Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00162
° COMMUNITY DEVELOPMENT DATE ISSUED: 7/30/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136CD -00500
SITE ADDRESS: 08050 SW PFAFFLE ST ZONING: C -P
SUBDIVISION: PACIFIC CROSSROADS CORP LOT : JURISDICTION: TIG •
PROJECT: PACIFIC CROSSROADS CORP.CENTER
Project Description: Building C. New building shell.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 3 W /SERVICE OR FEEDER: 8 PER INSPECTION:
201 - 400 amp: 1 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: 1 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: X CLASS AREA/SPEC OCC:
Owner: Contractor:
CEDAR HILLS DEVELOPMENT HILLSBORO ELECTRIC
915 NW TORRYVIEW LANE 21185 NW EVERGREEN PKWY #110
PORTLAND, OR 97229 HILLSBORO, OR 97124
Phone: 503 - 299 -3100 Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -499C
[ELPRMT] ELC Permit 7/30/2008 $561.55 LIC 134481
[ELPLCK] ELC Pin Rev 7/30/2008 $140.39 SUP 4941S
[TAX] 12% State Surchar 7/30/2008 $67.39
REQUIRED ITEMS AND REPORTS
Total $769.33
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 ma obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
_ Permittee Signature: '
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: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
8 50dw P � �-
jectrical Permit Application role OrFlc:I USE ()NIA
•
City of.Tigard Received � Sidi1 At Permit No.: 137 F - c/a %5
13125 SW Hall Blvd., Tigard, OR - 97223 � i `� Plan R v:
Phone: 503.639.4171 Fax: 503.598.19 VV • b � -� Plan Review a� Other Permit: .,,e.. i �-• au ..
..
Inspection Line: 503.639.4175 cy ® f _ L�. «• Date Ready /By: iris: See Page 2 for
Internet: www.ci.tigard.or.us MPS fi ��. � ` Notified/Method: Supplemental information
• TYPE OFOVItm
01 D . . 0., : . ' ' PLAN 'REVIEW.
[] construction ❑ Add ition /JJ acetnent Please check all that apply:
❑ Demolition El Other: ['Service over 225 amps, comm'I ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
. •' • CATECO V OF CONSTRUCTION • ,;'..:, : :... - '.-:.•:-; :;: ' of 1- and 2- family dwellings 4 or more new residential
ID 1- and 2 - family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi - family 0 Master builder 0 Other:
_. .. ['Manufactured structures ❑Occupant load over 99 persons u lured res or
JOB _ SITE INFORMATION', AND. LOCATION. ' ; ? ['Egress/lighting plan RV park •
Job no.: 5 1 3t) Job site address: 1)6a) sw ?'ft (Fie, St ❑Health -care facility ❑Other:
J _ Submit 2 sets of plans with any of the above.
City /StateJZlP:T' /), a 1 cn? ?- The above are not applicable to temporary construction service.
• Suit = - : pt. no.: Project name: S � :
1 � ` . ,..:..., FEE CHEDULE- R..., [., .. , .:,'' ',;�. -;:
_ J I 1' u Description I Qty. I Fee. I Total I
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R. or less 145.15 4
Subdivision: . Lot no.: Ea. add'l 500 sq. R. or portion 33.40 I
Tax map/parcel .no.: Limited energy, residential 75.00 2
Limited sr 75.00 . 2
•DESCRIPTION OR WORK' �x" : : : :: :' : :.j;_ : : :..i.a :
energy, non-residential to
..... ..., .... .. .. ... . ... . .. : - : _:; .::• . :... Each manufactured or modular
r , 1 VIA . . I . Cl _ , / A dwelling, service and/or feeder 90.90 _ 2
/V �//�/�/� ` 3 Services or feeders installation, alteration, and /or relocation
W G . ,
V mpso
� �..� I IJ B" 200 amps or less 80.30 1 2
." ;: ..... ... .': : III TENA 70 I ❑ : :; PROPERTY OWNER.' : ;i ° ; , _x :rV, ,,i.° ... l , am to amps 106 85 2
::.
' 401 amps to 600 amps 160.60 2
Name: • 601 amps to 1,000 amps • 240.60 2
Address: . • Over 1,000 amps or volts 454.65 • 2
Reconnect only 66.85 • 2
City/State/ZIP: • Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less • 66.85 1 • •
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 •
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits new, alteration, or extension, per panel
,...,., .., . P :. s; :_ ?r: . Fee for branch circuits will;
:.. .�' L .. ,.. ; .. : .� � ❑ : �. : „ f Q DE
A
Business name: service or feeder fee, each W 6.65 3 -1 2
branch circuit
B. Fee for branch circuits - •
Contact name: wilhord service or feeder fee, • 46.85 2 •
Address: each branch circuit
• Each add'l branch circuit 6.65 2
City/State/ZIP: . Miscellaneous (service or feeder not included)
•
Pump or irrigation circle 53.40 • 2
Phone:
( ) I Fax:: ( )
•
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
.
• ..;.' 2 limited-
CONTRACTOR :; g
:.. 4 :: ,,,:.,, ` ., energy pane , alteration, o
extension. Describe: Page 2 2
Business name: Hillsboro Electric L.L.C. -
Address: 21185 NW Evergreen PKWY Ste #110
tion 62.50
Each additional inspection over allowable in any of the above
Per inspec 62
City/State/ZIP: Hillsboro, OR. 97124 Investigation per hour (I hrmin) 62.50
Phone: (5 0 3) 439-9666 I Fax: (503 )6 01- 3 6 8 0 Industrial plant per hour 73.75
• ':..:':_:::'._ f° ' � !:.ELECTRICAL 1ERMIT FEES!"..::
CCB Lic.:13 4 4 81 Electrical Lic.:3 4 — 4 9 9 C I Suprv. Lic.: 49419 . Subtotal 2z-7. ($
Suprv. Electrician signature, required: kilo Plan review (25% of permit fee) 5.1(0
Print name: Joey Vi tacco Date: 2.- State surcharge4 of permit fee) �'�,25.
•
JI w TOTAL PERMIT FEE - 511. El/
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete .
Print name: . Date: • Fee methodology set by Tri- County Building Industry Service Board
•
•• Number of inspections per permit allowed.
i:\ BuildingWamirstELC- PrnnitApp.doc 12/03 40-4615T(10/02/COM/WEB
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Deceive Permit No.: E.�.2008. co b2
` • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
r I G n It I) Inspection Line: 503.639.4175 Date Ready/By: luris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: toot>P or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
job site: Description FEE SCHEDULE
Cross street/directions to
J P I Qty. l Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 l
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 3 80.30 24090 2 _
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 1 106.85 IQ 6.$5 2
Name: 401 amps to 600 amps 1 160.60 [ 60.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
> A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 8 6.65 53 . 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (I hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
•
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: S 0. 55
Print name: Date:
Plan review (25% of permit fee): 1 Q{ 0. 39
State surcharge (12% of permit fee): 61 • 3 9
Authorized signature: TOTAL PERMIT FEE: 149. 33
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp.doc 05/23 /06 440.4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 r Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00 •
Check Type of Work Involved:
•
❑ Audio and Stereo Systems*
•
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑' Other
COMMERCIAL WORK ONLY:
Fee for each commercial' $75.00
system
- (SEE, OAR 918- 309 -0000)
Check Type of Work Involved:
O Audio and Stereo Systems
❑` Boiler Controls
O Clock Systems
O Data Telecommunication Installation
❑ .Fire Alarm Installation -
❑ HVAC
❑- Instrumentation
❑ Intercom and Paging Systems
0 Landscape Irrigation Control* • . .
Medical.
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling_
❑ Other
Total number of'commercial systems:
'*NO licenses are required. Licenses are required
for'all'other installations
I: \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E1.C200 00162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30f2000
Phone: (503) 639 -4171 r1
Inspection Requests (24 Hrs.): (503) 639 -4175 .� ,.�� ° "__..
INSPECTION WORKSHEET FOR DATE: i112112008 TIME: 7:00AM PAGE: 20
SITE ADDRESS: 08050 SW PFAFFLE ST CLASS OF WORK: ./ !
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE: C
PROJECT NAME: PACIFIC CROSSROADS CORP.CENTER
DESCRIPTION: Building C. New building shell.
OWNER: CEDAR HILLS DEVELOPMENT, PHONE #: 503-299-3100
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503 -439 -9666
Inspection Request Scheduled For: Date: 11/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 078375 -01 503- 439 -9666 Y
Corrections /Comments /Instructions:
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 111 Date: 1 ' - 2 14 Phone #: (503) 718-
r +
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC20013.001$2
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/30/2008
Phone: (503) 639 -4171 1 �
Inspection Requests (24 Hrs.): (503) 639- 4175'L I
INSPECTION WORKSHEET FOR DATE: 11/19/2008 TIME: 7 :02AM PAGE: 13
SITE ADDRESS: 08050 SW PFAFFLE ST CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CROSSROADS CORP.CENTER
DESCRIPTION: Building C. New building shell.
OWNER: CEDAR HILLS DEVELOPMENT, PHONE #: 503 - 299 -3100
CONTRACTOR: HIL,LSBORO ELECTRIC PHONE #: 503- 439 -9666
Inspection Request Scheduled For: Date: 11/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection/ 078253-01 971- 219 -0077 Y
Corrections /Comments /Instructions:
d
t PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: It / l — ci ) Phone #: (503) 718 -
. ,
-- CM( OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2008-00162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/300000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/&2009 TIME: 7 PAGE: 18
SITE ADDRESS: 08050 SW PFAFFI..E ST CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CROSSROADS CORP.CENTER
DESCRIPTION: Building C. New building shell.
OWNER: CEDAR 1-111.1S DEVELOPMENT, PHONE #: 503-299-3100
CONTRACTOR: F11LLSBORO ELECTRIC PHONE #:- 503-439-9666
Inspection Request Scheduled For: Date: 1/5/2009 Pour Time:
Code # Inspection Description t Contact # Message
115 Electrical sop/ice 079361-01) 503-439-9666 ¥ •
(a. a
/ Nie
Corrections/Comments/Instructions: --
• 21)0 . 0 A Ai
A PASS El PARTIAL APPROVAL El CANCEL 0 NO ACCESS
0 FAIL 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
....--""
e 1\i 6 6 Liz.
Inspector: Date: 1 . 5 C I Phone #: (503) 718- 144,kel____
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Elt:2Q080Q162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/20011
Phone: (503) 639 -4171 '�I
Inspection Requests (24 Hrs.): (503) 639 -4175 __' �:_..
INSPECTION WORKSHEET FOR DATE: 11/17/2008 TIME: 7:00AM PAGE: 5
SITE ADDRESS: 08050 SW PFAFFLE ST S ail t 1 00 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CROSSROADS CORP.CENTER
DESCRIPTION: Building C. New building shell.
OWNER: CEDAR HILLS DEVELOPMENT, PHONE #: 503. 299 -3100
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439.9665
Inspection Request Scheduled For: Date: 11/17/2008 Pour Time:
Code # Inspection Description ( Confirifl # Contact # Message
115 Electrical service t 078151 -01 971 - 21300 \ Y
Corrections /Comments /Instructions:
\ i
; D_
,._ _.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: wse (-11
Date: 1 Phone #: (503) 718- /..'Flt
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/200f+
Phone: (503) 639 -4171 Amo4 t t
Inspection Requests (24 Hrs.): (503) 639 -4175 'I i..
INSPECTION WORKSHEET FOR DATE: 9129/2008 TIME: 7:02AM PAGE: 41
SITE ADDRESS: 08()50 SW PFAFFLE ST
CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP
LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CROSSROADS CORP.CENTER
DESCRIPTION: Building C. New building shell.
OWNER: CEDAR HILLS DEVELOPMENT, PHONE #: 503 - 3100
CONTRACTOR: HILLSBORO ELECTRIC
PHONE #:
503.439.9656
Inspection Request Scheduled For: Date: 9/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/slab cover 076011 -01 971 - 219-0096 N
Corrections /Comments /Instructions:
J kc vs >E Uc WW ■1 `c pa N€- AEI' "TMs 4 cAGI•p511Rf:
oo43Dv I`x' #fi - - , I t c_so --
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6-1 ABLE Date: I Vi 1 Phone #: (503) 718- Dig(),
CITY OF TIGARD . . •
BUILDING DIVISION PERMIT #: ELC200B.00162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2009
Phone: (503) 639 -4171 il��gr
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I _.
INSPECTION WORKSHEET FOR DATE: 9/12/2008 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 08050 SW PFAFFLE ST CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CROSSROADS CORP.CENTER
DESCRIPTION: Building C. New building shell.
OWNER: CEDAR HILLS DEVELOPMENT, PHONE #: 503- 299-3100
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 303 - 439 -9666
Inspection Request Scheduled For: Date: 9/12/2008 Pour Time:
Code # Inspection Description i Confirm :# Contact # Message
105 Underground/slab cover 076427 -01 503439.9666 N
Corrections /Comments /Instructions:
❑ PASS ❑ PARTIAL APPROVAL 12ANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: Cy N PA(.-,": Date: qii "1 Phone #: (503) 718- 1)1%