Permit CITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2007 -00242
COMMUNITY DEVELOPMENT DATE ISSUED: 4/17/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 520 ZONING: C - G
SUBDIVISION: ONE EMBASSY CENTER LOT : JURISDICTION: TIG
PROJECT: CHEMRAY INTERNATIONAL
Project Description: 4 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: 3 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:
WYSE INVESTMENT SERVICES COMPANY R C COSTELLO ELECTRICAL CONTRACTING
111 SW 5TH AVENUE #1100 PO BOX 336
PORTLAND, OR 97204 AURORA, OR 97202
Phone: 503 - 294 -0400 Contact #: PRI 503 - 982 -7400
FAX 503 - 982 -7401
FEES
Description Date Amount Reg #: ELE 3 -344C
[TAX] 8% State Surcharge 4/17/2007 $5.34 LIC 87402
[ELPRMT] ELC Permit 4/17/2007 $66.80 SUP 39345
Total $72.14 REQUIRED ITEMS AND REPORTS
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 th , gh 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: AK .�, AA!. Permittee 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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Electrical Permit ADD licilon FOR OFFICE USE ONLY
City of Tigard ECENED moved i Permit No..
74 Date/B . /
0 i07 t•
• 13125 SW Hall Blvd, Tigard, OR 97223 Flan Bevies
II Phone: 503.639.4171 Fax: 503.59A MO 1 2007 Date/B Ocher Permit. TIGARD
Inspection Line: 503.639.4175 i Date Ready/By Inns ta See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method Supplemental Information
ElihilialitiG DIVISION PLAN REVIEW
Please check all that apply (submit 2 sets of plans w/items checked below)
❑ New construction Addition/alteration/replacement
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground or exceeds 14,000 ❑ Commercial -use agricultural
El 1- and 2- family dwelling C ommerciaUindustrial ❑ Accessory building amps for all other installations buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately denved system.
❑ Addition of new motor load of ❑ "A ", E ", "l -2 ", "l -3 ",
Job no.: Job site address: U/l n t I� ' n J ^� 0 loop or mot . occupancy.
� D S � n !fry( ❑ Stx o< more restdenti units ❑ Recreational vehicle parks
®
City / State/ZIP' r ,./ ` � 0 ❑ Health-care facilities. ❑ Supply voltage for more than
❑Hazardous locations. � 600 volts nominal.
Suit ' J ldg. /apt. no.: 5 2 C y�f'�
U Project name: ;'� c ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qn. I Pee. I TOW I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft )
Limited energy, multi -family
- Rer//IC' A e9. • i' L 14. / 91 ,� f a ,n' residential (with above sq. ft.) 75.00 2
p Services or feeders installation, alteration, and/or relocation
G. /) ! •/A 200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1.000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
I A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee, /
Contact name: 46.85 2
first branch circuit
Address: Each midi branch circuit ) 6.65 19,9 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 90.90 2
Phone: dwelling, service and/or feeder
( ) Fax: ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
C / / Signal circuit(s) or limited -
Business name:
�� / �1P� 7,< t/ ,,,,,„„4,74.0 .% - s 6, energy panel, alteration, or
Address: 770 3 356 extension. Describe: Page 2 2
City / State/ZIP: 9vivi, e.2 � 7a HZ.. Each additional inspection over allowable in any of the above
Fax: Per inspection 62.50
Phone: (503) c
g2- 7 -/o (503 )' Z- 7!9U / Investigation per hour (1 hr min) 62.50
CCB Lic.: 2 -i`iUe Electrical Lic.: 3. 3( j c I Suprv. Lic.: 3 / 5 Industrial plant per hour 73.75 _
� A ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: `/c ,• Subtotal:
Date: L Plan review (25% of permit fee): •OV
Print name:
�� 107 State surcharge (8% of permit fee): .05 . 3�
Authorized signature: TOTAL PERMIT FEE. Tp
This permit application expires if a permit is not obtained witbi ISO
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
t.tBuilding\Pamita\ELC- PamitApp doe 05/23/06 44046 t5T(t t/O5/COM/WEB
I •` ,.,
Electrical Permit Application - City of Tigard ,
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDEN to WO ik ONLY : &" " :'; M-:° ,' xM6.:,
Fee for all residential combined ... $75.00.
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
MtiMMEirc AI WUR& ONLY:_..,`;; ` _3 -7, :', ,F r
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Buildmg\Pemib\ELC- PmnitApp d« 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00242
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/17/2007
Phone: (503) 639 -4171 � � �1n
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7 :00AM PAGE: 25
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 520 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: CHEMRAY INTERNATIONAL
DESCRIPTION: 4 branch circuits.
OWNER: WYSE INVESTMENT SERVICES COMPANY. PHONE #: 503.294-0400
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 503 -982 -7400
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confirm` Contact # Message
130 Ceiling cover 046706 -02 \ 503 -504 -6758 N
Corrections /Comments /Instructions: •
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tim.\( tp agl-q&.s r 1 smr s
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•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
∎2 FAIL ►4 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: & . N esU L-C Date: 14 OI 0 Phone #: (503) 718- 211-00
CITY OF TIGARD ;; •
BUILDING DIVISION PERMIT #: ELC2007- 00242
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/17/2007
' Phone: (503) 639 -4171 ma
Inspection Requests (24 Hrs.): (503) 639 -4175 ' " 'I L
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 520 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: CHEMRAY INTERNATIONAL
DESCRIPTION: 4 branch circuits.
•
OWNER: WYSE INVESTMENT SERVICES COMPANY, PHONE #: 503 -294 -0400
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 503-982-7400
Inspection Request Scheduled For: Da - . = 8/2007 Pour Time:
Code # Inspection Description Confirm -# Contact # Message
125 Wall cover 046706 -01 - 513-504-6758
N
Corrections /Comments/ Instructions:
•
•
•
' PI PAS - ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: IA t Phone #: (503) 718 - lilt%
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00242
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/17/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 ,„!i
INSPECTION WORKSHEET FOR DATE: 5/14/2007 TIME: 7:01AM PAGE: 26
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 620 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: CHEMRAY INTERNATIONAL
DESCRIPTION: 4 branch circuits.
OWNER: WYSE INVESTMENT SERVICES COMPANY, PHONE #: 503.294 -0400
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 503.982 - 7400
Inspection Request Scheduled For: Date: 5/14/2007 Pour Time:
Code # Inspection Description # Contact # Message
199 Electrical final 048224 -02 503.504 -6758 N
Corrections /Comments /Instructions:
\ t
/
•
V
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,`kip Date: I Phone #: (503) 718 -Zr0
1 '
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00242
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/17/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' "'I
INSPECTION WORKSHEET FOR DATE: 5/14/2007 TIME: 7:01AM PAGE: 27
•
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 520 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: CHEMRAY INTERNATIONAL
DESCRIPTION: 4 branch circuits.
OWNER: WYSE INVESTMENT SERVICES COMPANY, PHONE #: 503 - 294-0400
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING • PHONE #: 503 - 7400
•
Inspection Request Scheduled For: Date: 5/14 /2007 Pour Time:
Code # Inspection Description N\nfirm/# Contact # Message
130 Ceiling cover 0411 24 -01 503 -504 -5758 N
Corrections /Comments /Instructions:
•
•
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/
Inspector: ,\I Date : 6 `0 Phone #: (503) 718 -2