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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2000 -00429 r p . DEVELOPMENT SERVICES DATE ISSUED: 8/3/00 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AD -01800 SITE ADDRESS: 16662 SW 72ND AVE B -12 SUBDIVISION: ZONING: I -L BLOCK: LOT : 011 JURISDICTION: TIG Project Description: Installation of (2) 200 amp services with (4) branch circuits 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/ SVCI FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: 4 - 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 JOHANSEN ELECTRIC INC 15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERRACE PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000 Phone: Phone: 503 - 698 -3417 Reg #: LIC 00051539 SUP 2053S ELE 3 -243C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 8/3/00 $140.00 HAND RCPT Elect'I Final PRMT DEB 8/3/00 $9.90 HAND RCPT 5PCT DEB 8/3/00 $11.20 HAND RCPT (additional fees not listed here) Total $161.90 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 ISSUED Y: c /, y i / / 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: 09053 -S Call 639 -4175 by 7:OOpm for an inspection the next business day CI TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. �S0 Rec'd By 6 wL 4 r : 5 �� Date Rec'd 7- / 4 - ©V TIGARD OR 97223 -: i• O ® � ( 1 . Date to P.E. Phone (503) 639 -4171, x304', . } . Int or Type Date to DST Inspection (503) 639 -4175 ',.:••• Permit# ELC 2CJUU- i�v�izq Fax (503) 684 -7297 In4 m� will not be accepted called 1. Job Address: ` �M� 4. Complete Fee Schedule Below: Name of Development 11 Number of Inspections per permit allowed Name (or name of business) VC Or 3U S Park I Service included: Items Cost Sum Address (kip Z 51/ / - /2 --4 ✓ f " ' I I 4a. Residential - per unit 1 1000 sq. ft. or less $110.00 4 City /State/Zip J ( J G (t/Y/i Each additional 500 sq. ft. or Commercial c Residential El Limited Energy $25.00 ' Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: An (12 (Attach copy of all current licen es 4b. Services or Feeders Electrical Co i L Inst a ll a ti on, a lt era ti o n, or re tractor G , din �► •�1 ���/...� � q 200 amps or less Address 09'f �S E l 1 (f I Qi�J Terrace- 201 amps to 400 amps $80.00 2 City State L') Zip q 1 d I5 401 amps to 600 amps - $120.00 2 Phone No. ( 11 601 amps to 1000 amps - $180.00 2 Job No. Over 1000 amps or volts - $340.00 2 Elec. Cont. Lice. No. 3--,Li C Exp.Date Q[) Reconnect only - $50.00 2 OR State CCB Reg. No. Exp.Date 0t7 4c. Temporary Services or Feeders COT Business Tax or Metro No. 0 Exp.Date d 1 Installation, alteration, or relocation 200 amps or less $50.00 2 Signature of Supr. Elec'n 401 amps to 600 amps $100. 2 Over 600 amps to 1000 volts, License No aD 5 3 Exp.g ate see "b" above. Phone N. ((C1 3 - 5 y 11 ( 19 1 , -- Lji 4d. Branch Circuits New, alteration or extension per panel 7v 2b. For owner installations: a) The fee for branch circuits with 611.i• purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 2 b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required) :* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $ 100 . 00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 ,90 pm * Submit 2 sets of plans with application where any of the above apply. 5. Fees: ✓ Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ NOTICE Subtotal $ /'J. 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # Jfieg: Total balance Due Jio.10 $ lie I' 9 p __ 6„. k .12,Lo_...44 I: \DSTS \ELC96.APP Rev 9/96 '] f 7 - 97F/ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location (6 rpZ 5 V ? Z Suite g ( Z MEC Contact Person Ph 70 e/ —/ PLM Contractor Se.4 c Ph SWR BUILDING Tenant/Owner ELC .00G -GU 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 O 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 Final PASS PART FAIL <- ECECTRICAI ) eMce _ ough In UG /Slab Low Voltage Fire Alarm Fin 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 / Approach /Sidewalk Date Other eveyi, Ins �� 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 BUP Date Requested F- 3 I AM PM BLD Location l f' G Z 5 7 z--41 Su ite /2— MEC Contact Person Ed Ph 96 - y/ (/C PLM Contractor Calf/ Ph 7 04 -- / s 3 V SWR BUILDING Tenant/Owner ELC 2 -0 0 ef zq Retaining Wall ELR Footing Access / � � Foundation / G � ' �% 1 I/ -mil FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler /e/L /:- Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING N /C a, 9-e 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 CTRIC ervice Rough In UG /Slab Low Voltage Fire Alarm S • 'ART 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 Approach /Sidewalk Other Date 3 9-0. Inspector 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 BUP Date Requested � t" AM PM BLD Location / G G G Z 5 w Suite 6/ Z MEC Contact Person ( '/y/ Ph 704 -/5 3 (j PLM Contractor _ • . _,. _ _ _ / _ Ph SWR BUILDING Tenant/Owner ELC 2-4/v aU 4f21 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 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 Final PASS PART FAIL e t C TRIC c.e Rough In UG /Slab Low Voltage Fir rm ASS PART SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] pection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please call for reinspection RE: G (C 'Z o,9-tn ^ 4O ,, [l. p nable to inspect - no access ins Fire Supply Line ADA g./ / Approach /Sidewalk Date ""(d ' Ins Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 0 .n • . MEMORANDUM TIGARD TO: Distribution List FROM: Bethany Stewart RE: Address /Suite Number change for Oregon Business Park 1 - Bldg 12 DATE: 3/7/07 PacTrust has a new tenant for Building 12 located in the Oregon Business Park 1 (map below) WCTM 2S113AD- 01800. The entire building will have the address of 16650 SW 72 Ave. In addition they will have suites 100/110/120 divided out for specific areas (map attached). Please retire the following addresses :16662/16666/16670 /16698 SW 72 Ave. If you have any questions, please contact me at 503 - 718 -2459 or bethany or.gov. Thank you. 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