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Permit
pril CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00216 . COMMUNITY DEVELOPMENT DATE ISSUED: 4/9/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102CB -02300 SITE ADDRESS: 13240 SW PACIFIC HWY ZONING: C -G SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 008 JURISDICTION: TIG PROJECT: PACIFIC MEDICAL Project Description: Relocate and add (4) branch circuits. 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: 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: PACIFIC PROPERTIES E TECH ELECTRIC BY MARTIN JOHNSON 3350 NW ASHLAND DR 13200 SW PACIFIC HWY BEAVERTON, OR 97006 TIGARD, OR 97223 Phone: Contact #: PRI 971 - 570 -9298 FAX 503 -690 -9185 FEES Description Date Amount Reg #: ELE 34 -628C [ELPRMT] ELC Permit 4/9/2007 $106.90 LIC 156530 [TAX] 8% State Surcharge 4/9/2007 $8.55 SUP 5005S Total $115.45 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 t 80 days. ENTION: Oregon law requires you to follow rules adopted by the Ore. • • • i i 'o •-tion - • • Those rules are set forth in . OA 52- 001 -0010 throug •A • ' 11-0100. 1 -0100. You may obtain copies of these rules or dir- questions to OU ' at 503.24.. • .99 or .:00.332.2344. Iss ed By: 0 ' ' Permittee Signature: . \ i e ' 1 y ---- 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: •N Av i* T • : OR INSTALLATION ONLY . SIGNATURE OF SUPR. ELEC'N: .�//: DATE: 1q4 7 • LICENSE NO: 5 Call 503.639.4175 by 7: 1 1 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. Electrical Permit Application FOR OFFICE USE ONLY 14 ' 2 'IC tity of Tigard Date/By: ive 9 0 1 Permit No.: f_e. d 7 /4 a •13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T I G A It D Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for Internet:. www.tigard - or.gov Notified/Method: / Supplemental Information TYPE OF WORK PLAN REVIEW ❑ - New construction Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ' ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition li Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000, amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ,"Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ' ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived "system. ❑ Addition of•new motor load of ❑ "A ", "E ", "l -2 ", "1 -3 ", Job no.: Job site address: / s(,(/ px_cF /C / (� Six or more occupancy. ❑ 7 ' ❑Six or more residential units. Recreational vehicle parks. City/State/ZIP: '7/G1 Q ` DR ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations: 600 volts nominal. Suite/bldg. /apt. no.: Project name: / F-/ ,4_1 (0C¢( 020(40 ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Deserlption I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. 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 I' Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.). RED 4 . . Li e s i d energy, multi -family. 75.00 2 . 0 /n /�1,� �i C, residential (with above sq: ft.) ' Services or feeders installation, alteration, and/or relocation • 200 amps or less- / 80.30 $6,30 2 ❑ PROPERTY OWNER I ❑ TENANT 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 I ❑ CONTACT PERSON above service or feeder fee, each branch circuit it. 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 - 2 • Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85, 2 E -mail: Pump or irrigation circle 53.40 . 2 CONTRACTOR Sign or outline lighting . 53.40 2 Business name: E — T6C/-F ( L -E(Z T/2 / C L C Signal panel, or limited - / energy panel, alteration, or Address: 3 3 50 / /9 siZ/zf{ -- / O, - extension. Describe: Page 2 2 City/State /ZIP: /3651 j D ` c 7 0 Q & Each additional inspection over allowable in any of the above G / - Per inspection 62.50 . Phone: (q 7/) 5 — 9 2 7 8 Fax: ( S0)) 6q d - 9/g S- Investigation per hour (1 hr min) 62.50 CCB Lie.: / �" , 3C) Electrical Lie.: 3v ..7? L . Suprv: Lic.: 5005- , Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal:,. /0 . 90 Print name: Nl� /Y4�4 76 Date: - 9 —D 7 Plan review (25% of permit fee): ,/ St ate surcharge (8% of permit fee): g .55 5 7 Authorized signatu • TOTAL PERMIT'FEE: i t. 6 ,4c' Print name: // /Lk . /14 r y�► — 7 .- C) Date: y _ 0 `7 permit days after it has been a cepte as co ple e.' thin 180 / • Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440 4615T(I I /05 /COM/WEB Electric al. Permit' Application - City of Tigard Page 2 = Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: 1 Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* • • ❑ Heating, Ventilation and Air Conditioning System* - ❑ Vacuum Systems* ❑ Other: [ WORK ONLY: Fee for each commercial $75.00 • system • (SEE OAR 918- 260 -260) • Check Type of Work Involved: D . Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑: 'Fire Alarm Installation ❑.HVAC ❑ Instrumentation • • ❑, Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls • • ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations' I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00216 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/9/2007 Phone: (503) 639 -4171 J Insp ection Requests (24 Hrs.): (503) 639 -4175 � INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 50 SITE ADDRESS: 13240 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 008 TYPE OF USE: PROJECT NAME: PACIFIC MEDICAL DESCRIPTION: Relocate and add (4) branch circuits. 6/21/07 ADD (4) more branch circuits and relocate and adding (1) more 60amp service feeder. OWNER: PACIFIC PROPERTIES, PHONE #: CONTRACTOR: E TECH ELECTRIC _ \ PHONE #: 971- 570.9298 Inspection Request Scheduled For: Date: 6/22/2007 Pour Time: Code # Inspection Description Confir Contact # Message 199 Electrical final 050760-01 971- 570.9298 — Y Corrections /Comments /Instructions: (, � r 1� • N PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 b L _ Date: 6'Z Phone #: (503) 718 - 'p ; r CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00216 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/9/2007 Phone: (503) 639- 4171�i� Inspection Requests (24 Hrs.): (503) 639 -4175 F' INSPECTION WORKSHEET FOR DATE: 6/21 /2007 TIME: 7:03AM PAGE: 24 SITE ADDRESS: 13240 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: FRE1MNt;S ORCHARD TRACTS LOT #: 008 TYPE OF USE: PROJECT NAME: PACIFIC MEDICAL DESCRIPTION: Relocate and add (4) branch circuits. OWNER: PACIFIC PROPERTIES, PHONE #: CONTRACTOR: E TECH ELECTRIC PHONE #: 971 570.9298 Inspection Request Scheduled For: Date: 6/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 050670 -01 971 - 570 -9298 N Corrections/Comments/Instructions: Q 6 * • &I 6 To Wbp . © cik IX- Fioi. 5191, v . 1 c 7O6 II ►Q\( .• N6M *. 30116 N) F-Vca klAcutt■ Na-stArri 4 typez smo-- 24 oc_ viz C,o4ac ca. i Li N r Q oBI4, N INte.a.47 tKz_ WO `Ye Ilkrx 1 Psaftil e Fba.- V P 5 . ❑ PASS XPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C.7" I dg Lig Date: 6 '14.01 Phone #: (503) 718- leitifL CITY OF TIGARD BUILDING DIVISION t PERMIT #: ELC2007 -00216 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/9/2007 Phone: (503) 639 -4171 1 j l l i Inspection Requests (24 Hrs.): (503) 639 -4175 IL. INSPECTION WORKSHEET FOR DATE: 5/9/2007 TIME: 7:00AM PAGE: 56 SITE ADDRESS: 13240 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: FREWWNGS ORCHARD TRACTS LOT #: 008 TYPE OF USE: PROJECT NAME: PACIFIC MEDICAL DESCRIPTION: Relocate and add (4) branch circuits. OWNER: PACIFIC PROPERTIES, PHONE #: CONTRACTOR: E TECH ELECTRIC PHONE #: 971 Inspection Request Scheduled For: Date: 5/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message "'f' Eteettiettlfe41 047922 -01 971 - 570 -92913 N 1 ?�6 v"Ut... 05 NE'(v Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6_ ` ' ^' L. Date: 61 C O " ) Phone #: (503) 718- 2-4%