Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 "
PERMIT #: ELC2007 -00339
COMMUNITY DEVELOPMENT DATE ISSUED: 5/18/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 BD -00100
SITE ADDRESS: 07650 SW BEVELAND RD 200 ZONING: C -G
SUBDIVISION: BEVELAND CORPORATE CENTER LOT : JURISDICTION: TIG
PROJECT: PAYCHEX
Project Description: (3) branch circuits for printers in suite 200.
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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: 2 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:
ST VINCENT MEDICAL FNDN TRUSTEE CAPITOL ELECTRIC CO INC
GERLACH, ETHEL E TRUSTEE + 11401 NE MARX ST
HUNZIKER, EDWARD R PORTLAND, OR 97220 -1041
PORTLAND, OR 97225
Phone: Contact #: PRI 503 - 255 -9488
FAX 503 - 257 -7121
FEES
Description Date Amount Reg #: ELE 26 -496C
[ELPRMT] ELC Permit 5/18/2007 $60.15 LIC 48748
[TAX] 8% State Surcharge 5/18/2007 $4.81 SUP 3132S
Total $64.96 REQUIRED ITEMS AND REPORTS
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 1.800.332.2344.
Issued B U ..////./ / Permittee Signature: e; fr . 3/49 tic l ail
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
-s
.0 •• eN 1 I; , ` '''''''',c B V ,s: FOR OFFICE USE ONLY
f,lectrical Permit Applic ' ti t L... - -- Received
^
„ c+ r ;J += -•' • _, Permit no.: �� , 2Q
- as U l Date/By: S/t J SUv ��LtN� C� 133 J
City of Tigard Plan Review
r�
13125 SW HALL BLVD., TIGARD, OR 97223 qq 3 �+ 2001 4I 1 Date /By: Other Permit:
Phone: (503) 639 -4171 Fax (503) 598 -1960 t If'x f) CITX OF TIGARD Date Ready /By: Juris: ❑ See page 2I'or r .
Inspection Line: 503- 639 -4175 Notified/Method: Supplemental Information
www.ci.tigard.or.us _
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Internet: www.ci.ti � t!� - 1 �rrtMTt�t4�'
TI P QEV.- K -4 r wpt # `> ; ; , PLt1N'REVIEW° ,.: €'' .. r' :,t za: i
❑ New construction ❑ Add d�r�/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
3 '0
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
' , ;,' ' : '. ' „.CATEGOR' OF+ CONSTRUCTION '' „ _ o ., .. . . '1') where the available fault current ❑ Marinas and boatyards
❑ I- and 2 dwelling ❑ Commercial /industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi- family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agricultural
we.`. . .s- 'titAl'•;°°-' "JOB SITE ?1NFORIvIATIOND
AN'LOQATIO ,': '_j'
; :`: amps for all other installations. El buildings
Job no.: 270883 Job site address: 7650 SW Bethany ❑Fire Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State /ZIP: Tigard, Oregon 97223 El Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
100HP or more. ❑ occupancy
Suite /bldg. /apt. no.: 200 Project name: PayChex Printers ❑ Six or more residential units ❑ Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
'' r^' ,f .. ''° ,: ,,.
, .`. 5 °. ;7' FEE'SCHED[ILE,1r,'•_ 7 : -,, A•, „w , ; °7 " :. ,, e , 4,!
Subdivision: Lot no.: ' "
Bevland Building Description 1 Qry. I Fee. I Total I **
Tax map /parcel no.: New residential - single or multi - family dwelling unit.
• a �. j „t. ;,t :1N d ir„ ts- c'DESCRJP,TION OF`WORK, ` ' $ '" „, ` °t ;,'. t °,''"s't Includes attached garage.
(3)new printer circuits in the PayChex space 1000 sq. ft. or less $ 145.15 4
Ea. Add'I 500 sq. ft or portion $ 33.40 1
`❑ PROPERTY_ OWNER,. '?:',' ':' 41 L l ri, , j ;,' ;M, ,,,„„;,;❑;TENANT` „ „ _ .,. . � ,'gw - Limited energy residential
Name: (with above sq. ft.) 8 75.00 2
Limited energy, multi - family
Address: residential (with above sq. ft.) $ 75.00 2
Service or feeders installation, alteration, and /or relocation
City /State /ZIP: 200 amps or less $ 80.30 2
201 amps to 400 amps $ 106.85 2
401 amps to 600 amps 8 160.60 2
Phone: Fax: 601 amps to 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 454.65 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and /or
Owner signature: Date: relocation
200 amps or less 1 $ 66.85 I I I
' ;,s., 'i❑i -i'APPLICANTp; ;" ' .,, :'sµ `'i' "` ; ` ^, "tt C "In ;'' '%1G0VTACTh'ERS'ON ^' ^ 201 amps to 400 amps I $ 100.30 I I 2
Business Name: 401 amps to 600 amps $ 133.75 I 2
Branch circuits - new, alteration, or extension, per panel
Contact name: A. Fee for branch circuits with
service or feeder fee, each
Address: branch circuit 5 6.65 2
B. Fee for branch circuits' '
City/State /ZIP: - without service or feeder fee,
- - - - - . -. - _ first branch circuit • 1 . $ 46.85 46.85 2
Phone: Fax: Each additional branch circuit: 2 $ 6.65 13.30 2
- Miscellaneous (service or feeder not included)
` E -mail: Each manufactured or modular
,' t.. °'.: r, :;.. 5 5 J ' f" „j!u Z .:- o ': - a';; .>,,, „ `,s'I.COIVTRA' TOR : #,„ '., Po ° . , " ... . _ dwelling, service and or feeder $ 90.90 2
Reconnect only $ 66.85 2
Business Name: CAPITOL ELECTRIC CO., INC.
Pump or irrigation circle $ 53.40 2
Contact name: Gary Steiert Sign or outline lighting 5 53.40 2
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: Page 2 2
City /State /ZIP: PORTLAND, OR 97220 -1041
Each additional inspection over allowable in any of the above
Phone: 503- 255 -9488 Fax: 503- 257 -7121 Per inspection $ 62.50
Investigation per hour (1 hr min) $ 62.50
CCB Lie.: 48748 lElectrical Lie.: 26 -496C lSuprv. Lie.: 3132 - Industrial plant per hour $ 73.75
ELECTRICAL PERMIT FEES*; ; ' a . ' ' , 7;'.,s,7 4 %.: , - - ::?.',' , ', --- ;
Suprv. Electrician signature, required: ) ' a; h ° v '��
ljl-�l�iJ4.4 Jai Subtotal $ 60.15
' 'Print Name: DARRELL MCNEEL Date: 05/16/07 i Plan review (25% of permit fee)
Authorized signature: /� State surcharge ( 8% of permit fee) $ 4.81
- 444 ��/- � TOTAL PERMIT FEE $ 64.96
Print Name: DARR C EE This permit application expires if a permit is not obtained within 180
'- " - -• - • - .. days after it has been accepted as complete
. ' Number of inspections per permit allowed, .
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00339
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/18/2007
Phone: (503) 639- 4171mNm ii �I
Inspection Requests (24 Hrs.): (503) 639 -4175 �' �F`L.
INSPECTION WORKSHEET FOR DATE: 6/23/2007 TIME: 7:00AM PAGE: 52 .
SITE ADDRESS: 076550 SW BEVELAND RD 200 CLASS OF WORK:
SUBDIVISION: BEVELAND CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: PAYCHEX
DESCRIPTION: (3) branch circuits for printers in suite 200.
OWNER: ST VINCENT MEDICAL FNDN TRUSTEE, PHONE #:
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 - 255 -9188
Inspection Request Scheduled For: - • Date: 5/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact ## Message
199 Electrical final 1 971- 506 -3089 \ Y
L
Corrections /Comments /Instructions: —
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c l ‘ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: , N $ Date: 42231_a___ Phone #: (503) 718- Z