Permit '4,01k CITY OF TIGARD
� � � ;�
DEVELOPMENT 6
T SERVICES ELECTRICAL PERMIT -
RESTRICTED ENERGY
PERMIT #: ELR98 -0180
DATE ISSUED: 07/16/98
PARCEL: 2511OAA -00300
SITE ADDRESS...:14145 SW 105TH AVE
SUBDIVISION . ZONING:R -12
BLOCK LOT • JURISDICTN: TIG
Project Description : Limited energy panel, alteration or extension.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM BOILER • LANDSCAPE/ IRRI GAT. .:
GARAGE OPENER • CLOCK • MEDICAL ....
•
HVAC • DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: . . HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..:LIM ENERGY: :X
TOTAL # OF SYSTEMS: 1
Owner: FEES
SUNRISE: HEALTHCARE type amount by date recpt
14145 SW 105TH ST PRMT $ 40.00 GEO 07/02/98 98= 307004
TIGARD OR 97224 5PCT $ 2.00 GEO 07/02/98 98= 307004
Phone #:
Contract or:
ES & A INC $ 42.00 TOTAL
1210 OAK PATCH RD
REQUIRED INSPECTIONS -
EUGENE OR 97042 Low Voltage Insp
Phone #: 541 -485 -5546 Elect'1 Final
Reg #..: 111286
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule 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 uesti'•- of -t (503)246-1987.
' Permittee Signature Issued by .� gna
/ //,
_ —
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: —4/17 DATE: 9 76
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd > -fir r�
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST 1 f!8'-o /gG
Print or Type
Inspection (503) 639 -4175 Permit
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of I 1`_ 1`CL-b Service included: Items Cost Sum
Address 14 14 S 1 1 C J 4a. Residential - per unit
1 t 8-o-rci . 01-2.- ^ Each additional it or less $110.00 4
City /State /Zip
9 � D. o><� Each additional 500 sq. ft. or
Commercial EV Residential El portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all curre t licenses) 4b. Services or Feeders
Electrical Contractor
4 &._ Installation, alteration, or relocation Address 113 ?3 c Sl b*) m O ha uE. 200 amps or less $60.00 2 201 amps to 400 amps $80.00 2
City ' t ate LYE Zip 4 1 - 1000 2 401 amps to 600 amps $120.00 2
Phone No. (U 1 q- 1 4- 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. ' Exp.Date 10 - I - 9�
OR State CCB Reg. No. 1 : ' Exp.Date 2... 2. - ``fq, 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 4 .®xp.Date - I `% Installation, alteration, or relocation
�' 200 amps or less $50.00 2
Signature of Supr. Elec'n � �J 201 amps to 400 amps $75.00 2
,�- / 401 amps to 600 amps $100.00 2
Q O ver 600 amps to 1000 volts,
License No 4 S 16 , Exp.Date 10- 1 -99 see "b" above.
Phone Nc ( 1 $4.14- 4d. Branch Circuits
New, alteration or extension per panel
213. or owner installations: a) The fee for branch circuits with
purchase of service or
Print Owne ame feeder fee.
Address Each branch circuit $5.00 2
City State Zip b) The fee for branch circuits
ty p 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 circui $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 4
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
* 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) $ 7 -
NOTICE Subtotal $
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 # 4-2,
Total balance Due $
1: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (0/ 7/00 AM PM BLD
Location / L./ 145 (O S AY-- Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
ELC 7 p
7 "
BUILDING Tenant/Owner SUM. � �� �� ���Z/� -x� 79
Retaining Wall ELR 4g -DO 1 g
G o
Footing Access:
Foundation - FPS
Ftg Drain `)-.0 SGN
Crawl Drain Inspection Notes:
Slab �5�. fl S s
SIT
Post & Beam I O f
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler /i
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
PA P - FAIL
Service
Rough In
UG /Slab
Low Voltage
Fir- • larm
Fin -
PART FAIL
E
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 7 /03 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
.y
CITY•OF TI;GARD BUILDING INSPECTION DIVISION MST
2 4 Hour- Inspection Line: 639 -4175 Business Line: 639 -4171
- BUP
Date Requested AM PM BLD
Location la 4 t i4C t 0. M Suite MEC
Contact Person Ph PLM
Contractor 1 Ph SWR pp
BUILDING Tenant/Owner . = "I 1 xi L 'ELC '97 � '0 0
1 O '
Retaining Wall qty\ p / x A �iA . gF'°r f
iELR l /1 6)
Footing ::7^ti 'r 5;J t` f a! y '��il vfi.4-s0. •�... .. i t
`• '��' Y Z ��:;� � i�-.1 f' �..3;_ -. ...ti °i
Foundation .r ' i �;n -E. ° Y�- � TXx� '3< � -���' , ".:= � �`,'! 4 .: ; FPS
Ftg Drain f .Q V:.• ; `� y "` v '�:' ,:-4
Crawl Drain Inspection Notes:
SGN
Slab SIT
Post & Beam
Ext Sheath /Shear } / °�
Int F amingth /Shear Ji4�•T /° 006 f 1 'i ll C JA� .) --
9
Insulation (. e� CS \ A a
Drywall Nailing .A --J-01
Firewall U
Fire Sprinkler
Fire Alarm •
Susp'd Ceiling •
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
-K- -- Post & Beam -
..Under Slab
`` Top Out _,
Water Service q to f� �t r .
Rain Drains wer ( ; . C� no i�`� C a.� �1+�'��
Final V
PASS PART' FAIL ., . k. i .e___;i/\ e --s 9 - 1 61 n ,
MECHANICAL i %/r ! ', .,1 'M
Post & Beam '' r
Rough In f . ,i_ '
Gas Line '' r. " A ��
Smoke Dampers `
Final
PASS PART FAIL
(ELECTRICAL) 1 •
'Service-- . Al" .
Rough In a` i'''- v s
UG /Slab . ' -
Low Voltage / - ..-
Fire Alarm s
•Fi i m,, kw 1 r�
PASS PART FAIL _
SITE 1
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 Inspector Ext
Final ; ..
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
, TIler2A-cti7fild(41,/, ,
ACTIVE CASE: Grp Smry Edit Prcl Name Actn Cond Log -note Fee Doc Tag Misc Xit
List related cases in project group # 1388 -
— BUILDING PERMIT -- - '1
:BUP97 -0059: PROJECT:TIGARD MEDICAL REHAB: TATUS:R : UPD:06/14/97: :JT :
PERMITTEE:TIGARD MEDICAL & REHAB = PRIM..:SIT96 -0046:
SITE ADDRESS:14145 SW 105TH AVE JUR... :TIG:
— DESCRIPTION OF PROJECT (1)
Installing emergency generator and alarm system
HOLD C/O ON BUP96 -0389 UNTIL THIS HAS PERMIT IS ISSUED & INSPECTED
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION -
CLASS OF WORK.:FPS: FIRST • 2510:sf N: : S: : E: : W: :
TYPE OF USE...:COM: SECOND...: 0:sf PROTECT OPENINGS?
TYPE OF CONST.:5 -1HR: ...: 0:sf N: : S: : E: : W: :
OCCUPANCY GRP.:I1.2: TOTAL 2510:sf ROOF CONST: : FIRE RET ?: :
OCCUPANCY LOAD: 29: BASEMENT.: 0: AREA SEP. RATED: :
STOR.: 0: HT..: 0:ft GARAGE...: 0: OCCU SEP. RATED: :
BSMT ?: : MEZZ ?: : REQD SETBACKS REQUIRED
FLOOR LOAD 0:psf LEFT: 0:ft RGHT: 0:ft FIR SPKL: : SMOK DET..: :
DWELLING UNITS: 0: FRNT: 0:ft REAR: 0:ft FIR ALRM:Y: HNDICP ACC: :
BEDRMS: 0: BATHS: 0: IMP SURFACE: Osqft PRO CORR: : PARKING: 0:
VALU $: 3313: NOTES:
C'f) i( Si p q F
eeil q '
4 C�ci
1 — 037k — 6144-4-
0 ...... 1(
E f_ x_ q -- — etolq
ACTIVE CASE: Grp Smry Edit Prcl Name Actn Cond Log -note Fee Doc Tag Misc Xit
List actions for this case
— BUILDING PERMIT AM 4 -
:BUP96 PROJECT:SUNRISE HEALTHCARE : STATU::F : UPD:06/14/97: :JT :
PERMITTEE:SUNRISE HEALTHCARE PRIM..:VAR95 -0015:
SITE ADDRESS:14145 SW 105TH AVE ( UR...:TIG:
— DESCRIPTION OF PROJECT (1)
Addition of physical therapy rooms and offices to existing structure
HOLD C/O FOR ISSUE /INSPECTION OF BUP97 -0059 (GENERATOR)
REISSUE: • FLOOR AREAS EXTERIOR WALL CONSTRUCTION -
CLASS OF WORK.:ADD: FIRST 2370:sf N:1HR: S:1HR: E:1HR: W:1HR:
TYPE OF USE...:COM: SECOND...: 0:sf PROTECT OPENINGS?
TYPE OF CONST.:5 -1HR: ...: 0:sf N: : S: : E: : W: :
OCCUPANCY GRP.:I1.1: TOTAL 2370:sf ROOF CONST: : FIRE RET ?: :
OCCUPANCY LOAD: 29: BASEMENT.: 0: AREA SEP. RATED: :
STOR.: 1: HT..: 0:ft GARAGE...: 0: OCCU SEP. RATED: :
BSMT ?: : MEZZ ?: : REQD SETBACKS REQUIRED
FLOOR LOAD 0:psf LEFT: 0:ft RGHT: 0:ft FIR SPKL:Y: SMOK DET..: :
DWELLING UNITS: 0: FRNT: 0:ft REAR: 0:ft FIR ALRM: : HNDICP ACC:Y:
BEDRMS: 0: BATHS: 0: IMP SURFACE: Osqft PRO CORR: : PARKING: 0:
VALU $: 245000: NOTES: add area= 2370,new total 27000 add occload 29
■
)) 1)JeYt
�o \
)(" 6\
ATTRIBUTES: View Add Change Delete Esc
View notes about this parcel
— PARCEL
:2S110AA 00300 CREATION DATE: / / .
— PROPERTY OWNER LEGAL LOT' • •
:BEVERLY ENT TIGARD CARE CTR LAND VALUE..$: 449740:
:BY GEORGE MCELROY & ASSOC INC BLDG VALUE..$: 1234420:
PARCEL ATTRIBUTES
» Building Dept Action 12/30/98, research on 14145 105th. No
—NOTES (max 254 char)
12/30/98, research on 14145 105th. No final inspections on
Bup97 -0378, E1c97 -0079. Bup97 -0059 is "R ". Electrical contractor
— UPDATED: 12/30/98 JT
__�v aLIJ
» Building Dept Action 12/30/98, research on 14145 105th. No
» Building Dept Action 12/30/98 Issuing any further permits
NOTES (max 254 char)
12/30/98 Issuing any further permits as of this date is not
recommended. Requested Supervisor respond to either Debbie /Jeanne
UPDATED: 12/30/98 JT
- » = Special flag
i
Press F10 when done...
From: Hap Watkins
To: Jeanne Temple
Date: Wed, Dec 30, 1998 2:36 PM
Subject: Re: Parcel 2S110AA 00300, 14145 SW 105th Ave, Tigard Medical
Four outstanding permits, three with no inspections called. Yes, that sounds like one to hold all further
permitting until current permits complete. The owner /tennant or management company has to be called
and notified. Good call thx hap
1 1�
hap @ci.tigard.or.us (P I I q 1f
»> Jeanne Temple 12/30 1:07 PM »>
Please view my notes in Parcel Attribute and respond to either Debbie or I. Debbie is holding incoming
electrical application until further notice. _ /
Thanks! f" )_J M
1��a 111 r
Jeanne Temple /' / /
City of Tigard
Ac r Building Division r it /
503 - 639 -4171 ext. 310 )
Jeanne @CI.TIGARD.OR.US
CC: Debbie Adamski rr;
•