Permit ELECTRICAL PERMIT -
Phil' CITY O F TIGARD RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2002 -00091
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/23/02
SITE ADDRESS: 08770 SW SCOFFINS ST PARCEL: 2S102AA -02800
SUBDIVISION: TIGARD HIGHWAY TRACTS ZONING: CBD
BLOCK: LOT: 026 JURISDICTION: TIG
Project Description: Tenant Improvement - Fire Alarm System
Job No. 2040730
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TUALATIN VALLEY MENTAL HEALTH PROTEC INC
8770 SW SCOFFINS RD 720 NE FLANDERS
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 503 - 617 -3827 Phone: 235 -4000
Reg #: LIC 55414
ELE 34 -215CL
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 5/23/02 $75.00 2720020000 Wall Cover
5PCT CTR 5/23/02 $6.00 2720020000 Elect'I Final
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 j_e__ Permittee Signature al
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
Electrical Permit Application Mao received: P antie ao. � 2 - moll
Jt,V-.1'II City of Tigard y - �:` mf Froject/s • expire ate:
cioeini2ora Address: 13135 SW Hall Blvd. Tigard. OR 97223,,.. -. D��
issued: B I Reoeiptno.:
Phone: (503) 6394171
Fax: (503) 598 -1960 9 tau file no.: Paynteauypa
Land use approval: + ..,r �.x2►... r�;� t AJ 400/
• TYPE OF PERMIT
0 I & 2 family dwelling or accessory 0 Commercial/industtial . 0 Multi - family 0 Tenant improvement
0 New construction • * Addition/alteration/teplacement 0 Other- • 0 Partial •
JOB SITE INFORMATION
Job address: e "7t0 ' St.J 5co e•n 4 Bldg. no.: Suite no.: Tax map/tax loVaceount no.:
Lot Block: Subdivision: •
Project name: , an d location of work on premises: M 4U ' F;,, ' r, f.),
57} t ■
Estimated date of completion/inspection: 6 , `
CONTRACTOR APPLICATION TEE SCHEDULE
Job no: 7.04
• pestati • imp QtI -
Business name: ' r s3 a G .� - Nam reddened. sink or iredd- ta,n,77 per
Address: 7 r. E. - - -.S - dwdliosum includes ateoebadwig
City: {P4,. --1 a-. State: O .. ZIP: seryiaeittdaead 4
Phone: 23S to Fax: 2 3 5 — E -mail:
1000 •.7car
�S 4 Rath additional 500 sq. ft. or pardon thercaf
CCB no.: 5 Elcc. bus. lie. no: ' - 21 G L Limitre • - .. iaideetiat 2
Ctyhlsetro lie. n 4z4 Limited cn• .non•trsidcntial 2.
./.:/ ) - Each manufactured home or modular dwelling
Si:.. AL,.ervisin electrician (rewired) Date i$.. Serviceandlorfceder 2
73,:„„ a., 'Jemmy,: Services orraides- �lLvtioa.
II Sup• f ' name (pt' 7° 't 2 / attention orrelecatloa:
•
PROWL PROWL I li OWN Eli TOO mm airless 2
201 amps co 400 amps
Name t): �
401 amps to 600 crops
Mailing address: del •••s to x000 mope IMM 2
City: State: ZIP: over 1000 amps or vole IIIIIIIIIMIIMIIM Z
Phone: Fax: Email: Reconnaet
Owner installation: The installation is being made no property I own rampancy services orleaden- .
which is not intended for sale. larvae, rantm, or exchange according to u+ stalladotb alteratioaaertetomHorL
200 amps inlets
ORS 447. 455.479.670.701. 20! amps to 400 amps
Owner's signature: _ Date _ 401 to 600 am. r
ENGINEER Brien eirevaa - mew, alteration,
or mansion per path
Nance: • A Pee for branch citcuirs with purehue of
Address: sepia et feederfa. each hutch circuit
' City: State: - [ZIP: B. Foe for branch dteaivattltoutpurchase
of service or feeder fee. rust bunch circuit:
Phone: Fax: E -mail: Each additional !snitch circuit M MN
FLAN IWE. ICW (Note died: all drat apply) Mire. (Saran or reek r out Included):
0 &twice owe 225 amps.aononetsial ' 0 Faith-out facility Each - me or irrigation their 2
O Serviceava 320 uttps•ntiot of 16k1 0 Hata:d a1 carian taco sip or outline lighting 2
familydweUings CI Buitdin! over 10.000 square feet fttu or Signal eircuit(s) or a limited energy panel. ?
0 Syrstem mver 600votn nominal more n�dentialunit'in one souerure alceratioo.orextension'
7 � 2
0 Boilding over duce italics 0 Feeders, 400 amps or more •Dettaiptien:,
0 Oacvponl load over 99 persons 0 Manufactured atrueaatsa or RV park Etch additional Inspection over the allowable in an of the above.
0 Egrets/lighting pion 0 Otte. „ perinspeedon r 1 j L
Submit _ sees orplaar with any of the above. leveatigation fee
The above are not applicable to teeeporsry construction service. Other •
Permit fee S C''`
Na a iuri +t Net art aomr atdr. ideate evA lutiodietiae for mem Inicar uoa Notice: This permit application
0 Y,4 KmAi expires if a permit is not obtained Pl an review (at ` %) S ____ ___-
e • A ber! 1 a r , r ; • - De / Z. with 180 days after it h as be en State surcharge (8%) -. S _ ' • �`�
r�r ilt:r ,!-4 / ` accepted as complete. TOTAL S .C3 i . v U
�^ - u on t wet S d e • a
rtn.Wat aro41613 tercavtah
/ Zi )2) .3 - 0? 3 -- 1 / 6 D° .
r.nt r- ,P -7pA t t t : 74 RS11S4gt 4AR cl7'
P.02
Z0iT0'd E92OSEZ£OS D310ZId OZ:ET ZOO? - LT - AJIJ
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ J o, BUP
Received Date Requested / 2_ l fZ AM PM BUP
Location I raim i • Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC Access:
Ft /�
g ELR o — OC70�
Drain
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 ' — - ct ,
Roof
Other:
Final '
PASS PART FAIL ' — �
PLUMBING i D .i;. �
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
Apr MIta
Fire arm
ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
` ( PART FAIL
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA D �F C o I O. Inspector • s Ext
/
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL