Permit CITY OF TIGARD ELECTRICAL PERMIT
^. / i i i ; DEVw L SERVICES PERMIT #: ELC98 -0432
sCES DATE ISSUED: 08/19/98
1 A Hall Blvd., Tigard, (503)
PARCEL: 2S1O2CB -02300
SITE ADDRESS...:132O0 SW PACIFIC HWY
SUBDIVISION •FREWINGS ORCHARD TRACTS ZONING:C —G
BLOCK • LOT •008 JURISDICTION: TIG
Project Description : Mullikan Medical Center Job #2803
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 4 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 0 W /SERVICE OR FEEDER:1O0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp • 1 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • ) 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
MULLIKAN MEDICAL CENTER type amount by date recpt
13200 SW PACIFIC HWY PRMT $ 820.00 BON 07/28/98 98- 307750
TIGARD OR 97223 PLCK $ 205.00 BON 07/28/98 98- 307750
5PCT $ 41.00 BON 07/28/98 98- 307750
Phone #:
Contractor: - - - --
SHAW WEST COMPANY $ 1066.00 TOTAL
PO BOX 1427
REQUIRED INSPECTIONS
TUALATIN OR 97062 Ceiling Cover Elect'l Service
Phone #: 682 -3939 Wall Cover Elect'l Final
Reg #..: 63142
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)24E- 1
Permittee Signature: 6►'1 eo6A'Wf Issued By& 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
SIGNATURE OF SUPR. ELEC'N:6 T it c Ji \ DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check # - I %(..•
_
13125 SW HALL BLVD. Rec'd By
Date Rec'd 7-
TIGARD OR 97223 Date to P.E. O S9 . -
Phone (503) 639 -4171, x304 Date to DST It. - V 4
Inspection (503) 639 -4175 Print or Type Permit # £L ' - 6 3Z
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Mullikin Medical Center Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
I
Address 13200 SW Pacific Hwy 4a. Residential - per unit
Ci City/State/Zip Tigard, OR 97223 Each additional it or less $110.00 4
ty p Each additional 500 sq. ft. or
Commercial ® Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Shaw West Company Installation, alteration, or relocation
Address P.O. BOX 1427 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City Tualatin State OR Zip 97062 401 amps to 600 amps = $120.00 120 .. 00 2
Phone No.(503) 682 -3939 601 amps to 1000 amps $180.00 2
Job No. 2803 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. _ Installation, alteration, or relocation
� 200 amps or less 4 $50.00 200_ nn 2
Signature of Supr. Elec • . - ■ 201 amps to 400 amps $75.00 2
- 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No #1S p.Date 10/1/98 see "b" above.
Phone Nr 682 -3939
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit 100 $5.00 Son _no 2
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required) :* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
X Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00 •
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ Rhl • _ U nn
NOTICE Subtotal $
5b. Enter 25% of line 5a for 205.00
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
-
$ 1, 0Eb• 00
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
Page No. 1 CASE HISTORY FOR CASE NO.: ELC98 -0432
MULLIKAN MEDICAL CENTER
•
13200 SW PACIFIC HWY
03/04/99 •
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
•
Code Sent Done Done Date By
ELCC001 Application received / / / / 07/28/98 PASS BON 07/29/98 JSD
ELCC003 Permit created / / / / 07/29/98 PASS JSD 07/29/98 JSD
ELCC102 Plans routed to Plans Examiner / / / / 07/29/98 PASS JSD 07/29/98 JSD
ELCC115 Approved plans routed to DSTS / / / / 08/10/98 PASS CD 08/10/98 CD
ELCC500 (F)Issue permit / / / / 08/19/98 PASS B 08/19/98 BON
ELCC700 Ceiling Cover / / / / 12/15/98 Check accessability of boxes at final'. PASS BRP 12/15/98 J *H
ELCC700 Ceiling Cover / / / / 08/27/98 ok to cover electrical in fire rated PASS CD 08/27/98 CD
ceiling
ELCC700 Ceiling Cover / / / / 10/23/98 Electrical above ceiling pass, limited PASS BRP 10/23/98 J *H
energy cables above ceiling - pass, •
enter on ELR98 -0279.
ELCC720 Wall Cover / / / / 11/13/98 wall cover for the following areas: PASS CD 11/13/98 CD
x -ray - darkroom - dressing room - &
lab. •
•
ELCC720 Wall Cover / / / / 08/27/98 new area PASS CD 08/27/98 CD
•
ELCC720 Wall Cover / / / / 11/20/98 second floor wall cover - files, ekg PAQS CD 11/23/98 CD
room, nurse station, storage & corridor. _
•
ELCC720 Wall Cover / / / / 12/02/98 2nd floor, (2) bathrooms - (3) nurses PASS CD 12/02/98 CD
stations - conference room
ELCC720 Wall Cover 12/15/98 / / 12/15/98 Check accessability of boxes at final. PASS CD 12/15/98 J *H
Electrical and limited energy pass.
ELCC730 Elect'l Service / / / / 11/03/98 before final electrical inspection on FAIL CD 11/03/98 CD
service , the existing 400 amp feeder •
must have proper ampacity rating for 400
amp overcurent protection. ( section
serving panel g ) .
ELCC730 Elect'1 Service / / / / 01/28/99 Panel G, 200 amp CB, 250 MCM Al. wire. PASS BRP 01/28/99 B *P
9.9 KVA connected load.Existing service
appears ok.
ELCC799 Elect'l Final 12/15/98 / / / / on 12/28/98 sent inspection request NOTE JMT 12/28/98 JT
(research) on e1c98 -0375 to Chuck.
Jeanne T.
•
Page No. 2 CASE HISTORY FOR CASE NO.: ELC98 -0432
MULLIKAN MEDICAL CENTER
13200 SW PACIFIC HWY
03/04/99
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
ELCC799 Elect'l Final / / / / 01/27/99 Conduits not secured in elevator FAIL BRP 01/28/99 B *P
room.Inspection terminated, to determine
scope of elevator mechanic work.
ELCC799 Elect'1 Final / / / / 01/28/99 PASS BRP 01/28/99 B *P
ELCC800 Case Finaled / / / / 02/03/99 02/03/99 VLN
ELCC920 Miscellaneous action / / / / 08/27/98 temporary power to job trailer PASS CD 08/27/98 CD
ELCC920 Miscellaneous action / / / / 10/27/98 First floor final. pass. PASS BRP 10/27/98 B *P
ELCC920 Miscellaneous action / / / / 01/25/99 Second floor final. Complete final of ' PASS BRP 01/25/99 B *P
bldg.pending.
•
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST ; I ;
BUP ram
Date Requested ( 1 2. t acL
9 AM PM // �D� BLD ry V
' C c NAINL Location - r _ — _ �, k� A. _ Suite C/ MEC
Contact Person c / . h ( — oS • ? PLM
Contractor Ph SWR
BUILDING Tenant/Owner )(Y\ i 40 J ELC 4D , 63 7S`
Retaining Wall nit ? g d j
Footing Access: q
Foundation fP8 7 l --)U( l
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation /
Drywall Nailing ell e�I / (9- — sZ O U ii /. 6j � IJ ALL, CAD L11.j eo e ie_cl
Firewall / q p y
Fire Sprinkler ! � �cL d - r' `
Fire Alarm
Susp'd Ceiling n Iy /L
Roof z-I&C__- _ 9 �T — 03 G v o C�
Final
PASS PART FAIL a SS �� ii q /
PLUMBING
Post & Beam
Under Slab 6:L C 9 c— D4-3 S
Top Out
Water Service /94....5- , /L-7) l<
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL 0 ( F
Fi
Post & Beam
Rough In ��q,SS — ) /
Gas Line ����"'' ,
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �
Approach /Sidewalk — —
Other Date L Inspector t
Final
PASS PART FAIL , DO NOT REMOVE this inspection record from the job site.