Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2003 -00455
DEVELOPMENT SERVICES DATE ISSUED: 7/25/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09493 SW WASHINGTON SQUARE RD A -3
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: JOB NO. 24546 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: 21 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:
PPR WASHINGTON SQUARE LLC OREGON ELECTRIC CONST /GROUP
BY THE MACE RICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97214
PORTLAND, OR 97223
Phone: Phone: 503 - 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/25/03 $186.50
[TAX] 8% State Tax 7/25/03 $14.92 Ceiling Cover
Wall Cover
Total $201.42 Elect'l Final
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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1- 800 - 332 -2344.
Issued By: / .ajYY11 Permit Signature: Apia Al A . __d
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
JUL -24 -0" 09:59AM FROM - Oregon Electric Estimating 5032313587 T -768 P 001 /001 F -691
'Electrical Permit A,pp OFFICE USE ONLY
City of Tigard bate received: Permit no.:(4Q0'D3 -o4-+/.
13125 SW Hall Blvd �� D QEIV ® Project/appl. no.: Expire date:
..... _ ' t 0 :21 Phone: (503) 639. 4171, E . 59&1960 , Date issued: By: IReceint no.:
Internet address: wvwy.ci_tlgard or.0 Case file n0.: Payment type:
24 - Hour Infection Re. ,,: 513 .83� I- I 35 ,
❑ 1 &2 family dwelling or accessory EZ Comme al / / . 0 / 85❑ MUN•��ly O Tenant Improvement
El New construction CI `¢ riV.- : • i " placement 0�" 0 Other. . ❑ Partial
JOE SITE INFORMATION
Job Address: ' W'Washin, ton . ' = d No.: r Suite no.; #3 Tax maw lot/account no.:
Lot Block: Subdivision
Project Name; Mother Maternity Description a d location of work on2remises: Store TI Remodel
Estimated Date of completion/Inspection:
Will ou call for Ins • action within 24 hours? Yes C1 , ❑ Project Contact Mark Weinbender 503) 288.8950 Phone
CONTRACTOR APPLICATION EEe SCHEDULE
no.
Job No.: 24546 Description Oty Fog (oa.) Total Imo
`ewresl• is -r • ^ or
multi- tamlly per dwelling unit
Business name: Oregon Electric Group . Includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. 1000 sq ft or less 5 145.00 $ - 4
CI : Portland State: OR Zi e. 97214 ea Adel 500 SF or Portion 3 33,40 $ -
Phone: (503) 234-9900 Fax (503) 234-1001 E -mail: umhed Energy. 18 2 FamJy $ 75.00 $ - 2
CCB no.: 203 Elec. bus. lie. no.: 26 Limited Energy. Muttl -Famuy S 75.00 $ - 2
CI /me 1_,- li 0 -:
Each manufactured home or
, modular d'r V M
ling. SeCe
s,,.- ,,,,.d „ ,1de . _.t((l . t - / 7/24/2003 and/or feeder. $ 90.90 $ - 2
• Service or Feeders •
Su • . loot. Name r, - ,. r r ��A License no: 4460S Installation, Almrat an or
Relocation:
P •P I•<TY •WN 200 amps or teas $ 80.30 $ - 2
Name (print): 2olamps •400amps 5 109,95 $ - 2
Mailing Address: _ 4otamp3 .600amps $ 160.60 $ • 2
City State: 'ZIP: 60lamps . 10003mp5 5 240.60 $ - 2
Phone: , Fax: 1E-mail Orerlu00A S 454.65 $ - 2
Owner Installation: The installation is being made on property I own which is ReconnoctOn l $ 66.85 $ • 1
not intended for sale, lease, rent, or exchange according t O RS 447.45 F - S erv i ces
g 9 Feeders- Installation, ,
479, 670. 701. Alteration or Relocation:
Owner's signature: Date: 200 amps arises 5 66.85 $ _ - 2
20lamps - 400amps $ 100.30 $ - 2
Name: Over 4olamps • 600amps S 133.75 $ - 2
Branch circuits • New,
Address: Alteration or F:donsicn Per
Panel: A F00 fonbranch
City: State: Zip: - &Gilts with purchase of aervlce
or feeder fee, each branch
Phone: Fax: E - mail: circuit $ 6.65 $ • 2
B. Fee for branch circuits W/Out
Purchase of Sedco or Feeder.
1st Branch Cld ` 1 S 46.55 $ 46.85 2
0 Service over 225 amps -Comic ❑ Health -care facility Each additional branch circuit 21 $ 6.65 $ 139.65
❑ Service over 320 amps - rating of ❑ Hazardous location Miscellaneous • (service or
feeder not Included)
18.2 family dwellings ❑ Building over 10,000 square feet four or Each pump or irriaaeon Crete _ $ 53.40 $ • 2
❑ System over 600 volts nominal more residential units in one structure Each Sign or Outline Lighting $ 53.40 $ - , 2
❑ Building over three stories 0 Feeders, 400 amps or more signal Clroulgs) or Limited Energy
Panel Allerat.en or Extension
0 occupant toad over as persons 0 Manufactured structures e' RV park $ 75.00 $ - . P
0 Egress/lighting plan 0 Other: _._ - Dascnptian.
Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. Each AowrMnal lnspoouon aver
Not all accept Groat e&ae. piease cat Jura. for mare Info. the ARowoblo In any of file
n Ir
® VISA fl MASTERCARD Notice: This permit applitatian AbO1e. Per Inspectin
o 5 $ if s porno t Is
Card No 4246 - 0400 -0977 -7053 Was
obtained vonl hi too d nor aya who, It fnv�tiaar on fat:
AI W � ite e+ has been accepted as complete. (Other
m i dz✓ / � Permit Fee 5186.50
$201.42 Plan review 25% $0.00
Signature of carghddor Amount State Surcharge 8% $14.92 (T
Total $201.42
CITY OF TIGARD • 24 -Hour
BUILDING Inspection Lir.: (S03) 639 -4175
INSPECTION DIVISION . Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 1 AM PM BUP
Location q L( q 3 mo l' • S Q ggA Suite MEC
Contact Person Ph ( ) E 1 -0 -50 Vg PLM
Contractor Ph ,w ( ) SWR l
BUILDING Tenant/Owner l�� l � ELC 3 — 04D c 5
Footing
ELC
Foundation
Ftg Drain Access: ELR
•
•
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear F7 /1 G �( �� w R P i f
Framing .L� �9 l�
Insulation 2 �-- �] Y ) t 11 I N
,, V /�
Drywall Nailing �1�� ' ` VI' V I
Firewall ! I &P f / O
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Other:
Final � •
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
h Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL •
MECHANICAL ,r
Post & Beam r (t O x nI r l 2 ' g r O /
Rough -In V i V I/
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In
UG /Slab
Low Voltage ./ C-4-1/-e-4-1 Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Q Please call f• reins section RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspecti r Ext
Other:
Final DO NOT REMOVE this inspection recor from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour .
BUILDING Inspectio e : (503 9 -4175 MST
INSPECTION DIVISION • Business 03) 639 -4171
BUP
Received .Date Requested AM • PM BUP
Location (,) Pc 114__ Suite Pi - 3 MEC
Contact Person 7z /9L3 Ph ( ) g r S ! e PLM
Contractor Ph ( ) SWR Lis-Er
BUILDING Tenant/Owner td ELC 3 +0 d
Footing ELC' 2— 00 1)
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
PLUMBING FAIL D 40 I > �. i N 0-\\-\cvc(> Post & Beam c7�7
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 PA FAIL •
LECTRI A )
Se
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
� ) PART FAIL
❑ Please call for r-• spection RE: n Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date • s Inspector 0' -
Other:
Final DO NOT REMOVE this Inspection record e . - .-
PASS PART FAIL