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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.