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Permit CITY OF T ELECTRICAL PERMIT tvfN A DEVELOPMENT SERVICES PERMIT #: ELC99 -0019 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/11/99 PARCEL: 2S102CB -02300 SITE ADDRESS °..:13200 SW PACIFIC HWY SUBDIVISION •FREWINGS ORCHARD TRACTS ZONING:C —G BLOCK • LOT °008 JURISDICTION: TIG Project Description : Installation of sign lighting for 10 sq ft wall sign. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 500SF...: 0 201 — 400 amp ° 0 SIGN /OUT LINE LTG..: 1 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: 0 PER INSPECTION • 0 201 — 400 amp ° 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0 401 — 600 amp ° 0 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 $ 40.00 GEO 01/07/99 99- 312009 TIGARD OR 97223 5PCT $ 2.00 GEO 01/07/99 99- 312009 Phone #: Contractor: HIGHLIGHT SIGN CORP $ 42.00 TOTAL 8430 SW 37TH REQUI RED INSPECTIONS PORTLAND OR 97219 Elect'1 Service Phone #: 499 -5821 Elect'1 Final . Reg #..: 000104 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 9952_ ' -1987. You lay o • y of these rules or direct questions to OUNC iy callin (503)246 -19J . - / - Permittee Signature• / /;_, _A Issued By: allg"'�/ 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 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By p Date Rec'd /` 7m9 TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Print or Type Inspection (503) 639 -4175 Permit # �L� 9 O Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called / �/ 99 / 1. Job Address: 4. Complete Fee Schedule Belohi: Vitt Name of Development Number of Inspections per permit allowed Name (or name of busine Service included: Items Cost Sum I Address •. Mb JiJ�' 1� : 1 ' III 4a. Residential - per unit .' %i/� 1000 sq. ft. or less $110.00 4 4% Clty /State /Zlp .( Each additional 500 sq. ft. or Commercial 0 I Residential El Limited thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all curr =nt 'wises `� 4b. Services or Feeders Electrical Contractor .. ♦ . •. ��, �_4 ' '-. 6 • Installation, alteration, or relocation j C , fit 200 amps or less $60.00 2 Address ., on �:,�1�_. 201 amps to 400 amps $80.00 2 City , . k _1 - ' Zip °r _ 401 amps to 600 amps $120.00 2 Phone N At s , M► a'r 6. 601 amps to 1000 amps $180.00 2 Job No. j Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. Exp.Date 1.15 -1- er q OR State CCB Reg. No. b Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Me ro No. "A'7'6, Exp.Date - - Installation, alteration, or relocation 200 amps or less $50.00 2 Signature of Supr. Elec'n 04 d.e 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. a,a, L1 Exp.Date )b - I_ Phone No. I ,3L( OR LP 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 circ $5.00 2 - b) The fee for branch circuits City State Zip 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 circui $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 T $40.00 tin 'CO 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 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 $ # 0 • 5% Surcharge (.05 X total fees) $ Jt� NOTICE Subtotal $ 5b. Enter 25% of line 5a for 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 # $ 4/942) Total balance Due I:\DSTS \ELC96.APP Rev 9/96 • Page No. 1 CASE HISTORY FOR CASE NO.: ELC99 -0019 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 / / / / 01/07/99 RECD GEO 01/11/99 DRA ELCC003 Permit created / / / / 01/11/99 DONE DEB 01/11/99 DRA ELCC500 (F)Issue permit / / / / 01/11/99 PASS JSD 01/11/99 JSD ELCC730 Elect'l Service / / / / / / 01/11/99 DRA ELCC799 Elect'l Final / / / / 01/28/99 PASS BRP 01/28/99 B *P ELCC800 Case Finaled / / / / 02/03/99 02/03/99 VLN • • • • • • • ) CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 I 1 BUP IF_j�,E1 Date Requested I 2..R/ �1 ct AM PM BLD r' Location 4 . • ♦ '�� _ _ _ � tai _■ Suite MEC Contact Person C — h l - OS ? PLM Contractor Ph SWR BUILDING Tenant/Owner 1 y' ELC cD / 7S5 Retaining Wall Ems 7 g Footing Access: c � Foundation fPg q /- l Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing 1'1 e_l - -zoo l-1 ""TJ ALL , co 1il l j pc ie_01 Firewall y Fire Sprinkler v �'�L d — Fire Alarm Susp'd Ceiling n M � � f fr �T 0 3 Final � PASS PART FAIL /44 P q PLUMBING Post & Under Slabm /3 /— C 9 ,-- 04-3 CL ■ Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL ,/ 5 Post & Beam Rough In Q Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm 11410 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 �j Approach /Sidewalk D L Inspector Other t Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.