Permit •
CITY OF TIGARD • E LECTRICAL ENE
RESTRICTED ENERGY
r DEVELOPMENT SERVICES . PERMIT #: ELR2002 -00147
^= „ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 . DATE ISSUED: 8/1/02 -
SITE ADDRESS: 16060 SW 85TH AVE PARCEL: 2S1.13B0 -00600
SUBDIVISION: SEWER TREATMENT PLANT ZONING: I -P
BLOCK: . LOT: JURISDICTION: TIG
Project Description: TPS building: Voice /Data cabling. Job #107.09708602
•
A. RESIDENTIAL - B. COMMERCIAL
AUDIO & AUDIO & STEREO: . - . INTERCOM & PAGING:
BURGLAR ALARM: BOILER: L ANDSCAPE /IRRIGAT: •
GARAGE OPENER: _ CLOCK: MEDICAL:
HVAC: DATAITELE-COMM: .X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
• OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner:. - Contractor:
UNIFIED SEWERAGE AGENCY NETVERSANT CASCADES INC
150 N 1ST AVE . 9020 SW GEMINI DRIVE
HILLSBORO, OR 97123 BEAVERTON, OR 97008
Phone: Phone: - 503 - 646 -0533
Reg #: ELE 34- 258CLE
LIC 47238
SUP 2867JLE
• FEES Required Inspections
Type By Date Amount . Receipt Low Voltage Inspection _
PRMT . CTR 8/1/02 $75.00 2720020000 Elect'l Final
5PCT CTR 8/1/02 $6.00 2720020000
Total $81.00
This Permit is issued subject to 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 - 0.080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
- = Issued by r , , ` Permittee Signature h C
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. E LEC'N, J . - DATE: •
LICENSE NO: f
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
07/26/2002 09:50 FAX 503 641 6613 NetVersant Cascades, Inc 2001
r. -,-
.
Electrical Per tApplica v•
Date received :0 I d z, Permit no.: 0 Z , %0 ). — OD q 7
4 WItr• Pro }ecdappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd; Tigard, OR 97223 Date issued: C Receipt no.:
Phone: (503) 639 -4171 Case file no.: Payment type:
`Fax: (503) 598 -1960
Land use approval: •
0 1 & 2 family dwelling or accessory `'( Commercial/industrial ; ❑ Multi - family 0 Tenant improvement
O New construction • Addition/alteration /replacement 0 Other. O Partial
JOB'.SITE 1NFORIVL1TLON• .
Job address: Mr/ 13 - Bldg. no.: Suite no.: Tax map /tax lot/account no.: -
Lot: Block S r • 11 ' o . 1 :WARM raIIIIIIIIIIMIIIMIIIIIIIIIIIIIIIIIIIIIM
Project name: ' ' ' 43 I /V • Description and location of work on premises: 0 tee. - No - Ter 4 — ' /d
Estimated date of corn . letion/inspection:
CONTRACTOR APPLICATION r FEE. SCHEDULE::.. . s
Job•no: • 4 a g' • r Fee Mau
Descri • lion (ea) Total no. in" : Ito raaraa \ [� - ..A•Er � =r... -
New residential - single orntulti- famiiyper
Address: ci 020 .. W. ken b i E dweuingunit. Includes attachedgarage.
State: Oi . ZIP: - GO Senice Included:
1000 sq. ft. or less 4
i E- mail: Each additional 500 .. ft. or • onion thereof =mom
CCB no.: 00 ri a 3 5f Elec. bus. lie_ no: 34 - 2SSC LE Limited min , t,es ;dential MUM 2
City/metrolic.no.:00003 _ S� Limited energy, non- residential 2
ZOO o- Each manufact homeormodulardwelliflg
1111■
Signature of supervising electrician (required) D • Service and/or feeder 2 • •
License no: S•,TG Services or feeders— installation, ®. .
Sup. elect name (print): /9,-7 /��pg e,04.9 � alteration or reloeadoa:
PROPERTY OWNER 200 amps or less 2
Name (print): C - , h W f i i .2 201 amps s to 400 amps ___ 2
� � / ��� 2
Mailing address:
601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts - _IIIIII _ 2
Phone :, . -7 ; Fax: E -mail: Reconnectonl MIME 1
Owner installation: The installation is being made on property I own Temporary services or feeders - 11111
which is not intended for sale, lease, rent, or exchange according to Installation, alteratton,orrelocatlon:
___
ORS 447, 455, 479, 670, 701.. 200 amps unless 2
201 amps to 400 amps . � 2
__
Owner's signature: - Date: 401 to 600 nor • s 2
ENGINEER . Branch circuits- new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: • ZIP: Fee for branch circuits without purchase
- of service or feeder fee, first branch circuit: 2
Phone: Fax E -mail: Each additional branch circuit: •
FLAN. REVIEW ( Please- check all that apply) Misc. (Service or feedernot included): INN Service over 225 amps - commercial • • 0 Health -care facility Each pu • or irri : adon circle 2
CI Service over 320 amps-rating of 1&2 Cl Ha dous location , - Each signor outline lighting S__ 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extension* - 75.0 t 2 •
Cl Building over three stories 0 Feeders, 400 amps or more *Douai • don:
Cl. Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/ligluingplan 0 Other. Perinspection ' IMEl♦
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. V Other
Not all Juriadalons accept credit cards, please call raisdiction for more information.' Notice: This permit application " Permit fee $ — I S. 0 C3
' Visa Cl MasterCard V expires if a permit is not obtained Plan review (at _ %) $
alms l ti c `� gl d thin 180 days atter it has been State surcharge (8 %) .... $ . (9.0 0
� f &.P' °m $ Pi. a ,,..0
_ • /
•
.
• g-6 5 0 ooa2 `f73 4 440405 (6
0 - D
CITY OF TIGARD 24 -Hour r
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
l BUP
Received Date Requested ' 3/ , AM PM BUP
Location / c�� (, O Suite MEC
Contact Person Ph ( ) PLM
Contractor ( ) 3 3 0 - /7 3( SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access:
ELC
Ftg Drain ELR — 7
Crawl Drain
Slab Inspection Notes: n� ��L 1"--e _/ SIT
Post & Beam / F �D
Ext Shear Sheath/Shear th /Srs V Ext eah/Shear r � O /717 DD z „Ai,.
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -
Firewall L 116
'_ i�
• Fire Sprinkler •
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL ni
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 PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab •
Low Voltage
Fire Alarm
PAS Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS'" PART FAIL
SI ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspe - _ % :� ` Ext
Other:
Final DO NOT REMOVE this inspection record from th = Job site.
PASS PART FAIL