Permit CITY OF TI^ARD ELECTRICAL PERMIT
TIGARD #: ELC2004 -00581
,�,. DEVELOPMENT SERVICES DATE ISSUED: 9/15/2004
,�
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S110DC-02400
SITE ADDRESS: 11565 SW DURHAM RD 120
SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for new tenant space.
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: 3 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:
MOODY HOLDINGS COHO ELECTRIC INC
5701 NE 105TH # D PO BOX 40
PORTLAND, OR 97213 WILSONVILLE, OR 97070
Phone: 503 - 860 -0235 Phone: 503 - 582 -9774
Reg #: LTC 157169
ELE 3 -575C
FEES SUP 3483S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/15/2004 $66.80
[TAX] 8% State Surcharge 9/15/2004 $5.35 Rough -in
Elect'I Final
Total $72.15
This Permit is. issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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 than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are forth in OAR •52- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -669 or 1-800-332-23 . '
• / I 4 1 Pe rmit Signature: i, /
Issued �..�.._raa♦ g - ;.►..l� 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
/ ! i
SIGNATURE OF SUPR. ELEC'N: dINIIIIIIPrz..*. elf^ P� ' DATE:
LICENSE NO: /7?/ S
Call 639 -4175 by 7:00pm for an inspection the next business day
Aug 26 04 12:50p p.2
><Cal Permit ]Eiectr'
�� Per A. pplicaX dn
FOR O USE ONLY
City t►{ Tigard �s‘'I �`"'�, Received
1, h -
6125 SW Hall Blvd., Tigard, O q ui z , O Harem • g ( 94 D�( j rerR,;t Nu..£(� �Urj — g /
Phone; 501639.4171 Fax: t
Date Ready/By-
.1960 .G ∎ - / . - „1 [ \ Plan Review
Inspection Line: 503.639,4 _ 't,,' y li ����I ' � Daffy • Other Permit.
. 1 e
Internet: www ci Ugard,or us b 'e °` ^' "" � � ) . -
„c:-,‘',.., Notified/method 61 Sc e Page 2 rpe
s �, � y ��,�� 1,`a 'y a ,�, " l V. Supp[rmentai information
IYN�C�: !.'ti�6G:Tt�� ti. _ ip C ` + f� ! q;'�'''' '�lii�' r. ' r (' _ i
7�ni i •. C .� LCeriYi1.- t° : L . '`.r.F ` Vi• •p ry _ y � µ�,,{+,..�.
4 � r , -���. uYa..�. x:'W�i/?. .:•1 � ^'• ` " ! :l i r 'x+'�'J*
❑ New Construction 0 ddit?o alicration/replaccment Please check all that apply
❑ Demolition >; ❑Service over 225 amps, co
d0 rhm'I
� � " � �{ y � " a + t ❑Service over 320 a D idng oS location
r_;?F��k; 'y ' c h t o ixY1. ` t ` 'o m and 2 i1tpS - rating ❑RUildn v
`' ' t t -' �� ' 1 .+t-!' i el �•*' „ ';`",-y .'_ „ ' of 1- an-famil dwellings B more new residential
so I
r '' t ` `' Y 8s 4 or more new restUentia]
❑ I- and 2 - family dwelling /:1 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Job site address; \.k, 56
❑ Multi - family ❑ Master builder ❑Autldi
�t �4s i � l - �1i r,rr t a au , ❑ Other;
g over three stones ❑Feeders, 400 snips or more
Yi .1tx$r , �} , iSi' +� ° , t ry�� wir��i��S t p �t R ,� a r , ,c + r y f, t till+ p
r, l ` i 91 ,, t s r � + 1 � y t Y ! u t i ❑ gee. ant load over 99 persons ❑Manufac tur
;@n A A,e,, „!,, ji tigh -' . ,c A r : , a tl j k# M , ri f, ` ,t' � t«,y ed structures or
_ �"�` S s �i"`.fr11 ❑E S� s slli ghtingpl a n RV park
sue qtr•!, 5 ❑IIealtlt care facility ❑ Utt,cr:
Job no.: \°
City /Statc/LIp; Submit Z sets of plans with any of the above.
� ; e above are not applicable to temporary 4 �� 971 aaq The abov COnstrucpon service,
—
Suite/bld / *
8Apt, no ' Project name: . t 19 rtt:�: , •Y
- Description 1� '•:� „ s
Cross street/directions to job site: Qty. Fee Torn, •-
New residential single -or multi - family dwelling unit.
�______ Includes attached garage -
1,000 sq, ft or less 145.15 4
Subdivision; Pa. ndd'l 500 sq ft or portion Lot no.: sq. , p 33,40 I
Tax map /parcel no
� j c. Limited energy, residential ■ 75.00 2
Via !., �'a�31t 1 F i,,k`;� :,�';l'dS'( � � 74 � 6 } w �l! r � ' , � �:t��,a pit � t Li
, ..,a ,» �ni:. �� ` � b/' i! �K ciy , t'1 �t,' 1 z�{l�)�['«i�r t' '�r.�� L i Limited energy, non-residential
aY.vt a�'+?•rr,.,.3 .�L.fr'i,aa trt.,ltS'f!rr St' ,.t h t a}:, S! 75.00 2
J_)___ \ y `^ +i �Ptr: -rf L ► p Each manufactt[r or modular
k.
�G:'^`� �E �i rn�.- {( � dwelling„ service and/or feeder 90.90 2
� yy{{�� (� services or feeders installation, alteration, and/or relocation
i i r lYi �:�;tti g i> 7't. "11 1 f od ?,= s 31> ' a h�. f;'1:.�;it. l i f a A ,r ° 10i4 � a , . ,* !' [„
200 amps to l°° or
amps )6 85 2
2 lass 80 30 «ii .w2,r. S >'' 1
Name:, � • „ 401 amps to 600 amps ti0. L
' _.! 601 amps to 1,000 amps 240.60 2
Address: ( c; � , k N Over 1,000 amps or volts =I 454.65 lel
City /State/ZIP: `" ' Reconnect only Ei
�sa� t C�� �� , al85
Temporary services or feeders installation, alteration, and/or
i
Phone: ( ) 1 F ax: ( ) relocation
Owner installation: This installation is being made on property that I own which is not 200 amps to mps to less 66.8 MI
201 intended for Sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 a 400 amps 100 30 0 2
y
Owner signature. 401 amps to 600 amps MEI
rs,
Date: new, alteration, 133 75 2
p;t, a � ;y, 9{, y kS M : Branch circuits - new alteration or extension, per
r•zlk }�f+_ ±'�W1.�d��'�ri�l� �111� � Ssr \f'� )Cep +c i4 ' S '�,� '�� i ! u „rlt�IS 1 , r •r Is
,- f� �iy �`, '” t r t � I n ,, sit' w �, r & Pee for branch circuits with p p
� :1u -i1 e��;l�, ti��.f:lri 9�ae1;. T.0 .,, f ��,.,,�� t i ,
Business name: - service or feeder fee, each
branch circuit 6.65 2
Contact Hanle;
B. Yee for branch circuits '
without service or feeder fee,
Address: each branch circuit Q 85 b a , 2
City/S tutc/LIP: Bch acld'I branch circuit 6.65 g . 95 2
Miscellaneous (service or feeder not included)
Phone: ( ) 1 F ax: : ( ) Pump or irrigation circle
53.40
A
E-mail; -- ______ Sign or outline lighting
y � f � ,4 y , j ,.
,lth L iitai i"'Jt.;;"{.r,7] icy 'p N:: s i t 1, 'p'!M1 lye; 4 , , T , 7 . 5 ,., .A .trial P a e limited-
,r ��.�t, t" ' " \1{iMFR L �. ('1`7 1� ri�. Yk
�� � � r 1 iN energy panel, alteraltion, or
Business name: �-+_ extension. Describe' Page 2 2
Address: Q � r �
, C �-' 1 .�_
V cv IC A l 1 Each additional inspection over allowable in an of the above
City/Star JLIP: L� t '
, �� Qn Per inspection . -
w . D R C: N , Investigatinn per hour (1 hr m,r!) m . 62.50 9 -
Phonic: ( ) r _
"‹l, "l4 I Fax: ( ) 5 %a--`� Industrial plant ho 73.75 MI
_ r hour
CC$ Lie.; �� � Electrical Lic.: `" 5-1 Suprv, Lie : �Q W ` ,'�-'',',` trik ,'RO- �Yacp k :w,,.,n
Suprv. Electrician signature, required: �� i Subtotal 6� 0p
NA..., l Plan review (25% of permit fee)
-
State Su
Print name: 1 / _rcha S
surcharge (% of permit fec)
.. �[s. e lieu- Date: „ - a 6-(z.5- -4 . e J • 3 5
Authorized signature: - � Y
.. TOTAL. PERMIT FEE 5,.
• � , 1 r' — + ��� , This permit application expires e
Print name: ' ` l `L p If accepted is not oDtainen is.
wum..
days sitter It has been accept its complete
Date: - .. , Q • • Fee methodology set by TrrCuunty Building Industry Scrv,ce Board
�w7din
•• Number of inspections per permit a .lowed
E\roTruts�Er.C- PermnApo doe 17/0)
440 -461 5710 /02/COMrwl:D
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 0503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received / Re ested AM PM BUP
Location I / 3 7 2 . 0 / 4 -ez/M Suite / 20 MEC
Contact Person &A/16:d Ph ( ) 9 6W PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC S OT ( 7 / C ;7 ‘..-S - 6 2 /
Footing
ELC
Foundation
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
P�4,SS PART FAIL
E = . ..
e '
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date / ��Q
6 Inspector �Z� - Ext
Other:
Final DO NOT REMOVE this inspection record f om the jo site.
PASS PART FAIL
A