Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00617
� DEVELOPMENT SERVICES DATE ISSUED: 11/25/02
- 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639-4171 PARCEL: 2S102CB - 00302
SITE ADDRESS: 13185 SW PACIFIC HWY B -1
SUBDIVISION: ZONING: C -G
BLOCK: LOT : 033 JURISDICTION: TIG
Project Description: Install 200amp service and 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: 1 W /SERVICE OR FEEDER: 4 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:
ALADDIN MOTOR INNS OREGON ELECTRIC CONST /GROUP
BY BENZENISTE, IRVING 1010 SE 11TH AVE
10155 SW CAPITOL HWY PORTLAND, OR 97214
PORTLAND, OR 97219
Phone: Phone:
Reg #: ELE 26 -95C
FEES
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 11/25/02 $105.90
[TAX] 8% State Tax 11/25/02 $8 Elect'I Service
Rough -in
Total $114.37 Elect'l Final
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: CAALV.4 Atlf Permit Signature:
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. 04 ELEC'N: t Z ( 0 DATE:
`1
LICENSE NO: 4/Z 5
Call 639 -4175 by 7:00pm for an inspection the next business day
•
.
Electrical P il tier OFFICE. USE ONLY
Date received_ .... ti , Permit no : so, -196 , / ,
j i City of Tigard 21 2002 Projcct/appl. no.; Expire date:
Cily ofTigard Address: 13125 SW Hall BlvdM rd, OTC
Phone: (503) 639-4171 opt Of '11��� 10 N Date issued :,_ Receipt no.:
Fax: (503) 598 -1960 �v pIVIS Case file no.: Payment type:
Land use approval: Y 1�
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory omrncrcial/industrial ❑ Multi- family 0 Tenant improvement
0 New construction ddition/altcration/replacemcnt 0 Other. _ ❑ Partial
.IOB SITE INFORMATION
• Job address: 1 185 SW P -cific w Bldg. no.: Suiteno.:Bl Tax map /tax lot /accountno.;
Lot: Block: Subdivision:
Project name: Description and location of work on premises; tenant im rovement
Estimated date of completion /inspection:
CONTRAC'T'OR APPLICATION FEE SCHEDULE
Job no: 7 3 1 Fee Max
_ Business name: Description Qty. 024 Total no. insp
rPr7nri F1 e -j-r c (Crnlr� /
Address: 1 n 1 n F 1 1 1-H � Newmark :naal- single ormulli.tamilyper
Cit PQrtland stateOR I ZIP: 977 tg Servicetncl fa
Phone: 234-9900 1 Fax: 234-10 d f - mail: 1000 sq. ft. or ices 4
C� no.: Each additional 500 sq. fL or portion thereof
2 0 3 �_ Elcc. bus. tic, no: 2 6- 9 C Lim wall, residential
2
Gi cam: Ic no.: Limited energy. non-residential 2
:3115411 11/71/n, ^ Each manufactured home or modular dwelling
Signer s: LT•_"' 'r' Date Service and/or fccder 2
S "Pir _ `:2e1 I License no: . . • • Services or feeders- installation
PROPEF,Ti OWNER alteration or relocation:
200 amps or Icss 1 80-30
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amp to 600 ames 2
City: , 601 amps to 1000 amps 2
ty J State; I ZIP: Over 1000 amps or volts 2
Phone: lax: I E -mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary !cervices or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, errelocation:
OILS 447, 455, 479, 670, 701. 200 amps or less Z
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits . new, alteration,
Name: or extension per panel:
A. Fcc for branch circuits with purchase of 4 25. S 0
Address: service or feeder (cc, each branch circuit 2
_
City; State: ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E - mail: of service or feeder fee, first branch circuit; 2
Each additional branch circuit.
PLAN REVIEW (Please check all that apply) M➢. c. (Serviccor feeder not included):
D Service over 225 amps ommereial 0 Wealth -core facility Each pump or irrigation circle 2
D Service over 320 amps -rating of 1 &2 O Hazardous location Each silo or outline lighting 2
family dwellings
0 Building aver 10,000 square feet four or Signal circuits) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extension' 2
D Building over three stories 0 Feeders. 400 amps or mute - Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additinnal t
rr
O Egress/lighting plan 0 Other. aspcalion over the ollotbtcinanyot the above:
Pcr inspection 1
Submit sets of plans with any of the above. Investigation fee •
The above are not applicable to temporary construction service. Other
Not all jurisdictions avecot cn dtt cards. please rail jutitditriuto for man: information. Permit fee
D Visa D MasterCard Notice: This permit application o $ 1 05.90
expires if a permit is not obtained Plan review (at _ /o) $
Credit turd number: / / within 180 days after it has been State surcharge (8 %) $
Expires accepted as complete TOTAL $ ��,¢
Nome of Cardholder ax shown an credit card
r
$
Cardiwldcr signature Amount
4404615 (G/OINCOM)
899 -d ZOII /100'd 169 -1 -IlOad 16:P1 ZO- IZ-AON
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested /q/S AM PM BUP
Location / 3 / gS'. ' (( L l y Suite MEC
Contact Person L
.G c am Ph ( 5v3) 538 5 83 PLM
Contractor Oe'`e r z'7 b&-‹ Ph ( ) SWR
BUILDING Tenant/Owner ELC — t2 6 / 7
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Ext Sr Sh ea Anchrs
th / ear () }` �' C * /
Ext eah/h J (t:��/�lr� J
Int Sheath/Shear ( G U
Framing O 7
Insulation /�
Drywall Nailing 1 !) ('tees• 2
Firewall
Fire Sprinkler
Fire Alarm l Sr '4 G / ^ - � I/ .�* �1 F
Susp'd Ceiling : �l
Roof Of c\ el i'b •..) ,.. a f e• -------- ;
Other: ��//11,�� /
I I.:
Final YL c - i d � /� ; s --1.-.-) ? f
PASS PART FAIL �/ Y
PLUMBING Y om( ,
Post & Beam
Under Slab
Water 2 f J ,� A _r , ,
Water Service " �'�
Sanitary Sewer � J (.7,'....-P II(
Rain Drains
Catch Basin / Manhole 1 I
Storm Drain I I
Shower Pan
Other:
Final /
PASS PART FAIL
MECHANICAL
r c) Post & Beam
Rough -In 0 j O
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Eaciatra. Oj
1) \ / /
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PASS PART 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: - ❑ Unable to inspect — no access
Fire Supply Line
ADA /
Approach/Sidewalk Date Pco `8 , t'? Inspector _ a sus Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY Cal= TIGARD 24 -Hour 4 _
--BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested • 5 D2 AM PM BUP
Location 4.34ES_____c C lic aae Suite am-1 MEC
Contact Person h ( �) PLM
Contractor Q O-Yk 1 - Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam `�. /s 1�
Shear Anchors
Ext Sheath/Shear f <cr
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler L �� • ''» V
Fire Alarm �—
Susp'd Ceiling / '9Q :2 a/r a7 0)1
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
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
RI einspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART (`
SITE ❑ Please call for reinspection RE Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector .r f . _ /S % Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITYF TIGARD 24 -Hour r
'BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 6 a--' 3 AM PM BUP
Location '1 3 ! �.��C.1 Suite _ MEC
Contact Person .8-- c,tG�/ Ph ( ) 793 PLM
Contractor Ph ( ) SWR �%11
BUILDING Tenant/Owner 1 ELC Ov
Footing
Foundation ELC
Access:
Ftg Drain 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 � �Q ;
Susp'd Ceiling ' l
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
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PASS PART � 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ` 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date (~ o •3 O Inspector a_ 0 . Ext
IP
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
T
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received r Date Requ,ested I L2.__ AM ` PM BUP
Location / 3/ 3 Suite MEC
Contact Person CiLC/l ?an Ph ( ) " PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner r ELC (]
Footing er96
Foundation ELC
Access:
Ftg Drain 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
PASS PART FAIL
ELECTRICAL 6rA Service
Rough -In 1
UG/Slab ---
Low Voltage
Fire Alarm
W� Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
7; PART FAIL
SITE El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date OA m �) (73 Inspector /"
Ext
Other: �
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL