Permit 1 •
C ITY OF TIGARD ELECTRICAL PERMIT
° T V PERMIT #: ELC2008 -00667
COMMUNITY DEVELOPMENT ` `'� / ' DATE ISSUED: 12/10/2008
T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 -
PARCEL: 1 S 136DB -02601
SITE ADDRESS: 11606 SW PACIFIC HWY 100 ZONING: C - G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: HWY 99 LLC
Project Description: Installing (1) service.
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: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 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:
HWY 99 LLC ELECTRICAL SPECIALTY CONTRACTORS
2655 MARYLHURST DR • PO BOX 2853
WEST LINN, OR 97068 OREGON CITY, OR 97045
Phone: Contact #: PRI 503 - 723 -0371
FAX 503 - 656 -4537
FEES
Description Date Amount Reg #: ELE C126
[ELPRMT] ELC Permit 12/10/2001 $80.30 LIC 168161
[TAX] 12% State Surchar 12/10/2001 $9.64 SUP 1558S
Total $89.94 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: an vu , ) Permittee Signature: See 1(,` C `
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.
r
Electrical Permit Application RECEW I FOR 0 VI; ICE L:SF': ONI.1'
�"
'
City of Tigard
V ,••!P g Datc/B . ' I • O . • °, 1'crmiIN,,.; ke . II lb ,7
?4 i � 0 9
° 13125 SW Hall Blvd., Tigard. OR 97223 Dc C Plan Review
' Phone: 503.639.4171 Fax: 503.598.19610 2/Inn Datchiy Other Permit;
TIC A R l) inspection Line: 503.639.4175 - Dais Ready/By. Jaen: ® Sec Page 2 for
Internet www.tigard-or.gov s mental info on
L' tigian goo
niK
,J::. . .. . .[.' ,. : '¢'yr 's•t " ti .
: ...- •_ :w•., #. >..:w:-;•�� s� ,.. .r':'�•:. .'414..,,,t 1�tlR r r- ' ((4+S'y:r�>t'7�• }•.,� .
❑ New construction N Addition /alteration /replacement Pease check all that apply (sl 2 sets of plans w/items checked below):
❑ Service or lbcdar 400 amp% or mare ❑ Ruilding over three stories.
❑ Demolition ❑ether:
where the available Paull current ❑Marinas and boatyards.
-;: CATEGQRt:,9F�;CON�UCT Ol!l';`,;; . -.:','::,;.7,7,7,:.::1,:.::%,..,::;.;,-,:7,,.y, Y ; e m eels 10. 1100 amp at I50 volts or ❑ r'l buildin
❑ I - And 2 - faIDil dwellin less to ground or exceeds 14.000 ❑ Comivarcial•ute ngr I ur,,l
y g ommercial /industrial ❑ Accessory building amps tar all nlher Mel:,ll:diuns, buildings.
0 Multi-family [J Master buildcr ❑Other: ❑ lire pump. ❑ Installation of 75KVA,>r
: -.; _ - derived vystC,n.
• - , •; atcysys em
larger Separately e
... • . .:IOW: Sr* $;IIVFORMATIOPf���ANI);�tiOC load of 2 13
.. : ATION': = #". `; ; i �'::�. .; + -� new nMnr ad o
,. .: - - _ ` .... .. (] Addition of w I n ❑..�.. „ „ ..., _ ..
Job no.: I Job site address: f I l,pO(p 5V4 PQ.ei� !fl'v 1!OQ 10014P in more.
occupancy.
❑six ur more r�yidential units. ❑ Recreational vehicle parks.
City/State/ZIP: /� tr,1 ❑ Ile:dlh.cme facilities. ❑ Supply voltage ref ill a than
9° " -F ❑ Huznrdous locations 600 volts ltnmival.
Suite/bldg./apt. no.: I Project name: ❑ Service or lbedcr 600 amps or mom.
Cross streel/directions to job site: „ „ EDULE +: '.:.': •}
oeterhaioa, I ow. I Fee. 1 Told 1 •
New residential single- or multi - family dwelling unit.
includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or leas 145.15 4
Tax map /parcel no.: — Ea. add'I 500 sq. ft or portion 33.40 I '
Limited energy, residential
DESCRiP :WO , 75.00 2
`.: ` / `,'.' ' ,':, 1` :,•' ' : :.... �.'^,.s ... % ° ,,.. (w ith above sq. R.)
6 �r� n „ L energy, multi - family 75.00 2
J residential (with above sq. R)
Services or feeders installation, alteration, and/or relocation
® _ 200 amps or less 80.30 f�, r 2
:M QPERTY••OWNER : + „> . ��U';.TEFANT:: t " 201 am to 400 um Ina
.g5 .- ,. : :.... ...... .. .. � 10(
.. �, ..:.... .,. � amps Name: 401 to 600 am 160.60 2
—
Address: 601 amps to 1,000 amps 240.60 2
Over 1,1100 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 I
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 7.
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps 10 599 amps 133.75 2
Owner signature: circuits - new, altcratio or extension, per pond
... ; a e A. Fee inn Munch circuits with
'0 :LIC
APPT ; a ;. • :D ;CON,TAtT't`!ER ..:.. above service or feeder
I :' .....: -.. , . SO>': Y . = ' fee, 6.65 2
Business name: _ each bran circuit _
—
d. F''cc for branch circuits
Contact nand:: r aerVICC or feeder fee, 46.85 2
_ first branch circuit
Address: Each add', bunch circuit 6.65 2
Misccllanenas (service or feeder not Included)
City /State/ZIP: _ Each manufactured ur modular
['bone: — dwelling, service and/or feeder 90.90 2
_ ( ) _ Fax:: ( ) Reconnect only 66.05 2
E-mail:
Pump or irrigation circle
•. _ 53.40 2
_ . . : CON LCTOR ; ., .. Si or outlmc lighting
. , 1.J . '- . .. ,';1 53,40 2
Business nam /1 II J ^' / 1 -_J., y � Signal circuit(s) or limited -
l M 1 t.l /A (.(� i/ ( l (JT a energy panel, alteration, or
Address: P• Q• P i � J extension. Describe: Page 2 2
Cit � /� !7, q- 7 Each additional insp ction over allowable in any of the above
Phone: (5n) �1 Fax: ( ✓ Per inspection —
62.50
P
1 F - tJ / p rxt
0 / I nvestigation p e r h our (I h mice 62,50
CCB Lia: / Electrical r^ tg Industrial plant per hour 73.75
0 1 / I " I Sur L ie. :' O'✓
1 % — `” a.5:� . :;:ELEC RICA1li�P
i _ E ' '
&MIN. Electrician signature,
r • - / L.f . ' i Subtotal: ,
Print natal:: , ( /i . ` I� : • tr : /� , r rn D Plan review (25% of permit fibe): •
// f JQ state surcharge (12% of permit foe): , .�
Authorized signal n {, } ,, i / 1 —
�t'v[ �LI TOTAL PERMIT FEE:
Print name: Date: / r Thls permit application expire„ if a permit le not obi cd within 150 QG n
days after it has been accepted m complete o I —`
LVh , ildingivproi,slfiLC•Pe+ltApp • ac 05/23/126 • Number of inspecions allowed per permit,
440•1615T(1 I /05 /COWWEB
Z /1 # 0961869£05 ! tS:61 ',80 -60 -Z1
CITY OF TIGARD
BUILDING DIVISION PERMIT #:,2,7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 :..,d11ftr ° (r�
Inspection Requests (24 Hrs.): (503) 639 -4175 JA' '� LI
INSPECTION WORKSHEET FOR DATE: IZ ti' A TIME: PAGE:_
SITE ADDRESS: `` E, P AC4 tC. ` 6� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: D. te:1241•01 Pour Time:
Code # Inspection Description Confirm # Contact # Message
°\
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: " " Date:��� �� V D Phone #: (503) 718- Si/Z1
CITY OF TIGARD
BUILDIrNd DIVISION PERMIT #: EL C200�3.006; 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/10/2008
Phone: (503) 639 -4171 . isL41
Inspection Requests (24 Hrs.): (503) 639 -4175 f°' :�
INSPECTION WORKSHEET FOR DATE: 12/15/2000 TI ME: 7 PAGE: 12
SITE ADDRESS: 1600 SW PACIFIC HWY 100 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HWY 99 LLG
DESCRIPTION: Installing (1) service.
OWNER: HWY 99 LLC, PHONE #:
CONTRACTOR: ELECTRICAL SPECIALTY CONTRACTORS PHONE #: 5503-723 -0371
tc
,
Inspection Request Scheduled For: Date: 12/15/2008 V P our , m e : �
�• r
Code # Inspection Description 'Confirm # Contact # Message
115 Electrical service 07904301 503- 504 -3179 \ Y
Corrections /Comments /Instructions: CAL\25
A /d 0)1 7/ 't i o k
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: G---.. 1 a LSI Date:I2 . `G• Cr% Phone #: (503) 718- 2tiff‘
CITY OF TIGARD
BUILDING DIVISION , Ah ii PERMIT #: ELC2008.005€7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/10/2008
Phone: (503) 639 -4171 , rIi �
Inspection Requests (24 Hrs.): (503) 639 -4175 s:_..
INSPECTION WORKSHEET FOR DATE: 12/12/2008 TIME: 7 :00AM PAGE: 17
SITE ADDRESS: 11606 SW PACIFIC HWY 100 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: Hwy gg LLCM
DESCRIPTION: Installing (1) service.
OWNER: HWY 99 LLC, PHONE #:
CONTRACTOR: ELECTRICAL SPECIALTY CONTRACTORS PHONE #: 503 -723 -037'1
Inspection Request Scheduled For: Date: 12/1272008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 Electrical service 079006-01 503 - 723.0371 N
Corrections /Comments/ Instructions:
b t(A. L c O
¥H% A &,
❑ PASS ARTIAL APPROVAL ❑ CANCEL X NO ACCESS
i FAIL CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED
Inspector: Cr" N 6e t, G Date: 124 2 al Phone #: (503) 718- 1-