Permit 111 q CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT
PERMIT : ELC2008-00364
DATE ISSUED: 6/27/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S126DC-04400
SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT : 007 JURISDICTION: TIG
PROJECT: DENNIS CLARK DDS
Project Description: Health -care facility.
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: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 6 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/SPEC OCC: X
Owner: Contractor:
MARTIN BUILDING LLC WILLAMETTE ELECTRIC INC
9430 SW CORAL ST STUITE 100 PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 6/27/2008 $86.75 LIC 75059
[ELPLCK] ELC Pin Rev 6/27/2008 $21.69 SUP 4226S
[TAX] 8% State Surcharge 6/27/2008 $10.41
REQUIRED ITEMS AND REPORTS
Total $118.85
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 By: r Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own w ' h is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: �� DATE: 6 27 ^OL/
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.
OSee .!T.Y 'fig.' I Y R I V e S w
Electrical Permit Application �.:, FOR '' r OE.FICyE�U,SE f ONh, Y ,.. � fa'
, MMA. City of Tigard
; i °a 13125 SW Hall Blvd , Tigard, OR 97223 • evie • ,
$ " ° j Phone: 5036394171 Fax 503
.. 5981960 . Date/t.,
Other Permit pl e ,►
. / '/ C/� O �Z� it 7
T G Inspection Line: 503.639.4175 Uat .y /B} See Page 2 for
7 ` t - Internet. www.tigard - or.gov �i e /Met,° . ". r\easV . _ l 7 - � 4r, rn Supplemental Information
T YPE OF WORK ' �!R . PLAN REVIEW ,
New construction Addition/alteration/replacement
�� t1 t__ Ple check all tha apply (submit 2 sets of plans w1 tes checked below) ,$ 111 p .
Service or feeder 400 amps 01 more ❑ Building over three stories
❑ Demolition 111 Other:
\i ID Service
the available fault current ❑ Marinas and boatyards.
' - CATEGORY CONST RUC ' ` exceeds 10,000 amps at 150 volts or ❑ Floating buildings. t. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 10 Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
u , . • . ❑Emergency system. larger separately derived system. • JOW INFORMATION ,AND 'LOCATION - 1'f . ' • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: " Job site address: - l OOHP or more. occupancy.
6 ® � l r� _ ' " ❑ Six or more residential units. 0 Recreational vehicle parks
City /State /ZIP: 776-4$0-- 16P Health -care facilities. ❑ Supply voltage for more than
�G ` ❑Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: fo)d p I Project name: 6 (` e / ,r. ❑ Service or feeder 600 amps or more
d' r` , :, .. 1.F . ;SCIIED L w, _ 1,.-',.:':- .' I'',ir;
Cross street /directions to job site: Description I Qty 1 E Fee. �� Qty. Total e l "
New residential single- or multi - family dwelling unit.
( - er^ 44 y.,,.. I,— Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential
75.00 2
•D .K.41PTION ,, .Y.'WOR C ,, , - - ir . '4 (with above sq. ft )
44 1 � r n c Limited energy, multi-family
i ��� � / �� �v �✓ residential (with abbove e sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2 .
❑ PROPE OW . 1:1 ; T ENANT =" - . 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT, ' .. ':r .:,:
�❑ _; - ° �� "0rGONTACT't PERSON ; �_. above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, / &.�
first branch circuit
46.85 ,..2
Address: Each add'I branch circuit le 6.65 J / 9-12
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
.. . .'CONTRACTOR. ? *F_:• ° - Sign or outline lighting 53.40 2
Business name: Willamette Electric Inc. Signal circuit(s) r ration, d-
energy panel, alteeration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City/State /ZIP: Tigard, OR 97281 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 624 -3631 Fax: (503) 624 -2938 Investigation per hour (t hr min) 62.50
CCB Lie.: 75059 Electrical Lie.: 34 -283C Suprv. Lie.: 4226 -S Industrial plant per hour 73.75
,_• „ - .ELECTRICAL ',:` P.ERMI.T. FEES 7 _
Suprv. Electrician signature, required: _ — - .-- -- Subtotal: 15
-
Print name: David Fife Date: Plan review (25% of permit fee): a
State surcharge (12% of permit fee): /6 ,� -
Authorized signature: TOTAL PERMIT FEE: f
This permit application expires if a permit is not obtained within 180
Print name: Date: (lays after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Penn its \E LC -Per al itApp, doe O5 /23/06 440- 4615T( I I /05 /COM/WEB
CITY OF TIGARD d IA
r.,
BUILDING DIVISION , PERMIT #: ELC2008-00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2000
Phone: (503) 639 -4171 &ef4p
Inspection Requests (24 Hrs.): (503) 639 -4175 4g --..
INSPECTION WORKSHEET FOR DATE: 1114/2008 TIME 7.O3AM PAGE: 20
•
SITE ADDRESS: p CLASS OF WORK:
09430 SW CORAL ST 20f1
SUBDIVISION: l EI.iMANN ACRE TRACT LOT # 007 TYPE OF USE:
PROJECT NAME: DENNIS CLARK DDS
DESCRIPTION: Health facility.
OWNER: MARTIN BUILDING LLB`, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-624-3631
' I
Inspection Request Scheduled For: Date: 814/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
19 8 Electrical final 0736601 503-624-3631 V
345590
Corrections /Comments /Instructions: -,RT
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o 00e. vW, 0 s a, • ,, isi '!, .
•
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WA I \ , .
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/. PASS E PARTIAL APPROVAL CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G t ! Ve, L Date: l' 6 Phone #: (503) 718- 7-144
CITY OF TIGARD F.
BUILDING DIVISION PERMIT #:
ELC200G -0030
13125 SW Hall Blvd., Tigard, OR 97223 TE ISSUED: 6d'7f2ti0tl
Phone: (503) 639 -4171
4 I DA
Inspection Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE 0 /1 /2000 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 09130 SW CORAL ST 200 CLASS OF WORK:
SUBDIVISION: LEI ACRE TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DENNIS CLARK DOS
DESCRIPTION: Health -care facility
OWNER: MARTIN BUILDING LLC, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC 'i k, PHONE #: 503 - 6243031
Inspection Request Scheduled For: Date: winoaa Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 073596-01 503.6243631 '- '(
Corrections /Comments /Instructions:
® ? _ 0 "PQ-131' i4N fat, AU
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17 PASS H PARTIAL APPROVAL ❑ CANCEL U NO ACCESS
A FAIL K FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G---A 0 6G Date: • 1 • eft Phone #: (503) 718- 14
CITY OF TIGARD
BUILDING DIVISION '�� ^ PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27 /018 01,J3Cr4
2 013�3
Phone: (503) 639 - 4171 /o Ord ,
E;/27f2
Inspection Requests (24 Hrs.): (503) 639 -4175 j ?'I L.
INSPECTION WORKSHEET FOR DATE 7/31/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 09130 SW CORAL ST 200 CLASS OF WORK:
SUBDIVISION: I EHMANN ACRE TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DENNIS CLARK DDS
DESCRIPTION: Health - care facility.
OWNER: MARTIN BIJIWING LLC, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503. 6243631
Inspection Request Scheduled For: Date: 7 /31/2008 Pour Time:
Code # Inspection Description Confirm ` # Contact # Message
1 99 Electrical final 7 503-6243631 N
Corrections /Comments /Instructions: .
GO rtie■ c C akii: 1 Oi\. I a3 II 'k� bN
1 \ ' 11.- ® s
1P C z\a ► Qe kc, tA 6 j T 110 RAV)
Pl_rNA 6 AtJi) cotAv L- ICJ o a -
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918-271-0030
I I PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
X FAIL I/ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 O 1.E Date: 1 . 11 4 CA Phone #: (503) 718 - _.
. ,
CITY OF
, • \.,.
BUILDING DIVISION PERMIT #: ELC2008-00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/20011
Phone: (503) 639-4171 I. j'
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/22/2008 TIME: 7:01AM PAGE: 82
SITE ADDRESS: 09430 SW CORAL ST 200 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DENNIS CLARK DDS.
DESCRIPTION: Helth-care facility.
OWNER: MARTIN BUILDING LLC, PHONE #:
CONTRACTOR: WILLAMEIIE a.EcTRic INC PHONE #: 503
Inspection Request Scheduled For: Date: 7/222008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
. 120 Electrical rough-in 072942-01 503-624-3631 N
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Corrections/Comments/Instructions:
\ ... Ra,_ vt: ANT\ zt,LA04.1 Ft(L .. ADb*,‘-t ;16(\) At--
L N ) cz.---.) 4_,. 61461 wi (.) • • -3,1)
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ti Csmi Rd, GE Cs 14'0
Q 6 G tjiiI ga ZIP 1.-G- uLAt_g_L4 . C
• INI 5 1610 ik00 - Ii)
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1 1
PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
, 0 FAIL 0 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: CT N 6 8 Lte Date: 1 `1.-1 erb Phone #: (503) 718- 1--114
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2 7/2008
Phone: (503) 639 -4171 AA
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/2/20013 TIME: 7:01AM PAGE: 31
SITE ADDRESS: 09430 SW CORAL ST 200 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DENNIS CLARK DDS
DESCRIPTION: Health -care facility.
OWNER: MARTIN BUILDING LLC, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503 - 6243631
Inspection Request Scheduled For: Date: 7/212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 072129 -01 503-624 -3631 N
Corrections /Comments /Instructions:
•
b( r . Pf e G f-e p ,s cLv
e , e �� -fo b e/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
f] FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: i.a I Date: 2 "OP Phone #: (503) 718 -