Permit CIT OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00506
-lra DEVELOPMENT SERVICES DATE ISSUED: 8/11/2004
l
I ° 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2 S 112 D D -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160
SUBDIVISION: PACIFIC CORP. CENTER ZONING. I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Connect furniture cubicles.
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: 26 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 OREGON ELECTRIC CONST /GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 503 - 234 -9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/11/2004 $219.75
[TAX] 8% State Surcharge 8/11/2004 $17.58 Rough -in
Elect'I Final
Total $237.33
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- 332 -2344.
Issued By: -tQ_e - Permit Signature: r'e p \r �p
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
AU5 - 04 09:16AM FROM-Oregon Electric Estimating 5032313597 T -079 P.001 /002 F-064
104'' '.21 Permit Application ' -
City of Tigard J ra 7 . 7 , -0e �, --- PernutNo.• , '2ay 40
13125 SW Hall Blvd., Tigard, OR 97223 A., Plan Review Other Permit
P rionc: 503.639.4171 Fax: 503.598.1960 R ..„(4101104
� ° "' " ' � !l s DIlate/BYc
E� . '._I� Date Relay /By: � la See Page 2 fur
Inspection Line: 503.639.4175 NotitietVbfetmd: - (r- SupplemenrrtInform:ainn
Internet: www.ei.tigard.or.us
1 200
� Please check all that apply:
®
❑ New construction Addition /alteration/ lac Apo
['Service over 225 amps, comm•1 ❑Hazardous location
❑ Demolition ❑Other: G r�' � ,, , ptVISIO ['Service over 320 amps- rating ❑Bulking over 10,000 sq. ft,
• CA`1'LCORY .01' CO N RtJCT[ON .. • ' . of 1- and 2-family dwellings 4 or more new residential
['System over 600 volts nominal units in one structure
❑ 1 -and 2- family dwelling ® Couiunereial/industrial 0 Accessory building °Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other. Occupant load aver 99 persons ['Manufactured structures or
.' .' S F601 TION :A • .. , • • . - :!; ❑Egress/lighting plan 1W park
['Health-care facility ❑Other:
Job no.: 81360 J Job site address: 15575 SW Sequoia Parkway Submit 2 sets of plans with any of the above
City /State/ZIP: Tigard, OR 97224 The above are not applicable to temporary conseuction service.
• . • FEE' SCHEDULE •
Suite/bldg./apt no,: 6 0 I Project name: Captaris neuripeoe I Qir•J F ( Tyco I '- ,
New residential single- or multi - family dwelling unit.
Cross street/directions to job site: - includes attached garage.
1,000 sq. ft. or less 145.15 4
• Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: -
o.: _ Limited energy, non - residential 75.00 2
' �• • DESGRII°X' ON .:OF • WgR c • . • • Each manufactured or modular
• _ dwelling, service and/or feeder 9090. 2
Connect furniture cubicles Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 _ 2
201 amps to 400 amps 106.85 2
[l'•PROPER'1°y OWNER , • •• ' • 1 . • • . ; 7 �' .':..❑. .. • • • _ 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 , y 2
Address: _ Reconnect only 66.85 2
City/State/ZIP: 'temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 _ 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 amps to 600 snips 133.75 2
Owner signature: - Date: _ Branch circuits - new, alteration, or extension, per panel
• ❑ • APPLICANT . • ' I. ❑• CONTACT PERSON " • A. Fee for branch circuits with
• service or feeder fcc, each 6.65 2
Business name: branch circuit
B. Fec for branch circuits
Contact name: without service or feeder fee, 46.85 4 7 1 4- p
each branch circuit 1
Address: Each add'l branch circuit 1 6,65 /72 202
City/State/ZiP: - Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) _ Sign or outline lighting 53.40 _ 2
E -mail: Signal circuit(s) or limited-
... .. CONTRACTOR•... ,.. ::.•• ... .. tion, or
energy panel, ttr
extension. Describe: Page 2 2
Business name: Oregon Electric Group
Each additional inspection over allowable in any of the above
• Address: 1010 SE 11th Ave Pcr inspection 62.50
City /Statc/ZIP: Portland, OR 97214 investigation per hour tt hr a ts) 62.50
Phone: (503) 535 -2652 I Fax: (503) 231 -3587 Industrial plant per hour 73.75
• 1 " ' ELECTRICAL PERMIT FEES'
CCD Lie.: 203 Electrica . is • 26 • Suprv. Lie.: 4460S Subtotal a j e 2, > %---.
Suprv. Electrician signature, requi . • / — ' Plan review (25% of permit fee)
Print name: in
C�/ � State surcharge (8% of permit fee) /7. :
// � - I Dat= / pj ¶ TOTAL PERMIT FEE 03`J, 3j
Authorized signature: i 9-4�e,....(/.___ G 7 • This perm[[ ;inattention sapless If a permit is not obtained within 180
days after It bas been accepted as complete
19-4.. Print name: . /9/ii � �'�y , 1 „."7-.;-- � I Date: / Q Pee methodology set by Tri•Cotmty Building industry y Service Buard
Number of hr.pecdons per pennit allowed.
i usuiidIngTermit9 \Ei.c- nenmtAeDdoe h2/03 440 -441 TT WI/COM/wtn
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: •(903) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7' AM Pr/ BUP
Location � ` s� - ] S ,.,� .�.e�e -t.� Suite
/61- v MEC
Contact Person i')'1 a J J Ph ( ) 4 -39 3/ PLM
Contractor Ph ( ) - SWR
BUILDING Tenant/Owner ELC 6 D y - 6-4
Footing ELC
Foundation Access:
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
PASS 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
in ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date nz7 a 7 Inspecto V Ext
Other:
Final DO NOT REMOVE this inspection record from t Job site.
PASS PART FAIL