Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00252
i DEVELOPMENT SERVICES DATE ISSUED: 05/16/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00700
SITE ADDRESS: 15353 SW SEQUOIA PKWY
SUBDIVISION: PACIFIC CORPORATE CENTER ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (50) branch circuits for remodel. •
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/ FOR: 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: 49 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 BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 55 SE MAIN
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 233 -2006
Reg #: LIC 44569
SUP 2808S
ELE 26-451C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 05/16/2001 $332.50 2720010000( Elect'I Final
5PCT CTR 05/16/2001 $26.60 2720010000(
Total $359.10
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 -6699 or 1 -800- 332 -2344.
Permit Signature: Issued By: _cZa zz L ef4a=_A dj: L. ,
1 0 - Y? Cifiale-t2/1Zi7f>
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: 0)) Qi ) y lL A' 0-) /IYf otAj DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
e.,6
4 Electrical Permit Application
Date received Mil Permit no.: /7 , i i ,C
..4 City of Tigard �� D ProjecUappl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 MAY 16 2001 Case file no.: Payment type:
Land use approval:
M.b ,� 11UNl►ll DEVEL° NT
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory CI Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
. JOB SITE INFORMATION
Job address: 15353 5 03 Sec6 c 1..t7 el,__ 91(1,04 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: I Subdivision: •
Project name: B IN (5 - Lrxke 050xx9e I Description and location of work on premises: lZ.a..m o c),.Q_`
Estimated date of completion/inspection:
.- .CONTRACTOR APPLICATION FEE SCHEDULE
Job no: ci '
,C, Cj Fee Max
Business name: Description Qty. (ea.) Total no. insp
Bachofner Electric New residential -single or multi - family per
Address: 55 SE Main dwell ingunit.lncludesattachedgarage.
City: Portland I State: nR I ZIP: 97214 Service included:
Phone: 233 -2006 I Fax: I E -mail: 1000 sq. ft. or less 4
26 -451 C Each additional 500 sq. ft. or portion thereof
CCB no.: 44569 I Elec. bus- tic- no:
Limited energy, residential 2
City /metro tic, no.: Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervisi g electrician (re bred) Date Service and/or feeder 2
Sup. elect. name (print): William Bachofner License no: 2808S Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - ..-.
which is not intended for sale, lease, rent, or exchange according to Installation, alteration, orrelocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel: •
Name.: A. Fee for branch circuits with purchase of
Address: . service cr feeder fee, each branch circuit , p
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee; first branch circuit: 57) 6-65 332Q) 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service orfeedernot Included): •
❑ Service over 225 amps- commercial • ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of I &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories 0 Feeders, 400 amps or more •Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightngplan ❑ Other: Per inspection I I I 1
Submit _ sets of plans with any of the above. Investigation fce
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 33
� .St e
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I I within 180 days after it has been State surcharge (8 %) $ c - GO
Expires accepted as complete. TOTAL $ 3 S�1 • 1 0
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440 -4615 (WO/COM)
•
Electrical Permit Fees: Limited Energy Fees:
s
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 1, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 n 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 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 n Vacuum Systems*
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 _ Other
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 2 —
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
200
Installation, alteration, or relocation for each system $75.00
200 amps or l or less $66.85 2 Fee
201 amps to 400 amps $100.30 2 (SEE OAR 918-260-260)
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
New, alteration or extension per panel n Boiler Controls
a) The fee for branch circuits
with purchase of service or
feeder fee. Clock Systems
Each branch circuit $6.65 2
b) The fee for branch circuits n Data Telecommunication Installation
without purchase of service
or feeder fee. n Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 n HVAC
Miscellaneous
(Service or feeder not included) n Instrumentation
Each pump or irrigation circle $53.40 •
Each sign or outline lighting $53.40 n Intercom and Paging Systems
•
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
Minor Labels (10) $125.00 n Landscape Irrigation Control'
Each additional inspection over 0 Medical
the allowable in any of the above
Per inspection $62.50 n Nurse Calls
Per hour $62.50
In Plant $73.75
ri Outdoor Landscape Lighting"
Fees:
Protective Signaling
Enter total of above fees $ .
F 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.
Total Balance Due $ Fees:
Enter total of above fees $ •
❑ Trust Account #
8% State Surcharge $
Total Balance Due $
I:'dsts \forms\elc- fees.doc 10/09/00
: CITY OF TIGARD BUILDING INSPECTION DIVISION -Ll
X 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested 7' 3 AM PM BLD
Location / 5:T.4. lO I'- //>/C Suite g MEC
Contact Person Ph G Z ' / PLM
Contractor 84c_1 py Y , Ie ci • Ph SWR
BUILDING Tenant/Owner ELC ZS 2—*
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam �D � r.
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall 1
Fire Sprinkler 6e) d W, Y e ye D i TYYC k L / U` / I15C _
Fire Alarm
Susp'd Ceiling
Misc: L�a / - TYGGk /f T /Vl J C
Final
PASS PART FAIL
PLUMBING C;9 )7,1 J e / SeY VI C'e � d ,
Post & Beam
Under Slab
Top Out
Water Service / / S�
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL I
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
C(
ELECT
rvice
Rough In
UG /Slab
Low Voltage
Fi - Alarm
ASS ART 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 (�
Other
Date / _ Inspector /1.41.a-A
Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.