Permit CITY OF T I G A R D ELECT R I CAL PE RM I T
• i�ito �;,, 0 DEVELOPMENT SERVICES PERMIT #: ELC97 -0334
���`�.�i�'I DATE ISSUED: 06/17/97
l,L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DA - 01300
SITE ADDRESS...:06640 SW REDWOOD LN #301
SUBDIVISION •MLP96 -0002 ZONING:I —P
BLOCK • LOT • JURISDICTION:
Pro.j ect Description : Tenant Improvement: Orthopedic & fracture clinic JOB 1118041
- -- 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..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 1
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 2 W /SERVICE OR FEEDER: 11 PER INSPECTION : 0
201 — 400 amp • 0 1st W/0 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. :X
Owner: FEES
SISTERS OF PROVIDENCE type amount by date recpt
9205 SW BARNES PRMT $ 215.00 DRA 05/27/97 97- 295112
PORTLAND OR 97225 PLCK $ 53.75 DRA 05/27/97 97-295112
5PCT $ 10.75 DRA 05/27/97 97- 295112
Phone #:
Contractor:
OREGON ELECT CONSTRCTN /GRP INC $ 279.50 TOTAL
1010 SE 11TH
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'1 Final
Phone #: 234 -9900 Wall Cover
Reg #..: 036359
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 b
ll
• ing l 1',.)246 -1987. 6,,ZILMA.L.L.
Permittee Signatu e: A�i 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: .A0 Q Q' [ . 4CH 40-✓4 DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
rd
U ( 4 ,f N, 0_14 /5�
Riv - Commu D eve opment LECTRICAL PERMIT APPLICATION
A o l, 13125 SW Hall Blvd. 7....
�f ��
Tigard, OR 972� erm # LC 9- s--.5 v
,,�� �� tl Date Issued O(vo �
i � li Phone (503) 639 71 t-
FAX (503) 684 -7297 $ ._
CITY OF TIGARD TDD No. (503) 684 -2772
hi
i Inspection (503) 639 -4175 Ct�616io /� y )- 9592, 51:4,...3 L� \(,_,
i
1. Job Address: 4. Complete Fee Schedule Below:
OREGON BUSINESS PARK
Name of Development PROVIDENCE HFAT,TH M. 0. B. Number of Inspections per permit allowed
Address 6640 SW Redwood Lane U ( Service included: Items Cost(ea) Sum
City /State /Zip Tigard OR 97224 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) Orthopedic & Fracture Each additional 500 sq. ft. or
Clinic portion thereof $25.00
Commercial ® Residential ❑ Limited Energy $25.00 1
Each Manurd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor OREGON ELECTRIC GROUP 200 amps or less 2 $60.00 _1 9 0 00 2
Address 1010 S.E. 11TH 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
City Portland State OR Zip 97214 601 amps to 1000 amps $180.00 2
Phone No. (503) 234 -9900 Over 1000 amps or volts $340.00 2
Job NO. 18041
Reconnect only $50.00 2
contractor's license NO. 26 95C 4c. Temporary Services or Feeders
Contractor's Board Reg. No. Installation, alteration, or relocation 2
Signature of Supr. Elec'n 4 200 amps or less 2
201 amps to 400 amps $50.00
License No. 14815 Phone No. 9 3 9900 401 amps to 600 amps $75.00
2
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit 11 $5.00 55.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
First additional circuit bit 5$5.00
not intended for sale, lease or rent.
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension 1 $40.00 40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
X Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ 215.00
NOTICE 5% Surcharge (.05 X total fees) $ 10.75
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 225.75
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ 53.75
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 279.50
COMMENCED. wm
111 Trust Account #
$
prm.app
Balance Due $ 279.50
.
a
MEMORANDUM
CITY OF TIGARD, OREGON '` --
TO: Finance
FROM: Jim Duckett
DATE: June 5, 1997
SUBJECT: Receipt #97-295112
The subject receipt was entered with an indication that $279.50 went to ELPLCK 23- 0000 - 433040.
The correct entries should be as follows:
0
ELPRMT $215.00 23- 0000 - 431510
' ELPLCK $53.75 23- 0000 - 433040
TAX $10.75 10- 0000 - 230010
I __C
TOTAL $279.50 (
Thank you
1
Sizo Foote__ - ORT110 WO I C,
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: F'.2lo - / 7 A.M. P.M. MST:
/
Location: ♦ / !A ' ' ' _.11s 0 .I BUP:
Tenant: Suite: Bldg: MEC:
Contractor: ,__/ 44 # / /1 i r If Phone: )O t/ 3g7 3 PLM:p T-033
Owner: Phone: _ ELC: !
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam C. Service Sewer /Stone
Footing Roof UndFl/Slab Rough -In Ceiling . Water Line
Slab Framing Top Out Gas Line ' o : - I UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved pproved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved pproved Not Approved
FINAL FINAL FINAL FINAL FINAL
C --- .., ) I c •--7.,... C ... ...P) C2--:'' r ,c2/7"e9 c )-1
L7
O Call for reinspecta O Rein • : tion fee of $ required before next inspection O Unable to inspect
Inspector: / 4 ■__-_ Date: 2 ^- 6 'tee, 9 Page ( o/
i
3
CITY OF TIG BUILDIN INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: - A.M. P.M. MST:
Location: (Q to Li D A L o_A ( ,A/1 BUP:
Tenant: Suite: 3o ( Bldg: MEC:
Contractor: 10 5 £ Phone: PLM:
Owner: Phone: ELC: 7 0 :2,3
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL EJ ECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved No pproved Not Approved
FINAL FINAL FINAL FINAL FINAL
3 - (-- L,4_5 r¢ f' Q./\e f' yyr ci9 If c
r' /7.6 -- /g
z) t ��, s ,old
^ � - MOWRY _ i ge , 4.0
r A .41 z! it ' -- /
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: /1 r (n ` TP I r RCA. Date: / -- q 7 Page of (
C I
• CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: ` / t - 2 (, - cq A.M. P.M. MST:
Location: � ;6-, / L � ! / r- r f_Ce-c..6 1 7 - �%� BUP:
Tenant: 1 , V I DE icE--� o I 1 o/F Suite: 501 Bldg: MEC:
Contractor: + Phone: PLM: a
Owner: Phone: ELC: 0S 3 c-
r��-tt1 NA1. --- F <I 1 /, \ 1� p ? ! -7 ELR:
t iD 1 `�vl. �V t I_() 3 "saC.l,Fi !J' TED STT:
BUILDING BLDG (con't) PLUMBING MECHANICAL . SITE
Site Post/Beam Post/Beam Post/Beam _ _ . Sewer /Storm
Footing Roof UndFl/Slab Rou -In Ceiling Water Line
Slab Framing Top Out Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved NotA proved Not Approved
FINAL FINAL FINAL FIN FINAL
7A/4s L A...ls-
1 Call for reinspection e' tion fee of $ required before next inspection CI Unable to inspect
Inspector: Date: U Page of