAl' b4615 t4 »4
04/09/2001 08:16 503 - 872 -8290 TICE ELECT.SERV.DEPT PAGE 03
164,16 SW 72nd Contractor Tice Electric Job 99.4990
Electrical Permit Fees: • Limited Energy Fees:
A.
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below; Restricted Energy Fee., — .... 576.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Type of Work Involved:
Residential - per unit ❑
1000 sq. ft• or less $145.15 4 Audio and Stereo Systems
Each additional 500 sq. ft or 1 ❑
ponlon thereof 533.40 Burglar Alarm
Limned Energy 575.00
Each Manure Home or Modular ❑ Garage poor Opener
phwetGng Service or Feeder 590.90 • 2
•
•
Services or Feeders ,,,. ,,.. , .. ,,._ .... ._ ❑ .. Beating. Ventilation and Air Conditioning System', . •
Installation, alferatiori, er redo ®lion •
200 amps or less 580.30 2 El Vacuum Systems'
201 amps to 400 amps $106.85 • 2 •
401 amps to 600 amps 5160.60 2 a Other
601 amps to 1000 amps 5240.60 _ 2
Over1000 amps or volts • 5454.65 .. 2
Reconnect only 566.85 2
Temporary Services or Feeders .
TYPE OF WORK INVOLVED - COMMERCIAL ONLY • InsfaOa alteration, or relocation TYPE
2 Fee for each system...•. --- 575.00
200 amps o 400 (SEE OAR 918. 260 -260)
201 amps to 400 amps 5100.30 2
401 amps to 600 amps $133.75 . • . 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above • . , : '
0 Audio and Stereo Systems
Branch Circuits
New, efteration or extension per panel ❑ Boiler Controls
. a) The fee for branch circuits
WIN purchase of service or ❑ Clod Systems
feeder fee
• Each branch circuit $6.65 2 ❑
b) The fee for branch circuits Data Telecommunication Installation
without purchase ofsenlce
o First branch circuit 1 $46 46'. • • • 0 Fire Alarm Installation
Each additional branch odrcult 2 56.65 13. ❑ HVAC
• Miscellaneous • .
(Service or feeder not included) 553.40 0 Instrumentation
Each► pump or irrigation circle
Each sign or °aline fighting $53.40 ❑ Intercom end Paging Systems —
Signal drcult(s) or a limited energy
panel. aftera0on or extension 5$25.00 n . Landscape Irrigation Control"
Minor Labels (10)
Each additional inspection over 0 Medical
the allowable In any of the above •
Per Inspedion $ 2.50 ❑ Nurse Calls
Per hour 562.50
In Plant • 573.75 ❑ Outdoor Landscape Lighting'
• Fees: ❑
Protective Signaling
Enter total of above fees s 60.15
4.81 n Other
81 State Surcharge
. Number of Systems
251 Plan Review Fee •
See 'Plan Revleve section. on $ • NO ticerhses are 'squired. Licenses are required for ap other 4hsl3safions
front of applkation.
Total Balance Due $ 64.96 Fees;
Enter total of above fees s
El Trust Account 0 1 AA
81 State Surcharge 9
Total Balance Due $ .
•
i:'dsts\forms\ele•fees.doc 10/09/00
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
2 4 Hour Inspection Line: 639 -4175 Business Line: 639 -4171 .� BUP
Date Requested AM PM BLD
Location /tIl G 54.d 22."4 Atv'c Suite MEC
Contact Person Ph ,3W -23 Z - PLM
Contractor j/ ('• t Ph • SWR
BUILDING Tenant/Owner
ELC 2e(1/- 0/e Z—
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
• Firewall
Fire Sprinkler #5
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
PI-
, PASS • - FAIL
ELECTRIC • L
Se
Rough In
UG /Slab wWsa /ice
Low Voltage C b Ar
Fire Alarm
Fin
AS PART FAIL
-1TE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for rei spection RE: [ Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date AP Inspector Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received ' 1 C Date Requested ` `0".• AM PM BUP
Location i ln416 5L) � � V'.-CL '1r2J Suite MEC
Contact Person 1 e OY* V 1! A R 5, I^-e SS Ph (-5-1 44 -c�G 'b PLM
Contractor J _Sre ( ) SWR r' ''`- �
BUILDING Tenant/Owner ELC i_T &o � �
Footing ELC L 'j' ard J2_
Foundation • Access:
Ftg Drain • 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
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 P. RT FAIL
E � �►
Servic
Rough -In t44
Low Voltag
‘Z roxi Low Voltag
F' = larm� /j ,
gia) PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S Please call for reinspection RE: Unable to inspect — no access
Fire
ADASupply Line 1 l - /z- o / ' /(1'
PP
A roach/Sidewalk Dat Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL