Permit n ELECTRICAL PERMIT
Ali
D I O F TIGARD PERMIT #: ELC2002 -00638
l ? ' f'EVELOPMENT SERVICES DATE ISSUED: 1/9/03
� .� I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S134BC -00401
SITE ADDRESS: 12442 S W SCHOLLS FERRY RD * * **
ZONING: C -N
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical tenant improvement to exam rooms and conference room. Alt/add of (10) branch circuits,
some work is on 1st floor and some is on 2nd floor. Job No. 70060.
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:
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: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 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: X
Owner: Contractor:
SISTERS OF PROVIDENCE IN OR L H MORRIS ELECTRIC INC
BY STEVE FOSTER 7051 SW SANDBURG ST, #100
PO BOX 13993 TIGARD, OR 97223
PORTLAND, OR 97213
Phone: Phone: 503 - 639 - 2334
Reg #: LIC 1838
ELE 20 -39C
FEES SUP 3006S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/12/02 $106.70 -
[TAX] 8% State Tax 12/12/02 $8.54 Rough -
[ELPLCK] ELC PIn Rev 12/12/02 $26.67 Elect'I Final
Total $141.91
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
fo ore than 1: • : - . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon U ' otifi.: tion Center. Those rules are set,
orth in OAR 952-001-1. 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct uesti }n / : OUNC at (503) 246 -6699 or- —
LsLed 800 - 332 -2344. /al
By: / �l „ l 4 Permit Signature
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: 1/I U In LA-66 • DATE:
a
LICENSE NO: ooep5
Call 639 -4175 by 7:00pm for an inspection the next business day
11/08:2002 16: - 03 FAX 5035981980 CITY OF TIGARD X002!003
+
Electrical Permit Application
Date received: ATM P itno.: 1._e, ,4p- '(,63g
}' 111 (.i of Tigard RECEIVED Project/appl. no.: • Ai aire date:
City of Tigard Addrr;;s: 13125 $W Hall Blvd Tigard, OR 97223 Date issued: MOM % Receipt no.:
Phone: (503) 639 -4171 DEC + 2002 F:tx: (503) 598 -1960 Casc fileno.: Paymentrypc:
Land use approval: — CITY OF TIGARD
T1'1' Or PERT 1IT •
O I & 2 family dwelling or accessory MI Commercial/industrial 0 Multi - family O Tenant improvement
0 New construction O Addition/al teratiort/rcpl ace mcnt 0 Other 0 Partial
. _ . JOB SITE INFORMATION
Job address: 12442 SW SCHOLLS FERRY RD Aldg. no.: Suite no.: Tax map /tax lot/account no.;
Lot: ! Block: Subdivision;
Project name :S HO S F RY MOeription a nd location of work on premises: TENANT DEVELOPMENT
Estimated dale of completion/inspection:
CONTRACTOR APPLICATION ITC SCHEDULE
/1 / Max
Job Do: Dec. ' tlon Qty Total no.insp
Business name: L. H. MORRIS ELECTRIC INC
New residential -single arwidd- t
Address: 7 0 51 SW SANDBURG ST # 1 0 0 dwelling wit includes attached garage.
City: TIGARD State: OR ZIP: 9 7 2 2 3 Service include& a
Phone: Fax 6 2 0 — 7 4 1 g-mail: loon sq. ft. or less
• • _ , Fach additional 500 sq. ft. or poritdd thereof �—
CCB no.: 1 8 3 8 Elec. bus. lie. no: 2 0— 3 9 C �
Limited energy. residential _
Citylmetro tic. no. Li railed enervy, non-residential 1•111111 2 7
Each manufactured home or modular dwelling' ■� ■
�a r' I - C� 9._ Service andlar feeder 4
ri ngs a of SUQ ts',T�1:� 111ff,z_. Darr
Sup. elect_ name (print): GARY PEOPLES License no :3 6S Services er feeders - installation. 11111
olter*tiott ar relocation:
. PROPERTY OWN tR 700 amps or leas 2
201 amps to 400 am • s
Name (print)' 401 emit! to 60 amps IIIMIN
Mailing address: 601 • • - s to 1000 amps EMI= 2
City; . State: ZIP: Over 1000 amps or volts MIM 2
Phone: F E -mail: Reconnect only
Owner installation: The instaliatibtl is being made on property 1 own Temporary services orf eedets-
installation. aIterat(pn,or
which is not intended for sale, lease, rut, or exchange according to
200 amps or less
ORS 447, 455. 479, 670. 70l . 201 Props to 400 amps 2
Owner's signature: Date: _ 401 to 600 amps 2
. i `NG1NFEIt • Branch circuits- new, alteration,
or extension per panel:
Name: A. Fcc for branch circuits with purchase of
Address: scrvict or feeder fee, each branch circuit 2
B. Fee for branch circuits without ptusiiMe
City: State; • ZIP: of service or feeder fee, first branch circuit; e� 6
Phone: Fax: E -mail: Each additional bralleh circuit: �» 9 :EMI
REVIEW (I Ie.tsc check ull that apply) Misc. (Serricear feeder net included)! II Hi .
0 Sonticc war 225 *mpsrornmercial O Health -care Facility Each pump or irrigation circle
O Service ovcr320 amp - rating of 1&2 3 Hasrdouslocation Each sign or outline lightin:
family dwellings ❑ Building over 10.000 square feet four or Signal circuit(s) or a limited ene.$Y panel, a
rill
0 System over 600 volts nominal more residential units in one structure alteration. or extension"
U Bu ilding over direr. stoties O Feedcrt, amps ormore "Descri .don: _--._,.
13 Occupant load .3ve7 persona 0 Manufactured structures or Pv Park Eath additional Inspection over thc allowably in arty of ttte above:
O Egressflightingplan ❑ Other — Per inspection I I I F
,Sdbmit sets of plans with any of the abovee. Invesdgadon fee
The above are not applicable to temporary construction service. Other •
� _ � Permit fee ... $ . .1_0_6__,17_()__
p si. au j,. isa;ctione accept trans tags. Piave Cal Jt.rh cri6a far mere informairn. Notice; This permit application Platt rev (at _ %) $
❑ visa Q MasterCard expires if a permit is not obtained _____„,t1_51._
/ / within 180 days after it has been State surcharge (8%) .,., S
Credit cad namnu .. 1 1 5 . 2
Fxpirae accepted as complete. TOTAL 3
Name of rgrdeeltkr m aatwm on crcdst card S plan review fee 26.68
r older Signature Amount 440-1415 (610clCOM)
TOTAL 1 41 . 91
CITY :.OF TIGARD
24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received _ Date Re nested - ° 1 AM PM BUP
Location / °Z L/ °Z ti Suite MEC
Contact Person Ph ( ) / 3 / r PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC — (3B'
Footing
Foundation Access: ELC
Ftg Drain ELR
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
Susp'd Ceiling
Roof
Other:
Final
P ASS 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
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
•
ADA
Date / ° d Inspector - i� �e� . <<iJ Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL