Permit ' • CITY OF TIGARD
ELECTRICAL PERMIT -
RESTRICTED ENERGY
J � l DEVELOPMENT SERVICES PERMIT #: ELR2002 -00154
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/12/02
SITE ADDRESS: 06640 SW REDWOOD LN 2ND FL PARCEL: 2S112DA -01300
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Low voltage to Nurse call.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS: X
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES OREGON ELECTRIC CONST /GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone:
Reg #: LIC 203
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/12/02 $75.00 2720020000 Elect'I Final
5PCT CTR 8/12/02 $6.00 2720020000
Total $81.00
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. � �
Issued by 4 ,4 �= cc.�X�/i•J Permittee Signature ljh ai / ,
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 ) - 1 ( 42 1 / 6 DATE:
LICENSE NO: y 6o S / I/
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
AUG -09 -02 04:46PM FROM -OR ELEC SERVICE 5035352763 T -111 P.01 /01 F -280
. - ✓ - v
' E lectrical PermitApplication f ll l i(i.: t �s CIN,.,
Date received :`g - - /1•-0 Pomtit no.•0 ' ? o - 9/
. .,,4.11 City of Tigarii . < < - Project/appl. no.: Expire date:
City o /Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Date issued: u -
Phone: (503) 639-4171
. Receipt no.:
Fax: (503) 598 -1960 AUG 0 C, 2007 Case file no.: Payment type:
Land use approval: RA ° l- kip - 1,021 L' '
r
. I VI' F OF PFR,N,rr
❑ 1 & 2 family dwelling or accessory D Commercial /industrial 0 Multi - family CKTenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other: 0 Partial
Job address: 6640 SW Redwood Lane Bldg. no.: Suite no.: Tax map /tax lot/account no.;
Lot: I Block: I Subdivision:
Project namePOrt-Land Clinic Description and location of work on premises: Nurse Call - 2nd floor
Estimated date of completion/inspection:
C ON . r,i(,croft APPLICATION ITT; SCl11CDlll.h.
.fob no: - -
Fee Max
Business nameoregon Electric Group nescriotlon Qty. (ea.) Total no.lnep •
Address:1 010 SE 11th Ave
Nonresidential-stogie ormold-family per
awell,ngtm$, Includesaltached garage,
City:Portland I State: OR IZIP: 97214 Serriceincluded:
Phona234 -9900 IFax2,34 -100hE -mail: 1000 sq. R. or loss 4
CCB no.2 0 I Elec, bus. lie. not 6 , 9 5 O Each additional S00 sq. A. or portion thereof
U Limited energy, residential 2
City c. Limited craw, nonresidential 1 1' 75 2
/ J 1%_ 9 _ p 7 Each manufactured home or modular dwelling
Signs - of suporvisi jelec pate Service and/or feeder 2
r � c4460$ Servleesorfeederx— Installation
Sup. - - name (print). M ■ k Ken • - , Li cense n ,
alteration or relocation:
PHOpI:R'I':' OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 turps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: State: ZIP: Over 1000 am• or volts 2
Phone: Fax: E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders•
which is not intended for sale, lease, rent, or exchange according to installation, alleradon , orreloeaGon:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
LAC IN E 1:12 Branch circuits • new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fte each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: I Fes: I E-mail: Each additional branch circuit:
M ist • (Service or reedernot included):
Cl Service over 225 amps-commercial 0 Health-care facility Each pump or irrigation circle 2
0 Scricc over 320 amps•raties of i&2 Cl Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square (Zen (bur Or Signal eireuit(s) or a limited energy panel,
C) Sytwm over 600 volts nominal more residential units in one structure alteration, or extension 2
0 Building over three stories 0 Feeders, 400 amps or more •Aeseriorion:.,,, —
O Occupant lead over 99 persons O Manufactured structures or RV patio Each additional inspection over the allowable in any of the above:
O Egrcsaligttting plan 0 Other. Per inspection r I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
tVot a nal • urinninti ma accept cr°dii cams, ptwtte ,all jurisdiuuun far mum Information Notice: This permit application Perm it fee C _ fl ()
fFYisa 0 Masse O p- expire if a permit is not obtained Plan review (at _ %) $
Creytt cud umber: 7 3 3 �� G ail? within 180 days after it has been StatC Sureha[ Igo (8 %) $ 6 -
" ry 7 „ate..+ Pif" accepted as complete. TOTAL $ 81 . 0 0
: Stta der to shown cm credit card
4..../e. $ • `°
Cardholder signature Amount 440.4615 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /0 — / AM PM BUP
Location [, C 416, 56.a P cl i•4"1 v� L ✓ ` Suite MEC
Contact Person Poet/44 Ph ( ) S 7 2. 3 G) f PLM
Contractor Off71) fsc j� Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR / S
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - - � _ - _
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm �p _� Susp'd Ceiling (h1 , l� ® �'e�`! ; %'� Oct > b1 /
Roof
Other:
Final /H r COd P4-
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
FAIL
Al
Service
Rough -In
UG/Slab
Low Voltage
Fir larm
in Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE E Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA (4) C
Approach/Sidewalk Date �° 1 �� Inspector - -, � 7 Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL