Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 =00630
COMMUNITY DEVELOPMENT DATE ISSUED: 9/11/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AB-02300
SITE ADDRESS: 14150 SW MILTON CT ZONING: I -L
SUBDIVISION: BONITA INDUSTRIAL PARK LOT : 005 JURISDICTION: TIG
PROJECT: MEDICAL TEAMS INTERNATIONAL
Project Description: (2) feeders for ups and panel.
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: 2 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
Owner: Contractor:
SHEININ - MENDENHALL LLC I E C COMPANY
BY PARROTT PARTNERHIP PO BOX 10286
12725 SW 66TH AVE #202 PORTLAND, OR 97296
PORTLAND, OR 97223
Phone: • Contact #: PRI 503 - 220 -5377
• FAX 503 - 295 -3012
FEES
Description Date Amount Reg #: ELE 26 -45C
CITY OF TIGARD MENU 9/11/2007 $160.60 LIC 49737
[TAX] 8% State Surcharge 9/11/2007 $12.85 SUP 3924S
Total $173.45 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 By: � � A Permittee Signature: ,07.7 4kl � f - 7
• 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.
09/10/2007 19:18 ; .. ' k � PAGE 01
._
Electrical Permit App ' ' -t'on FOR OFFICE" IISE ONLY
City of Tigard SEP 11 200 Received
13125 SW gall Blvd., Tigard. OR 97223 ate/By io/o 7 ,t3 �etmitN -Ce 1D 006.50
Phone: 503.639.4171 Fax: 503.598.19 r \; plan Review
�T Y O A 1 -.; ; i{ Dat�Y other Pew
Inspection Late: 503439.4175 � 7 Aat
� • ' s e y J , u , t
ard.or.u8 r3 bTG Reaa See Page z fo r
Internet: w w.ci.ti
8 .L7 r ' iVOaSed/Method Supplemental etttq ter
pPL Reformation
;iy i / l .�'! 1 ( 1 } a ' " .` tr 17. ;,.; .fi tt ( e 7dr. Y i y n i , r h } .. " t ' •1 tl ' , Y N o . !Lr h -/ t '. r � 11i a -7 ,
..,.. ", -.. •r. , 4:1. .�:; r .•+ 1 ),,`%„ ` . ... i.l .;;.::::01%,, , r -. ill'� ? / rF 4 l !f .' tt J ! i L r ( (,t ,
New construction 1 I) all,, _Y '.:(!l,t,':
❑ ❑ Addition/alteration/replacement Please check all that apply: ��� •
❑ 11Demolition ID Other: • . ❑service over 225 amps, comm °Hazardous location
tf l' , Y ,, i. - kY ,r4:)+ ^ fi r, , r r t r,r.rr , ❑Service over 320 a s -rand udn over
.uz -!..l 1.. ,, ' i,r t ',. •_ , 0. f t i'r t 1 t t, t I 'riM. r 4 (: s + '< / fi r {r r a 1 F S „: Of 1- g ❑ Bll 8 10,000 3q.
ti al
ft.,
. 1 Jl
,i r,» r r „ „i , , t.t.; -�, �• and 2- family dwellings 4 or more new residential
0 1- and 2- family dwelling 0 CommerciaVindustria) 0 Accessory building ['System over 600 volts nominal units in one structure
❑ Minn family [ ] M aster budder ❑ Other °Building over three stories ❑Feeders, 400 amps or more
! f , r S ' ' ,l :' r t r ' r ?,'tit, -. ' „ -,'-,••,,.• ` , i r 1' r , 1 t l r r r c f ' g l 1 ", i j t , '' ,; OGC ant load over 99 persons ['Manufactured str�cn,res or
. ,: . ... , ( ._.,, <.r',, s'5:t Ir . .,�s )„ ,; !,,?s; Q fiSress/lightingplan RV park
Job no.. Job site address: `l,k,S 6 S1.) ❑Health-care facility ❑Other
Submit 2 sets of plena with any of the above.
City/State/ZIP: r 4 1 3� applicable to to The above are not temporary construction Service.
\S V."' Suite/bldg. /apL Do.: r 1iS/' � + ` ` j
P roject name: �C \ Gh'\ �l�R ► �N� I !: � r •. ,5�..1 a'.:1 1 :) +Yt �E' ., tt+Y ?
. r r K i� li •ll
Dnerlptwn Qty. Fee Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft- or less 145,15 4
Subdivision: Lot no.: 1:.a add'I 500 sq. ft orportion 33.40 1
Tax [nap /parcel no.: Limited energy, residential 75.00 ` 2
1 +`i( f �` ; i t {' {'e .l r . { ! . `" f , ` 1 ^ L ° , > i2 J 1�+ , ' � < , y 1 { Limited energy, non - residential W 75.00 2
t
A. < ••,;.0 io, ... tc u. ,r . : .... .r, . 4.' ,fi �, it -0 ,, mach manufactured Or ttwdular
- 1..-0 S 1� A dwelling, service and/or feeder 90.90 2
�* �� (' C ✓J +�► �� s Services or feeders installation, alteration, and/or relocation
o■•, d P A -t 1 .200 amps or less 80.30
� %Cu- o 2
p
) h 1 3 �- ( :/ Y' '1,,.','-.,:;:,,,,,:-',, L 106.85
, ,i ,1 iF , �, s t : ,1,� c ', '1t 1i�k1c ,s (, ',>, i , � �. 2 am to4 amps
t ! ! 4 - , 1 , .,,.,.,,e.!,1 ,,, 1,.t- >., t� _,, , 7 y . ;t ' 401 atopsto 600amps 160.60 2 2
Name: 601 snips 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 •
•
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner instillation: This installation is being made on property that I own which is not --
201 amps [0 400 amps 100.30 2 •
i intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 600 amps 133.7 2
Owner signature: Date: Branch circuits-. new, alteration, or extension, per panel
t 1 i; i ; rt s' ` F A Fee for bra circuits with .
' u
f}� " i t 1 r { • , �'y 3 3 , >';+ ,,''f4 : ) >, ;.` • : s ,.r M ,,. ; O ;� serv or f ee d er f ee, each
13usiut:ss name:
branch circuit 6.65 2
ti
- B. Fee for branch circuits
Contact name: wilhoui service or feeder fee.
Address: each branch circuit 46.85 2 .
Each add'l branch circuit 6.65 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: mg[I+ circa' s or limited- •
r t rt� •p!1 ,:, •: f 3tin qY 1 1 r t• , ,\I , ( A e 1 , I L `'' ) ', -- > J t ( . _i extensi energy on. lh panel, alterati scribe. or
Page 2
r1. r- n_., .t- r.7r:• •,. }:..,i k i..:_.4. ; •r , .■' ", w ?'„ , .,t 9 L ` ::f , .. , w +..;c .r}.,•;,,. 2
Business name.: F C .
•
Each additional inspection over allowable in any of the above
Address: b
I V atiY 1 0 3 Per inspection 62.50
City/State/ZIP: SON eft s1) •L Investigation per how (1 hr min) • 62.50 1
� r Industrial plant per hour 73 75
Phone: (Sp7 ) . .0 S •.,1 I Fax: (3 o' ) 4 /� - 3 o i y L , ( , ' - '- ' : ,t ,•7 xz r i l o t - ' r 41.rf l i • { A S 114 i ■` ii {1 •
- ." . . .,.v!: "... . . „ „." ° ., •r
,.q.... d,: .: ,. T .1+. , ....zL ... ,u(1.
GCB Lic.: yA13 -1 (Electrical Lie.: � .
: t S Suprv. Lic.: 19S p S Subtotal 1 L O - CO ,
Suprv. Electrician signature, required: Gig a Plan review (25% of permit fee)
(J / State surcharge (8% of permit fee) , '� .,Rs-
Print name: G re c.0 y , m Date: y_! /- C TOTAL PERMIT FEE �
'3 . /A J
Authorized signature:
This permit application expires if permit i not Obtained Within 180
days after it bas been accepted es complete
Print name: Dale: metho se y b I ri Comity Buil Industry Service Board
•• Number of i nspecEaas ology Per permit allowed •
LswtdinpwennisslEL.C•PemtM,p.doe 12#03 aao 46t5r(tO�ovCOnUWBB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00630
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2007
Phone: (503) 639 -4171 /�sary,�
• Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/18 /2007 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 14150 SW MILTON CT CLASS OF WORK:
SUBDIVISION: BONITA INDUSTRIAL PARK LOT #: 005 TYPE OF USE:
PROJECT NAME: MEDICAL TEAMS INTERNATIONAL
DESCRIPTION: (2) feeders for ups and panel.
OWNER: SHEININ - MENDENHALL LLC I, PHONE #:
CONTRACTOR: E C COMPANY PHONE #: 503.220.5377
Inspection Request Scheduled For: Date: 9/18/2007 Pour Time:
Code # Inspection Description Con i # Contact # Message
199 Electrical final I 05587401 503-680-3903 N
Corrections/Comments/Instructions:
Cr) ? Gc1 It 2 0.14
G � N�, � 4 6 NDi r•� ' 5,� �9��L. _ b^(v c1)
V
S FFCLV\ "` v15
Nz c-13 caML r a(`1 cg w i, i A &T 233 5�(ZV 1 O3 .
1
PASS k4 RT • P ' •VAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FO SPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Na Lx Date: 911 (Y) Phone #: (503) 718- 2, '