Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00832
� l�i . DEVELOPMENT SERVICES DATE ISSUED: 10/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 110DC -02300
SITE ADDRESS: 11545 SW DURHAM RD B -6 ZONING: C -G
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT : JURISDICTION: TIG
Project Description: Electrical TI, health care facility. Job No. 106.
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 WIO SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 30 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:
DURHAM /99 ASSOCIATES LTD PTNSH WILLAMETTE ELECTRIC INC
BY CRIIMI MAE SERVICES LP PO BOX 230547
ATTN: LOAN SERVICING TIGARD, OR 97281
ROCKVILLE, MD 20852
Phone: Phone: 503 - 624 - 3631
FEES Reg #: LIC 75059
SUP 1965S
Description Date Amount ELE 34 - 2830
[ELPRMT] ELC Permit 10/27/200' $246.35
[ELPLCK] ELC Pln Rev 10/27/200' $61.58 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 10/27/200: $19.70
Total $327.63
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 w • • • - in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
susp ded for more th. • 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rul: s are set forth in OAR '52-se 00 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct question to OUNC at
50:- 246 -6699 • 1- 800 -332 •
Is ed By: — / Permittee Signature: V 4 ,_ • 46 . „,
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:
ONTRACTOR INSTALL , TION ONLY
SIGNATURE OF SUPR. ELEC'N• A�� 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.
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.. Hard 5 OR 973 t 2 — — — —
r6 50.,.63', . 1t Fax_ - 0 .59 8 .19(10 4 r ' I ,,,„
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.° ton Line: 503 639.4175 o�, 2 , , , ,,;1, oq,e Ready / &v: t— — - - :4• ' '2 e.e Page 2 for - - - I
Intel i et. ' i t.gard.o -_ t.1 �� Su p__menta, Information 1
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New c.,&ustruction .Additioi9Pt a , Please check all that apply:
❑ Demolition ❑ Other: over ouv
....... ....:::. ',r „ra ,:P »„ g;7y,,,.�� =r;t:.,`_m €::�' sT,, := ?fzaoc -:<b.. x r;� =u, <. ,�:..: .<.;,�, : • ft., Service r225amps comm'1 ❑Hazard location
• y - c� x � ; � � � � M� A � ❑Service over "s20 amps rating ❑Bt ildng over l0 000 sq. ft.
, ., , . @`:' E3 ORY QF CON' STRU@TION of 1- and 2- family dwellings or residential
„ y,•sa., ,, -s., , , •ma y ,, - r , n s 4 r more new residen
❑ 1 and 2 family dwelling 56 Commercial /industrial ❑ Accessory building I ❑System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other: ❑Building over three stories [Weeders, 400 amps or more
,* ..„ _.- �' - ri= ;.hex °tt= . cupan 99 persons d structures or
builder _ DOccupant load over 9 ❑Manufactu re
", ."t: ; - `'' :TOI3 SIT 'm OM:fia ?$ A I OGA` OIYt" .,, . , 1 i ess /li htin lan RV park
n ealth -care facility ['Other: no.: /0 Job site address: f� $ / S'rw` �J� ✓�� �� , Submit 2 sets of plans with any of the above.
City /State /ZIP: 4 � o i The above are not applicable to temporary construction service.
Suite/bldg. /apt, no.: f3 Project name: �f r "; ` `$; E HEp IIE
,/
S ':' .-:..: '', R
• y e t.(j f' Descriptio Qt Fee. Total
Cross street/directions to job site: / 9 / New residential single - or multi - family dwelling unit.
Includes attached garage.
_ 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: • ,. ; , < ,, 8 �,5.. ,< .. » ,,. h . e , a . . Limited energy, non - residential 75.00 2
, a i?,4< V , x r pESCRTPT i O E %V r,' ,3" �'4)' ., i . •
,... - ,,,t, ? , ,t : ;. ., n. ,,,_,,,.,, -- „m,.,_,, -.. � t .1 t Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
, ki iii 5 Via,Ww•i a,; :_, :,.;,.. e: : :11, ,. n i fie „4
4 ' ; , .. „. �,;::0Aig 45 .:, . ., a 201 a s to 400 amps 106,85 2
< -i,i ,;, l 1tOPERTYIaO ER� * ' 47 ”;
„ i ^. 1 TEN �T aL ' r +.
- ��: +?a .„,f ,.. ��,,. ,n. .m ;�.:�F� �f< a.,,. � 4,.�.. s; �..,. vw, .�..�� .:.-. �.� .., ,�:�.��.l 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2 '
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
er ”- "nJ:_< °�° cw r :`;'„': "` =;
" - ,,, t� APALIC' n a lf: .� p . ❑i OI C P r-`'� *" " k A. Fee for branch circuits with
- . '-•. s?'s.±aaa -'�- ri` i:° , i.,r:....tnz "s,.�, <,.Y .r,%sF�.eux s =r: »M. >t!.^ -.',-. ;fi �,:�?t
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits _
Contact name: without service or feeder fee, / 46.85 y lI s 2
each branch circuit
Address:
Each add'I branch circuit Do 6.65 J ✓ Y 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 - mail: Signal circuit(s) or limited -
u�.it,'c '"w: ",ss- ;i �.z s - .,: - -� -. ., M..na^ cfx�°'5::c "`z ::s::. z °.'•;tn; - >a`r -t,^•� ' °'n l _
�r='M ,.-:r .. = it eJ,1 i ,,, .:„ . �.4, , 4F,,. . "r ='° energy I.. `�: - ,.�' , �- `- :�(1N`rp ,� CTOR�'�.... �,�"M;;��.a. -.�, r. ; .~,,:; _ � �_;;,s. ,...�;�.._ gY anel, alteration, or P
!_ r' w :' : ' r i:., n* A.:., le.V:-,^ .a:§i »tz•„•`..'t':,'..:= e +'..., .._. ._.:lra.- ....�sa >i,,>wu..z,.. _.Ps?e�•�:J.r:.r�„i i.§+;;. ,.sr. >.,.. , ...�,an.,, +�.:.,c.,
extension. Describe: Page 2 2
Business name: - f,,,, ,
t Each additional inspection over allowable in any of the above
r
Address: 6/ ' , '• 0 y o } Per inspection 62.50
City /State /ZIP: t 1 9 f ; , Investigation per hour (1 hr nun) 62.50
Phone: (S y) 6, -2 ti - 6' Fax (56 ) ,2 v ` Industrial plant per hour 73.75
CCB Lic.: 4) .3 G+ Electrical Lic.: 3,11. 74-3 ,r _ Suprv. Lic.: (•y G. 5" ° Subtotal ,) y4 3 S'
Suprv. Electrician signature, required: -- Plan review (25% of permit fee)
State surcharge (8% of permit fee) / 7' '�
Print name: r , a Date: (0 - Z. )' - e I-- 3
. / A " I e ' ` TOTAL PERMIT FEE '307 7
Authorized signature: This permit application expires if a permit is not obtained within 130
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \P arras \ELC- PermitApp, doc 12/03 440- 4615T(10/02 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005•00832
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27l:2005
Phone: (503) 639 -4171 pool l *lj
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/5/2006 TIME: 7 :00AM PAGE: 47
SITE ADDRESS: 11645 SW DURHAM RD 136 CLASS OF WORK:
SUBDIVISION: WLLOWtBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: DR. WILLCOX
DESCRIPTION: Electrical TI, health care facility. Job No. 106.
d?
OWNER: DURHAM /99 ASSOCIATES LTD PTNSH, q I " u PH ONE #:
CONTRACTOR: WILLAMETTE ELE :CTRIC INC PHONE #: 503 -624 -3631
Inspection Request Scheduled For: Date: 1/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199N4 Electrical final 024422 -01 503-624-3631 N
Corrections/Comments/Instructions:
IX PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
l I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
Inspector: i' D-3--- -. Date:/
Phone #: (503) 718 - Y‘746"--
,
CITY �~�����N��������
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BUILDING DIVISION ~�~°"~~~°""~~~ ~="°"~~"~~"~ PER/N|T EL(��O05DUO33
| #: `
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 .��r ^ �L.
INSPECTION WORKSHEET FOR DATE: 1/4/2000 TIME: 6:69AM ' PAGE: 42
SITE ADDRESS: 1164G5W DURHAM FKQB CLASS OF WORK:
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: DR. WILLCOX
DESCRIPTION: Electrical TI, health care facility. Job No. 106.
OWNER: DURHAM/99 ASSOCIATES LTD PTNSH, PHONE #:
CONTRACTOR: WI LLAh8ETTE ELECTRIC INC PHONE #: 503-624-3631
Inspection Request Scheduled For: [] ate : 1/412005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13O.J Ceiling cover 024342^01 503'624-3531 N
Corrections/Comments/Instructions:
� �
V -1111
.
.
0 PARTIAL APPROVAL 0 CANCEL 111 NO ACCESS
|| AIL 0 CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
.� � �//��
Inspect /+^�^*��-'
Date: ~' u�� Phone #: (503) 718- ~� �� �/��
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00832
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/1/2005 TIME: 7 :06AM PAGE: 56
SITE ADDRESS: 11545 SW DURHAM RD B-6 CLASS OF WORK:
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: DR. WILLCOX
DESCRIPTION: Electrical TI, health care facility. Job No. 106.
OWNER: DURHAM /99 ASSOCIATES LTD PTNSH, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503 -624 -3631
Inspection Request Scheduled For: Date: 11/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125
019988-01 503 - 624 -3631 N
Corrections /Comments /Instructions:
7 1 N PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CTA(Z, Noe) Date: 11 • l • C6 Phone #: (503) 718 234