Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00714
•LI DEVELOPMENT SERVICES DATE ISSUED: 12/28/00
13125 SW Hall Blvd.. Ticlard. OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00300
SITE ADDRESS: 15230 SW SEQUOIA PKWY 130
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Tenant Improvement
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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 MY ELECTRICAL CONTRACTOR
15350 SW SEQUOIA PKWY #300 -WMI HUYHN MY VAN
PORTLAND, OR 97224 2193 SE 73RD AVE
HILLSBORO, OR 97123
Phone: Phone: 591 -9694
Reg #: SUP 4144S
PLM 2528S
ELE 34-431C
LIC 111153
FEES • Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 12/28/00 $86.75 2720000000( Elect'I Final
5PCT CTR 12/28/00 $6.94 2720000000(
Total $93.69
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 ordirect questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE _ ! 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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
f
rf ,__;
& I9 /1/153 i \ -z J o -
Community Development ELECTRICAL PERMIT APPLICATION
"" 13125 SW Hall Blvd.
Tigard, OR 97223 Permit # Vii!
t
/4-000,4(4, Date Issued 7 /
Phone (503) 639 -4171 /
,..,-4,1- en.. (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 1 4. Complete Fee Schedule Below:
Name of Development T346- OU3N - RO Number of Inspections per permit allowed
Address 4C2-30 SUJ . ac..)6S)t1-)- ld-ul>4y Service included: Items Cost(ea) Sum
City /State /Zip 47 22.4- 3C) 4a. Residential - per unit
n • -�,� �y 1000 sq. ft. or less $110.00 4
Name (or name of business) P,tGr 1j11N {d Each additional 500 sq. ft. or
portion thereof $25.00
Commercial Residential El Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor M"t' ZRI A 200 amps or less $60.00 2
Address cric N e...O C_ORD 201 amps to 400 amps $80.00 2
City pc) en State eg . Zip en ?.j / 401 amps to 600 amps $120.00 2
y p 601 amps to 1000 amps $180.00 2
Phone No. k I ' / --erg S Over 1000 amps or volts . $340.00 2
Job NO. Reconnect only $50.00 2
contractor's license NO. 4c. Temporary Services or Feeders
Contractor's Board Reg. No. / I Installation, alteration, or relocation
Signature of Supr. Elec'n - r- 200 amps or less 2
2
License No. e--// y e/5 Phone f 5 - 5/-ri 1,79 201 amps to 400 amps $50.00 2
- ' 401 amps to 600 amps $75.00
-
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 I ee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
$ 5.00
not intended for sale, lease or rent. First branch circuit $
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 $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
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 $
NOTICE 5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec.3) $
A PERIOD,OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordkomde &eo- ❑ Trust Account #
$
prm.evp
Balance Due $
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: • Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 • 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2 111 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
•
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 -260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit I $46.85 ❑ HVAC
Each additional branch circuit l_ 1 $6.65 d
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00 ❑
Each additional inspection over Medical
the allowable in any of the above ❑ Nurse Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Q
Enter total of above fees $ e r lic n Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See °Plan Review" section on $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
q
Total Balance Due $ / 3,6?
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts\forms\elc- fees.doc 10/09/00 •
A TY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00714
u tjij; ,'DEVELOPMENT SERVICES DATE ISSUED:fi2 /20: =00
-!-" 13125 SW Hall Blvd., Tisaard. OR 97223 (503) 639 -4171
PARCEL: 2S 112DA -00300
SITE ADDRESS: 15230 SW SEQUOIA PKWY 130
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Tenant Improvement
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 MY ELECTRICAL CONTRACTOR
15350 SW SEQUOIA PKWY #300 -WMI HUYHN MY VAN
PORTLAND, OR 97224 2193 SE 73RD AVE
HILLSBORO, OR 97123
Phone: Phone: 591 -9694
Reg #: SUP 4144S
PLM 2528S
ELE 34-431C
LIC 111153
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 12/28/00 $86.75 2720000000( .Elect'I Final
5PCT CTR 12/28/00 $6.94 2720000000(
Total $93.69
•
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 CO
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.
PERMITTEE'S SIGNATURE / : ��- ISSUED BY: a _e_ e_ J
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
BUP - Building Permit ELC - Electrical Permit Q.
Inspection Description Date Passed By Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls _ Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in / 2/2 ,yr
• Slab Electrical service
Crawl drain Electrical final -of c/
Underfloor insulation
Post/beam structural -
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing I Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
� Inspection Description Date Passed By
Drywall nailing
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection S ystem Permit Plumbing underslab
Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final V RP/backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By _ Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils I Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM SWR ELC ELR MEC SIT PERMITS
,CITY.OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested / z Z 9 AM PM BLD
Location l 5 2 SP9'u.G /A— Suite /3e) MEC
Contact Person dd' Joe, Ph 9S 1 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC v —LV 7/y
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear _
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
. Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
PASS PART FAIL
MECHANICAL
- Post & Beam
Rough In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL •
(,- LECTEiLAL
Service
(Aoughln ->
JIG /Slab
Low Voltage •
Fire Alarm
Fin- •
40 PART FAIL
S '
Backfill /Grading
Sanitary Sewer •
Storm Drain • [. ] Re_inspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE: [ �% -ble to inspect - no access
ADA /
Approach /Sidewalk • , ;
Date ate Inspect Ext
Final
- PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
70 -/ I pr
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 • Business Line: 639 -4171
BUP
Date Requested r �� s' / AM PM BLD
Location /5 Z 3 o S -51 t Suite 3 MEC
Contact Person it/4 Ph 9�'- 99g-7 PLM
Contractor /4/1 . l 6.c. C r : Ph . SWR
BUILDING Tenant/Owner ELC vivo V 7/ Y
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: -
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling .. _
Roof
C...q :LID
Misc:
Final •
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out -
Water Service •
Sanitary Sewer -
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam -
Rough In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL
LECTRJCAr
tervice
Rough In
UG /Slab •
Low Voltage
Fire Alarm •
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA -
Approach /Sidewalk /_ Z �
Other Date O/ Inspector Ext
Final
PASS - PART FAIL • DO NOT REMOVE this inspection record from the job site. •