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Permit ,, _C I TY OF T I GAR D ELECTRICAL PERMIT PERMIT #: ELC2003 -00100 ���� DEVELOPMENT SERVICES DATE ISSUED: 3/3/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S1 13AA -01000 SITE ADDRESS: 16550 SW 72ND AVE B -09 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING. I -L BLOCK: LOT : OOC JURISDICTION: TIG Project Description: Install 1 temporary sere. /feeder and 7 branch circuits. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: 7 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 BRIDGETOWN ELECTRIC 15350 SW SEQUOIA PKWY #300 -WMI 22732 NW GILLIHAN ROAD PORTLAND, OR 97224 PORTLAND, OR 97231 Phone: Phone: 503 - 621 - 7122 Reg #: LIC 103824 SUP 4177S FEES ELE 26 -887C Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/3/03 $113.40 [TAX] 8% State Tax 3/3/03 $9.07 Rough - Elect'I Final Total $122.47 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- 32344. Issued By: , 4edj4 . ) �(� Permit Signature: cT'h Q .p p ! ; 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: 17 7 Call 639 -4175 by 7:OOpm for an inspection the next business day . -- 4,, Elec�rical Permit Application Datenxeived: 3 -s-a 3 Permit no• LC „)Gla ? -OV/De -1j;' `'I �! City of Tiger Project/appl no.: Expire date: City�gard Address 13125 SW Date issued: By:66 1 Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 FEB 2 7 Case frleno.: Payment type: Land use approval: 2003 I:I It TYPE OF PERMIT 0 1 & 2 fancily dwelling or accessory 24oaunerciaUmdustrial 0 Multi - family 0 Tenant improvement • 0 New construction O Addition/alteration/replacement ❑ Other 0 Partial JO11 SITE INFORMATION Job address: (6 ;(1-..! . 7 A. 1....etl- • Bldg. no.: Suite no, j 0 9 Tax map/tax lot/account no.: Lot , ` Block: Subdivision: I Project name: Q. GHQ 1 'Description and locatiionpf work on premises:X ,,, - se 7 L', Wit;, S Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: 9 11 F e Max i cliff-own F f W n t.� L fr-a' c- Desctiptlon Qty. (ea.) Total no. insp Business name: New _�ornmIti- famiyper Address: a.4)-1 3 - W CO / ! s ke rik. /l4L. dwellingmtiLIncladtss 6edgarage- • City: PO Jett-4 k yl- 1 State: OI ZIP: 172,31 Servicemdude k 1000 sq. ft or less 4 Phone: (A 2-1 I Z 2- Fax le'ZI '7 123 1 E -mail bit' (,t1t?Y1 1r. Each additional 500 sq. ft or portion thereof CCB no.: 1 03 S 2,-1' 'Elec. bus. lie:. no: 2.(p - 147 C. , Limited energy, residential 2 City/ , tro lic. no.: 34,11) Limited energy. non- residential 2 L _ - d� a-21-0? Eacb manufactured home or modular dwelling _ Si: •" Dace Service and/or feeder 2 ., . , • - • ing electrician (required) /� Sup. elect. name (print): IC'i' ! '1 S We /1 S � t . i [ ) License no: 41775 Services or feed re errs— i n s t a l l a t i o n , PROPERTY OWNER 200 amps or less 2 201 amps to 400 amps 2 Name (print): 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: 'State: 12,1P: Over 1000 amps or volts 2 Phone: 1 Fax: 1E-mail: Reootmectonly 1 Owner installation: The installation is being made on property I own Temporary servlexsor feeders - which is not intended for sale, lease, rent, or exchange according to . msmllst , alteration,orrelocatiorc 44Y � g 200 ampsortess / .• 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 2 Branch circuits - nett', alteration, or extension per panel: _ Name: A. Fee for branch circuits with purchase of S Address: service or feeder fee. each branch circuit 7 2 B. Fee for brooch circuits without ptadrase City: I State: Z � ' of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not iUClaled)r 0 iiealth-carefacility Each pump or irrigation' circle 2 0 Service over 32 amps-commercial O 5avisova320 amps-rating of 1812 0 NaranddQSleeatioo Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more reside nlal units in one structure alteration, or extension* 2 0 Building over three stories 0 Feeders. 400 amps or more *Description: 0 Occupant load over 99 persons 0 Manufactured structures or RV park Each addhloaal Inspection over the allowable in any of the above: 0 Egressllightingplan 0 Other Per inspection i i i 1 Submit _sets of plans with any of the above. investigation fee The above are not applicable to temporary construction service. Other Permit fee $ / / 3.' n Not a j1Mo:retires tempt credit cards. please call jurisdiaioo for more information. Notice: This permi application Plan review (at _ %) $ Visa O expires if a permit is not obtained' g� 7 i -403 Z t2e1+ -6 TN 47 it within 180 days after it has been State surcharge (8%) .... $ 1 -ei h n eta Sf+P-f'+'156rer accepted as complete. TOTAL $ / )1, `t 7 / + - 7 o aura card $ / to / Cardholder signature Amount 440-4615 (6001COM) 1' C21L- TZ9 -EOS ptlsuaalS yo.ta>1 et,E:8O ED L2 clad CITY OF,TIG4RDi 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested ` — ¥ AM PM BUP Location / (o. CS Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) 71?. d SWR BUILDING Tenant/Owner KeLefil.4. ELC � — Da / v Footing , ELC Foundation Access: Ftg Drain • ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation ` �.tn Drywall Nailing �^' 7 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 T FAIL TRICAL Servic uG ST � ; U ab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA - , % Ext Approach/Sidewalk Date Inspector i Other: Final DO NOT REMOVE this inspection recor from th = ob site. PASS PART FAIL CITY OF TIGA D , 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Received Date Requested l — 1 AM PM BUP Location / 57) A.--e - uite (3 MEC Contact Person A . Ph ( ) 6a-1-71 -a- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC '‘20/ DO Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Q� Drywall Nailing - - 1J• 1 ` �, "` Firewall , �►�, Fire Sprinkler ■ Fire Alarm 2 � V Susp'd Ceiling Roof Other: Final /Or Or 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 �L G PASS PART FAIL ELECTRICAL W* 3 " \ o P VNS - p VV Service (7 1 0 I 1 N) 1 Low Voltage L-F` 0 �_ i) Fire Alarm - Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. (7470 FAIL 0 Please call for reinspection RE: Unable to inspect - no access Fire Supply Line n / ADA D `� ` Ins e r �. _ Ext Approach/Sidewalk - P Other: Final DO NOT REMOVE this Inspection record from the jo site. PASS PART FAIL CITY OF TIGA RD , 24-Hour BUILDING Inspection Line: (503) 639 -4175 - INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUR, . Received Date Requested _ ° AM PM BUP Location ` SS 7 o � z' Suite 6 - cl MEC Contact Person Ph ( ) PLM Contractor Ph ( ) 6 a` - 7 1 a'a SWR BUILDING Tenant/Owner ELC 3 HOC) / d d Footing ELC Foundation 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 LY 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 T FAIL ELECTRICAL Rough -In UG/Slab Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAIL SIT Please call for reinspectio RE: Q Unable to inspect — no access Fire Supply Line ADA . Approach/Sidewalk Date ■41r • Inspe , AP • %✓4 = Ext Other: Final DO NOT REMOVE this Inspection recor from th Job site. PASS PART FAIL