Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00279
DEVELOPMENT SERVICES DATE ISSUED: 6/4/99
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S 113AD -01900
SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Electrical TI
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: SIGNAUPANEL:
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: 18 PER INSPECTION:
201 - 400 amp: 1 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: X CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES STONER ELECTRIC
15350 SW SEQUOIA PKWY 1904 SE OCHOCO STREET
STE 300 MILWAUKIE, OR 97222
TIGARD, OR 97223
Phone: Phone:
Reg #:
SUP 4025S
ELE 26 -122C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT BON 5/11/99 $230.00 99 -15286 Wall Cover
Elect'l Service
PLCK BON 5/11/99 $57.50 99 -15286 Elect'I Final
5PCT BON 5/11/99 $11.50 99 -15286
Total $299.00
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 -6699 or 1 -800- 332 -2344.
Permit Signature: j ` ✓v . i • Issued By:
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
\,/
1111111, P lan C h: # - ��
IiF TkARD E lectri c al Permit Application , •
13125 SW HALL BLVD. RECEIVED Recd Byll J►
Date Redd � - � ` ter
71GARD OR 97223 � 199 Date to P.E. G-11-4 Phone (503) 639 -4171, x304 APR 1 Print or Type Date to DST ;- Z? -9,
Inspection (503) 639 -41 CU MMUN DE�S iplete or illegible will not be accepted Permit q
Fax (503) 684-7297 (--,Pr yM
1. Job Address: 4. Complete Fee Schedule Below: Ms
Name of Development / Number of Inspections per permit allowed
Name (or name of business) PR cisi �:� lw rc t y- Service Included: items Cost Sum
1
Address ) ( 4 t , St 7e44,7 4a. Residential - per unit
q � n // 1000 sq. ft. or less $110.00 4
City /State/Ztp gn-- i v % 7 Z `- _ Each addilionai 500 sq. ft. or
Commercial Residential portion thereof $25.00 1
limited Energy $25.00
Each Maned Homo or Modular
Dwelling Service or Feeder 565-00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor"' ' L installation, alteration, or relocation I �
2 - 7 0! 5e- l�,F 200 am or less $80.00 2
Address 2 01 amps to 400 amps _� $80.00 _ 2
City State 17 Zip 97 2ZCZ- 401 amps to 600 amps $120.00 2
Phone No. 2 601 amps to 1000 amps $180.00 2
Job No. 354/. / s Over moo amps or volts 5340.00 _. 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 247 23 Exp.Date loll /
OR State CCB Reg. No. 44523 Exp.Date 3/2,0 1e4D 4c. Temporary Services or Feeders
COT Business Tax or Metro N. •c . IC. Exp.Date Co It 114 lns amps t les alteration, or relocation $50.00 2
200 / � 201 amps to 400 amps $75.00 - 2
Signature of Supr. E1ec'n // . _ , _ _ ►■..._ 401 amps to 600 amps 5100.00 2
Over 600 amps to 1000 volts,
License No. .3 4.96, Exp.Date %o li`oi see "b" above.
Phone No. Z 3 `3 (::_. 4d. Branch Clrcult5
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
°
Print Owner's Name feeder fee. Each branch circuit / 55.00 90 Q� 2
Address b) The foe for branch circuits
City State Zip without purchase of
Phone No. service or feeder tee.
First branch circuit 535.00 2
The installation is being made on property 1 own which is not Each additional branch circuit 55.00 -r
2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature _ Each pump or irrigation circle 540.00 2
Each sign or outline lighting 540.00 2
3. Plan Review section (if required):* Signal elrcuit(s) or a limltad energy
panel, alteration or extension x• 2
Minor Labels (10) 5100.00 _ 1
Please check appropriate item and enter fee in section 58.
4 or more residential units in one structure 4f. Each additional Inspection over
›e:- Service and feeder 225 amps or more the allowable In any of the above
System over 500 volts nominal Per Inspection
- 5 00
Classified area or structure containing special occupancy Per hour $55 00
as described in N.E.C. Chapter 5 In Plant .
* submit 2 sets of plans with application where any of the above apply. S. Fees: 2 3o
Not required for temporary construction services. 5a. Enter total of above fees $ - j jO
5% Surcharge (.05 X total fees) $ 24 50
NOTICE • Subtotal
5b. Enter 25% of fine 5a for S75D
.\ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) 5
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS AT ANY Account # $ 299
TIME AFTER WORK IS COMMENCED.
Total balance Due
i \OSTS\ELC98.APP Flay WM
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7-20- AMA PM BLD
Location j (e (' ( f D ' 77! — Suite / MEC •
Contact Person be an4-4 1)1. Ph � J�' ZS3 PLM
Contractor UU Ph SWR
BUILDING. Owner pre,C. ( ')4 '7 . ELC 1 qqq- Z7c1
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: /,� �� �''� �"'- SGT
Slab
WI) SIT
Post & Beam n I e ^ 12
Ext Sheath/Shear �( ' W
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall 4A016 44 Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof Cis)4
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
Final
PASS _FART FAIL
(LECTR
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
7 PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA Q'
Approach /Sidewalk
Other Date V i p Inspector F;t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 - ) - q 9 AM PM BLD
Location 1 (.0( 040 '77. (10'... Suite &ID MEC
Contact Person ( . ' (, Ph :31-7.,s?) PLM
Contractor Ph S1NR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: gg SGN
Slab a1- lA �✓� ^� SIT
Post & Beam
Ext Sheath/Shear n
Int Framing th/Shear i 9 k 'tt )2 D 0 °�" { .M , .; !I � /volt ' Gc ,0 _
Insulation
� t t
Drywall
rewalll Nailing &C-C- �� �
9 ! 00/.. � '" '"r � � 'CAW- 41 Cam•! s y
Fire Sprinkler
Fire Alarm Susp'd Ceiling 6-Lc.- 9G1 - �� gAJA -c.� C eza
Roof qq--oo) 02 _,)
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
Final
PASS PART FAIL
CXLECT
Service
Rough In
UG /Slab
Low Voltage
Fire 411arm
na
PASS PART FAIL
SITE
Backfill /Gading
Sanitary Sewer
Storm Drain [ J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ 1 Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector P Ext
-
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Date Requested ( -q61 AM PM BUP
�7 �l BLD
Location 1 (O�� D Ci � - Suite �J --/ t� MEC
Contact Person le)G Ph ► - 2,533 PLM
Contractor Ph SWR
BUILDING na Owner PiT [. --k�l V • ELC J -c l ( ' °Q'Qj) I
Retaining Wall ELt r !a 1 ? [— ooz8O
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: ��qq SGN
Slab �� f.'1 pyoy SI T
Post & Beam
Ext Sheath /Shear 4 i 9R-Ca"),/,6 '7"-•-
Int Sheath /Shear
Framing - Oft! Cr?
Insulation /�
Drywall Nailing LG L- CS. 9 - C> / z.S (gin/ /r L 9 c •rooi
Firewall / /6/446
Fire Sprinkler ‘leir-e,.)t
Fire Alarm �
Susp'd Ceiling . �� Q //'/_
Roof
Misc:
Final
PASS PART FAIL
PLUMBING > 17U.A! ' C4 :6) 7W. so
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
Final
PASS PART FAIL
ECT IC
$Thvrce r
Rough In
UG/Slab
Low Voltage
Fire Alarm
I.
SS PART FAIL
BackfilllGrading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Appro
Other ch/Sidewalk / t; ` %� �C,I Ext
Other Date (U 9�/ Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.