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Permit CITY OF T' GA R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00577 I� DEVELOPMENT SERVICES DATE ISSUED: 09/27/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110DC -02200 SITE ADDRESS: 15660 SW PACIFIC HWY A -6 SUBDIVISION: WILLOW BROOK FARM ZONING: C -G BLOCK: LOT : 011 JURISDICTION: TIG Project Description: Electrical tenant improvement. Combining spaces A6 & A7. 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: 1 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: 20 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 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: TIGARD CENTER LP DRYER + SONS 9777 WILSHIRE BLVD 5536 SE WOODSTOCK BLVD STE 609 PORTLAND, OR 97206 BEVERLY HILLS, CA 90212 Phone: Phone: 774 -1606 Reg #: LIC 000011 SUP 2311S ELE 26 -43C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT BON 09/27/199£ $187.25 99- 318636 Elect'I Final 5PCT BON 09/27/199E $13.11 99- 318636 Total $200.36 ORiGINAL This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Speaalty 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE - ( lUn _ n m ISSUED BY: 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: I V\ a ( \Cappro-r\ DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD trical Permit Application Plan Che 13125 SW HALL BLVD. RECEId Rec'd By TIGARD OR 97223 Date Recd Phone (503) 639 -4171, x304 SEP 2 7 1999 Date to P.E. Date to DST Inspection (503) 639 -4175 COMMUNITY DEVELOPMENT Print of Type Permit # 7 Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called 1. Job Address: ,r� 4. Complete Fee Schedule Below: • [ Name of Development LOU ' S 3 Number of Inspections per permit allowed Name (or name of business) , Service included: Items Cost Sum Address I S (.QIP O 5t t-) [ -t a ,G`:g ( C 4a. Residential - per unit City/State /Zips1)(TA-1 1000 sq. ft. or less $ 117.75 4 Ea ch additional 500 sq. ft. or portion thereof $ 26/5 1 Commercial Ig.. Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). t Installation, alteration, or relocation Electrical Contractor ■ . ' e elm. ee, N 200 amps or less $ 64.25 2 i 201 amps to 400 amps $ 85.50 2 Addr s 553 �� � n / .ae �i�11 • 401 amps to 600 amps $ 128.50 2 Ci ief./ �_�: State QI Zip '' 1 ,0(o 601 amps to 1000 amps $ 192.50 2 Phone No. - 04- - I (.Ot7(1) Over 1000 amps or volts $ 363.75 2 Job No. cm 41 O Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 240-43C.. Exp.Date I O J / 00 .4c. Temporary Services or Feeders OR State CCB Reg. No. I t 14 Exp.Date I l I7-, q Installation, alteration, or relocation COT Business Tax or Metro No Exp.Date I qof 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, License No. 23 V I S Exp.Date 10/01/o1 see "b" above. Phone No. 11 4--t, (0 (( n New, , Branch ech Circuits w, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit - $ 5 .35 / ©7 civ 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit / $ 37.50 37 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 _ Owner's Signature Each sign or outline lighting , $ 42.75 47 7 Signal circuit(s) or a limited energy (if required):* panL alteration or extension $ 60.00 3. Plan Review section ( Minor Labels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: • 5a. Enter total of above fees $ / n * Submit 2 sets of plans with application where any of the above apply. 1(ID 5� 'o Surcharge (.05 X total fees) $ j 3 7 r Not required for temporary construction services. ubtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ • PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 2.4o. 36 IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 2,e,. 3‘ is \dsts \forms \el ectric. doc 12/17/1999 Activities for Case #: ELC1999 -00577 2:07:37 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC800 Case Finaled 12/07/1999 HAP ' PASS No Hold DGW 12/07/1999 ELCC001 Application received 09/27/1999 • BON DONE No Hold BON 09/27/1999 ELCC003 Permit created 09/27/1999 BON DONE No Hold BON 09/27/1999 ELCC730 Elect'l Service 09/27/1999 09/27/1999 No Hold BON 09/27/1999 ELCC799 Elect'I Final 09/27/1999 09/27/1999 12/07/1999 BP PASS No Hold DGW 12/07/1999 ELCC500 (F)Issue permit 09/27/1999 BON DONE No Hold BON 09/27/1999 ELCA700 Rough -in 10/14/1999 10/14/1999 10/14/1999 CD PASS No Hold DGW 10/14/1999 wall cover....note: Plaque both sub panels ELCA700 Rough -in 11/05/1999 11/05/1999 11/05/1999 BP PASS No Hold VT 11/05/1999 ceiling area - dining room - pass note: fixtures and boxes should be extended to within 1/4" of finished surface. Art. 370 -20 96 NEC • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested L2-I•? I q ( AM PM BLD Location /5 (00 a�� 4W (( Suite 44 MEC Contact Person Ph PLM Contractor -Pc -y0 w Ph - / (0062 SWR BUILDING Tenant/Owner (/JLc. 5 D ELC / Retaining Wall ELR Footing Access: Cib 2 fri. C&- /79 P- ' c c & 64 -i Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall L-- l - / Fire Sprinkler l � }'� � / :, S , Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In igpr Gas Line Smoke Dampers Final PASS PART FAIL — - 1 ELECTRICAL - Service a Low Voltage Fire Alarm S PART FAIL SIT 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 / - i4 Approach /Sidewalk Date / 7 Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.