Permit A__ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00473
1, DEVELOPMENT SERVICES DATE ISSUED: 8/14/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DC 01400
SITE ADDRESS: 15865 SW 74TH AVE 105
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT : 004 JURISDICTION: TIG
Proiect Description: Tenant Improvement
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: 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: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC AMERICAN PROPERTY EXCH RURAL ELECTRIC INC
PACIFIC SANTA FE CORP 5285 NE ELAM YOUNG PKWY
17700 SW UPPER BOONES FERRY RD SUITE A900
PORTLAND, OR 97224 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 -6696
Reg #: LIC 00047478
SUP 4062S
ELE 34 -82C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT RCP 8/14/00 $37.50 0004467
5PCT RCP 8/14/00 $3.43 0004467
Total $40.93
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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 --- iha rc e e d) 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
_ '' CITY OF TIGARD Plan Check #
13 ;125 "SW HALL BLVD. rN3w Xll�I lu rmit Application Rec'd By - ) Q' ,, � 2 • TIGARD OR 97223 0002 ®Z one Date Recd
Phone (5046 - 39 -4171, x304 Date to P.E.
Inspection (503) 639 -4175 G3AI333 Date it DST
P rint of Types._ Pe Permit a �.,,,,,?019 _ tom 103
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Creekview Number of Inspections per permit allowed
Name (or name of business) Cognex Corp Service Included: . Items Cost Sum 4-
Address 15865 SW 74th Ave 4a. Residential • per unit •
CityiState/Zip - - Tig Or 9 - . 1000 sq tt or le ss $ 117.75 - -- 4
Each additional 500 sq. ft. or
Commercial'_' Residential ❑ portion thereof $ 26.75 1
Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or retocation
Electrical Contractor RURAL ELECTRIC, INC. - 200 amps or less $ 64.25 2
Address 5285 NE Elam Young Pkwy #A900 201 amps to 400 amps $ 85.50 2
City Hillsboro State OR Zip 97124 401 amps to 600 amps $ 128.50 2
Phone No. 503/648 -6696 601 amps to 1000 amps $ 192.50 2
Over 1000 amps or volts $ 363.75 2
.lob NO_ _ 0036 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 34 -82C Exp.Date 4c. Temporary Services or Feeders
OR State CCB& Reg. No. 47478 Exp.Date • Instalation, alteration; orretocatiorr
COT Business Tax or Metro No. 5287 Exp.Date 200 amps or less $ 53.50 2
r; � . � 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 401 amps to 600 amps . $ 100.00 2
- - - ---- - - -Over-600 amps to 1003 volts,
4062 -S see "b" above..
License No: Exp.Date
Phone No. 503/648 -6696 4d. Branch Circuits New, alteration or extension per panel
a) The fee for branch circuits
213: For owner installations: with purchase of service or
feeder foe
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PrintOwners Name Each branch circuit • $ 5.35 2
Address b) The fee for branch circuits
. wlOrouf purchase of service
City State Zip or feeder fee.
Phone No. • First branch circuit 1 $ 37.50 37.50
Each additional branch circuit 1 $ 5.3A5 5.35 _
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner s. Signature- . . . Earhsign.oc nrrtlinr+ lighlipry . $, 42.75
Signal circuit(s) or a limited energy -
3. Plan Review section (if required) �* panel, alteration or ext $ 60.00
r 5 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over •
4 er rime rt':liderlttBfuntt4ln ofle structure
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour • $ 50.00
System over 600 volts nominal In Plant $ . 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5_ 5_ . Fees:_ ..
5a. Enter total of above fees $ 42.85
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 3.43
Not construction services. Subtotal $ 46.30
6b. Enter 25% of line 5a for
NOTICE Plan Review if rprv $ Q)
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'PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 46.30
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # 0 •
AT ANY TIME AFTER WORK IS COMMENCED. Total balance. Due $ 46 _ 'I Q
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
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Date Requested ? / 7 AM PM BLD
Location Ca+� S 7 y . A Suite (&) MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC i bl/i- 0 4 /73
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
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof e
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
CELECTRICAL)
Bryce
Rough In
UG /Slab
Low Voltage
• - alarm
• S PART FAIL
SITE
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 einspection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk Date /9 Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.