Permit - ~ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00365
DEVELOPMENT SERVICES DATE ISSUED: 6/19/03
N� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09646 SW WASHINGTON SQUARE RD
SUBDIVISION: GI HINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Adding (2) branch circuits for TI - Job No. 23522
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: 1 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 ROSE CITY ELECTRIC CO INC
BY THE MACE RICH COMPANY 4012 NE CULLY BLVD
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97213
PORTLAND, OR 97223
Phone: Phone: 287 -6164
Reg #: SUP 21275
LIC 3567
FEES ELE 26 -113C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/19/03 $53.50
[TAX] 8% State Tax 6/19/03 $4 Rough -in
Elect'I Final
Total $57.78
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 - . -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 -33 344.
Issue By: 1/ l Permit 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: f DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
06/12/2003 13:36 5032821060 ROSE CITY ELECTRIC PAGE 02
�_, -
J c*rI F. e Per nutr2V d
caI
9- J w b 0b Received $IecMe�
1 0 y; -05 or} S l'ettnit N °. 3 34-5--- City of Tigard �,
13125 SW Hall Blvd. JUN 2 0 3 Plan yea Permit No.:
Tigard, Oregon 97223 ax. C 1Ty F I G A • ' Date/By: Perm tNo.:
Phone: 503. 639 -4171 Fax: 1 3- i319; I V I c� , PO R`viow r end Use
Internet www.cLtigard.or.us U LJ u LJ +• i : � , Darealr Casa No.:
24-hour Inspection Request 5034394175 ` A---t- ,� I" Contact a ethed_ I jU^s = I Sea Page n r
I SupDle°lmttallafol4aatlon.
.'lie!: d iViORK
• IIIIIII� New construction 1 '� - ��I �,l7�A���_''� III • ��i� it. i � . ' �. � ' ? 'G,
Demolition ■ SONice over 225 amps- N Health-eare facility
Addxtion/$ a .lacemcllL w Other commercial ❑ Razaraous location
Y ,''� Pliii l Gg 14 it I � L, ' o ELY: KS,TRT1 CTI Osinvice
2f aver dwellings amps�at>ng of ❑ four rig over 10,000 square foot,
1 & 2 family dweltiti s four or more residential ,m;rs in
❑ 1 & 2 -Famil dwellin Comm ercia /industrial D System over 600 volts nominal one structure
Accessory �Ulldir>q Multi-Family l ❑ scalding over three stories ❑ Feeders, 400 amps or more
Master Builder 1] E es& m load o l a n 99 Demons Q Otter eaaee� s>:ucu►ees or RV park • �'�.': , � :, � • Other. 1J Egress/lighting Pltin �j C)�er.
E ' 1 ; I r i IKEDRIII OP :,;), - � L r, . }
Submit sets of pis= with nay of Oho above.
Job site address: IO C S W SAS YI 11"" cr. , The a are not applicable to tee° ra construction service.
Suite #: BId . J • t. #: S&
- I Number of inspections per permit allowed .
va
Pro ect Name: gin/ SINFY._, • nes Qi' Fee tea.) Tata
Cross street/Directions to job site:
dwelling raldrPubia4shrRle or now-fondly per - f
dwelling unit Includes attached garage.
Service 1neltided:
1000 sq. (t or leas 145.15
Each additional 500 ss R roe th
or portereof 33.40 4
Subdiv;,sion_ l Lot #: tainted mew, residential 75.o0 1 t
_Limtaa9 ancre nor rnidential 75,00 2
Tax mat) /parcel #: Each maouA awed home or modular dwelling •
Db16C> IRROX02'5 service tastVor feeder 90.90 2
Services or feeders - Installation,
alteration or reloratiou:
200 amps or len . 8030 2
201 amps to 400 amps mass _
, • Ir i., , 601 amps • , 401 wogs to WO ant 160.60 2
;�- • '. OWN • "::. REN' ni 1 o , to 1000
- 240.60 2
Name: Over 1000 amps or votes 454.65 2
Reeennect only 65.85 2
Address: Temporary services or feeders - installation, - -
City/State/Zip:
alteration, or relocation:
200 amps alms 6615 1
Phone: I Fax: 201 tams to 400 atm 100.30 2
401 to 600 amps
': 21 f t . , ire •il . Ir •'CONTACT REI 133.75 2
— Branch circuits � sew, alteration, or
Niil]1C� /
extension per panel:
Address: ( A. Fee lbr leech circuits with purchase of
„ :.— _ seer.ie esr feeder the each branch Cllr uit 6.65 2
City /State/Zji B, Fee 16r broad circuits without purchase of
Phone;.' Fall service or feede nteneh ettrait � 46.85 �� 2
: Each a 'cowl brmseh circuit
6.65 — 2
E -mail:
?awls twice or 1LMer not Included):
COIL; Sash err' circle 53.40 2
�. 5.--4-9,9-1 F g & or outl a lighting _
- 7 g 53,40 2
Job No:
5i dreuit(s) or a /roiled QTY panel,
Business Name: ROSE CITY ELECTRIC CO Ij7 ar "raj" — '°`�1 _ Page _ __ _2
Address: 401 2 NE CULLY BLVD
City /State/ZipL V OFT' D , OR 9 7113 Rae6 additional inspection over the allowable In an of the obeyer
Phone:
Per inspection nu hour (min. 1 hour) 62.50 i
503 287 $1& fax: S()'1 9R2 'Olin Eivestigationfee•
CG'16'Lic. # 356 J Lic. 6 li 3C °'
Supervising electrici �/ 4Elietitriri J r_
sic require ` � — $uhtoral S
Plan Review125% of Permit Fee) S
Print Name: R L .-o th ar1 I Lic. #: 2127 S State Surcharge (8% of Permit Fee) $ 4 ' -
Authorized TOTAL PERMIT SlEE S 7 8 _
Si e: Notice: This permit appliemtlen expires if a permit as nut ei within
Date: 180 days after It has bean accepted AS complete.
*Fee methodology set by Trl•County Building Industry Service Beard.
(Please print name)
i:'Dsts\P'ermit Fa¢n'tst6lereamitApp -doe 01/09
CITY OF TIGARD. 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested _ a AM PM BUP
Location q601/(0 4' P( - S &• RD Suite 6- IL( MEC
Contact Person rZ —") Ph ( 2 '7 — Co 14 T PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ? � Le z-- ELC
Footing
Foundation ELC
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
Fir-
r E PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line � / /
ADA
Approach/Sidewalk Date Inspector �/ , Ext
Other:
Final . • DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL