Permit �: CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00437
I DEVELOPMENT SERVICES DATE ISSUED: 7/19/2004
r � J I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
xalj. PARCEL: 2 S 114AA -00200
SITE ADDRESS: 16285 SW 85TH AVE 103
SUBDIVISION: DURHAM HALL BUSINESS PARK ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Wire (1) subpanel & (2) 20 amp circuits.
Job #71281 -24. '
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: 1 W /SERVICE OR FEEDER: 2 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/SPEC000: .
Owner: • Contractor:
BIRKEMEIER, BRENT T /JANET D TRS E C COMPANY
BY THE BIRKEMEIER FAMILY TRUST PO BOX 10286
10573 SW NAEVE ST PORTLAND, OR 97296
TIGARD, OR 97224 .
Phone: Phone: 503 - 552 - 5503
Reg #: ELE 26 -45C
LIC 49737
FEES SUP 4040S
Description Date Amount •
Required Inspections ,
[ELPRMT] ELC Permit 7/19/2004 $93.60 •
[TAX] 8% State Surcharge . 7/19/2004 $7.49 •
Total $101.09 •
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 -000- 332 -2344
Issued By: -, J1 fl ' Permit Signature: '
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 7:00pm for an inspection the next business day
•
07/14/2004 19:52 503220 PAGE 04 T
Electrical Permit AppIi ski ' - i RJR ► ! z t ► 1 T l ( • I: l .',r t i N 1. \
.itybf Tigard 1 JUL 1 b 200 ;r py CAE
113125 SW Hall Blvd. Ti PamitNo.: n d�fj O ,Q y3 ',
ga rcl, OR 97223 Plan v env l ..L f/
Phone: 503.639,4171 Fax: 503.598.1960 ,'•* -4-1„ 1DatdB Other Pamir nspecd Line: e: 50g
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1 ��ai; ,�dlvl�+�t rf/ /� 1 �� I �, c, ! �,� 1F c } , o, , _ 1
❑ Ad . , ent 1 Pl ease ehec J all that app s r s }� c'`�
❑New cons Additior►/alterauon/re „�..,.� ° .. . ' - � ..' ' ., "'.' . °.�
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Detnolition ❑ Othe ❑Service over 225 amps, comm'1 ['Hazardous location
i1' .. ,. , ,:;;mt,, ;; ; z ;.v ::...... ., _ crvice over 320 amps
'tfs� �,! ��; �;'`� ;' � i t � r r • ,, ;' r' � -- []Huildng over 10,000 sq. ft.
K $ ,. f,.rr Y - ., , : - ; " ; ,7 • of i - artd 2- famil due o l d s 4 or more new residettial • 0 I - and 2- family dwelling 0 Commercial/industrial dustrial 0 Accessory building ❑Sys o ver 600 volts nominal units in one s tructure
OBuilding over three stories ['Feeders, 400 amps or more
[] Multi - family O Master builder d Other
r ,err o- 'r r w QOccupant load over 99 persons 0Manufactured structures or
: r o f c r l c, 1 , ' : 7„ ,c' , ..;:'•"7: ; ;;';":",;-"; ti 2 ` + �" Q1~gress/tighting plan RV park
no. :�vag \ ^ a� `I Job site address: (.2 S t 10 0Health -cm facility ❑Other:
�' Subrrat 2 sets of plans with any of the above.
City /State/ZIP: -T �_, X 0 x-•17-3 1 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: ! �' ' , ,` ;, 1 ,,., "�,{;
N N l ' 1 u } r , r, r r 1� t c t A, :i fkS i 011i�:��i: i +�
peon Qty. Foe. Taw ••
Cross ste eddirections'to job site: New residential single- or multi - family dwelling unit.
\ * Includes attached garage.
3 1,000 sq. tt, or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. B. or portion 33.40 l
Tax map/parcel no.: Limited end, residential 75.00 2
1L � Limited
_. t :,r`1�'�l'tfi � } � . r I � �r �v1 �� �
�' . - �I ��� �in ,r �'�S� , energy, non-residential 75.00 2
I gligia ip !t�. �lO ;i t 71 � e t,i '4 7 (i , r r r t u1 t
(( i:, „,,.r..a,.t�4..i .nr. , ,..r.. M ,.. a..� . :, ti � 4 r .,. ,: , !. Each marlufacturedormt3dular
�A lrt� aU 3 �� C ,r "�� dwelling. service and/or feeder 90.90 2
�) \ �t ( ;� SH� "¢ K ) Serviceg or feeders installation, alteration, and/or relocation
200 amps or less \ 8030 %D. 2
. „�, e 1 1 i1�Y 1 1�It 1 i '11l i Ii t' n i y �y.. "'tt ,1 �, +ia< •t� , i t `+, ` a r .. , . 1 sw• 201 amps to 400 amps 106.85 2
1rt,.t n� „u�`d'TA� ,.i, `,ir.: c�,.rl' 1 1tr...ii. f . .,. � .. ..... !.. `. C .., .,r , 401 stops to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Addrcsai: . _Over 1,000 amps OT volts 454,65 2
City/State/ZIP:
Reconnect only 66.85 2
emporery services or feeders installation, alteration. and/or
Phone: ( ) Pax: ( ) relocation
_ 200 amps or less 66.85 I
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. ^ 401 amps to 600 annps 133.75 2
Owner signature: Date: Branch circuits • new, alteration, or exten per panel
.. . =. °_,, Ui. f �i,t. •Sli 1 j1;” �t Mll,!i,Yj,1 ��, H1�1{i1J<,11,i1�� T � �. ��. rr � f > r{ , { nth i fl 7 h I ; a 1 '11 f 1 i , E „ i ,q,' A. Fee —
�.,. _,tu..r...u.. , . ...n :: �.. Y;,:,',, .1.'" ', 1 l, 6 "wri':: , ,.��1t:;,,ali' :. ic, branch rf ee ,te w
service or feeder f ee, ea
Business name: r•- 6.65 `��0
_ branch circuit
Contact name:
B. ee or branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ( ) — Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E
S circuit(s) or limited-
' '''11-1::4 f' ' 4 ti i '
h' ' ti ' in' i il'IM t vr t ra n , en arch i
�! . .i, ,. � I lr i d 11{ _1,i.,,,,3nnlat.tnm. t , �. r',.'k� 4 T , efRY p
ntorwkY '. ,, . ,,., ( .„ ,, .1 l l
Business name: `.L Cov -• '9A
exttnsion alterat on, or
Page 2 2
Address: P tL G � G f Each additional inspection over allowable in any of the above •
� 6 5 � Per inspection 62.50
Ciry /State/ZIP: 9 \ \) 01Z p\ -Na` -' investigation per hour (i hr min) 62.50
' Phone: (S o") nab- S ; Fax: (s ) ao. - -3U \Z Industrial plant perho r 73 75
CVP Llc,. 1 3 4coi l � IYI J.!1 1 ,.. f 1 /.J A.):∎/ , I;F' ( �' 1
-' { o tLr r '' e$AI d N9t is6(i :'t
y� –try) Electri i : a ( ,.. Lie.: S ubtotal
� 1 q1 - Go
Suprv. Electrician signature, required: s r 1( Plan review (25 % ofpermit fee)
Print name: u� Date: ie � State surcharge (8% of permit fee) 1 �G1
TOTAL PERMIT - FEE , b \. C'\
Authorized signature: This permit application expires if a permit if not obtained within I so
days after It bas been accepted as complete
Print name: Date: • Fee methodology set by Tri - County Building lndustry Service Board
•• Number of inspections per permit allowed.
, Iltoldin e•Penoim■ELGPennhApp.dpe 171113 440.461 ST( 10rm2/t;QM,W B
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested �' AM PM BUP
Location 6 9s gl-C Suite /0 3 MEC
Contact Person _ Ph ( ) .50 76 [4' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC �� 7 -GO 3 7
Footing
Foundation ELC
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
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 /11/ `-2.12 0.14-F14'
PASS PART 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.
RT FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
is /
Fire Supply Line
ADA
Approach/Sidewalk
Date d• Inspector La� .6r; — � Ext
PP
Other:
Final DO NOT REMOVE this inspection record from the j . site.
PASS PART FAIL