Permit � . CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00755
4;il� DEVELOPMENT SERVICES DATE ISSUED: 11/30/2004
` 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S112AD-01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 150
SUBDIVISION: PACIFIC CORP. CENTER ZONING. I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: (5) branch circuits.
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: 4 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:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES BRIDGETOWN ELECTRIC
15350 SW SEQUOIA PKWY #300 -WMI 22732 NW GILLIHAN ROAD
PORTLAND, OR 97224 PORTLAND, OR 97231
Phone: Phone: 503 - 621 - 7122
Reg #: LIC 103824
SUP 4I77S
FEES ELE 26 -887C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/30/2001 $73.45
[TAX] 8% State Surcharge I I/30/200, $5 Rough -
Elect'I Final
Total $79.33
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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 may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800-3 -2344.
•
Issued By: _�� /� 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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
•
RECEIVED
Electr ai-Permit APPIAffitis_Lb 2004 FOR OFFICE USE ONLY
City of Tigard • .. n B ii p 2/ B6 Permit G.a. -- 0 7 75 -
13125 SW H41 Blvd., Tigani, OR 9722 eITV OF TIGARD ,...., Plan m Other Permit
Phone: 503.639.4171 Fax: 503.59g,,1 D6p ?r1 I ' DaY-
Inspection Line: 503.639.4175 ()tJILDING DIVISION 11,x, e `' 1 Date Ready/By. Jam: 0 See Page 2 for
Internet: www.ei.tigard.or.us Notified/Method: 7 /t Supplemental Information
'rim iit*VIEW
❑ New construction . g tddition/alteration/ iacenient Please check all that apply:
El Demolition • ❑Other
['Service over 225 as,comm'l ['Hazardous location
y _ ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGOR OF 'CONSTRUCTION _ of 1 - and 2 family dwellings 4 or more new residential
1:1 1- and 2- fancily dwelling Cornmercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
[]Building over three stories ['Feeders, 400 amps or more
ID Multi - family ❑ Master builder ❑ Other:
❑Occupant load over 99 persons ['Manufactured structures or
• . JOB :SITE.:L�il ..ORIV><3AT1ON•:AI3]) LO(AT)OlY "•. ❑Egress/lighting plan RV park
-� � ..- .... r � f Health -care facility �
Job no.: �� 9� Job site address �� �7FS sa
�" • .'t i_ sets of plans with any of the above.
City/ State/ZIP: 1 above are not applicable to temporary construction service.
Suite/bldg apt. no.: I Project name: ia"..i )1iQ / e l ; _ . . .. ...._ .i FEE . kIEDULE.; T • . ' :
i Description Qty. Fee. otsl
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
....... . _ _ .... _ • _
Includes attached garage.
- - 1 , ( t 0 0 sq. ft. or less •._• _.. - - • - 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
Tax map/parcel no.:
.. p / .. a .. ... non 75.00 2
....2:1:`,;'•:::. � FS(�t1P'f1~UT_I' bFi�i!QRK ' Each � manufacntred or modular
4 i`f - c • f - 5/ C t Y C. u ; #S an G� L� C (.0 - I r ` e. : C .1. 3^GU . r _ t Services ng, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
• 200 amps or less 80.30 - 2
,.-. ........ 201
amps to 400 amps 106.85 2 • II . .. - • RT.. ::. ` . , � :-.`,....• ; . '_;', . TENAI`IT; '' .. :: ;,' 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
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 1 l
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. 1 I
401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
' ® AP ' PLICAI'fi'' F` * " ' 1= ; >1 G ; CONTACT egri:SO F= M.;� A. Fee for branch circuits with r f service or feeder fee, each 6.65 2
Business name: V`-t , - - rn. ( j £ I�TF''t C. branch circuit
B. Fee for branch circuits
Contact name:
L i i IN �'' V .S CL. (€ without service or feeder fee, AA
� _ each branch circuit 46.85 'r/ S'S
Address: ,2.,?-1 �j .2. U.:: q 1 11 ( '� � ,(?{z Each add'1 branch circuit Mil 6.65 . (CO EN
City /State/ZIP: � 1 elr' KS UK-- 7 a-3/ / Miscellaneous , t
Phone: ( 3 (p 2 7 ( --- I Fax:: 6/3) 1p24 - 71 -3
Sign or oudine lighting r
E- mail:. j -f- W Signal -
Q �.5' f f ull' circuit(s)
_r . . ...
• . _,,.:• .: ... - - .! .... • . . tens 2
Q , , g:�•. �..:':• � energy pane . erahon o
extension. e: Page
Business name: er ctle ri E e th r i L
Address: ZL �rX fj W qi f (1 4 Rofi k Each additional Inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: ' ()-(-( ( k t J OK 1 t -3 ( / D 1 Investigation per hour (I l min) III 62.50 _-
Phone: (5�i3) ( p 21 - 7 1 ..,)•_. J Fax ($�33) (p2- 7 I e 3 ,
CCB Lic.: I G38 )._ . Electrical Lic: 2(p4 7 C S . Lic.: if/ '7,1 S
Suprv. Electrician signature, req `-•-•. ,,,qp, 0, ' O . t_
Plan review (25% of permit fee)
" i l r\ Sf e v 5/ D
Authorized si ature. a State surcharge (8% Print name: to
l;n Th (s permit application expires [f permit is not obtained with in 180
days after it has been accepted as complete
Print name: Date: Nov 2004 • Fee methodology set by Tri- County Building industry Service Board
CITY OF TIGARD
BUILDING DIVISION
I ' cl E2TG- TZ9 -EOS ptIsuaa4S 111.TaN ebIiII 1.0 DE AOIJ
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Request / /d AM PM BUP
Location /' ! G� �� c Suite /- MEC
Contact Person Ph ( ) 7/ aa— PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner i /// �" / ELC ,QO Y —DD
Footing
1 Foundation ELC
Ftg Drain Access: 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
PASS PART FAIL
PLUMBING
r
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 Pc /) / 011 0`ii
Fire Alarm
Q1 Z - 75 - PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA �" " �
Approach/Sidewalk Date Inspector �v��� Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL