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Permit C ELECTRICAL PERMIT CITY ®F T I G A R D PERMIT #: ELC2002 -00406 'l�, DEVELOPMENT ) 639 -4171 SERVICES DATE ISSUED: 8/22/02 - 13125 SW Hall PARCEL: 1 S126C0 -01107 SITE ADDRESS: 09755 SW WASHINGTON SQUARE RD D -3 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of service, (11) branch circuits and signal circuit/limited energy panel for 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: 1 MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: 11 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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 DYNALECTRIC P.O.BOX 21545 2904 SW FIRST AVE. SEATTLE, WA 98111 PORTLAND, OR 97201 Phone: Phone: 503 - 226 -6771 Reg #: LIC 066793 SUP 2950S ELE 26 -59C FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 8/22/02 $206.85 2720020000( Rough -in Elect'I Final 5PCT CTR 8/22/02 $16.54 2720020000( Total $223.39 This Permit is issued subject to the regulations contained in the Tigard Muniapal 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: 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: G g/4/6Z,/ e 4 DATE: f/ 2 / 0 LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received:' zL oz._ Permit no.: 5 2624,02 -Di `'D , j_° , City of Tigard Project/appl. no.: - Expire date: J City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: • - eipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: , Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ErCommercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ' ❑ Partial JOB SITE INFORMATION Job address: W S 44 ki 9' 755 Bldg. no.: Suite no.: Tax map /tax lot/account no.: • Lot: I Block: I Subdivision: /yl .0 3 T°� m erbS ;' " .0) • ,z, c. EL[. Co77' Project name: '7° Vrt pb/�ao I Description and location of work on premises: . Estimated date of completion/inspection: - - ,_ - , , . -FEE SCHEDULE - C01�1 RACTOR API LICATIOn � "` =` ` ` ` Job no: /— 3 5 &' Fee Max Description Qty. (ea.) Total no. insp Business DV �/ L . ;�`� r �" New residential - single or multi - family per Address: 2 g,Q_ t/ 5• t •f 9 dwellingtmit. Indudes attached garage. City: p( Y r 1.4 ( State: 0&._ I ZIP: 1 Service htduded: Y 1000 a ft or less 4 Phonera y amiss? J Faxiy -2"4-11.29 1E-mail: Each additional 500 sq. ft. or portion thereof CCB no.: ` 6 To s /y/'o I Elec. bus. lic. no: �$ 9 C Limited energy, residential 2 City/metro lic. no.: oa., 73 3D 5 Limited energy, non- residential 2 W I/A, 2 Each manufactured home or modular dwelling Date _ Service and/or feeder 2 Signature of supe sin lectrician (required) Services or feeders Installation, Sup. elect. name (print): (p _ , 0 License no: • alteration or relocation: PROPERTY OWNER 200 amps or less 1 ra30$'0,30 2 201 amps to 400 amps 2 Name (print): 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: (ZIP: Over 1000 amps or volts 2 Phone: I Fax: 1E-mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary seivhxs or feeders - installation, alteration, orrelocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit ii 4, ( w4 2 State: I ZIP: B. Fee for branch circuits without purchase City: of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW' (Please check all that apply) - Misc.(Service or feeder not Included): • Each pump or irrigation circle 2 ❑ Serviaover225amps- commercial 0 Health-care outline 2 Signal sign gn or ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each �h E h circuit(s) in limited r-i �� family dwellings ❑ Building over 10,000 square feet four or B ut a nd energy panel, � 5 $ ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* ❑ BuIIding over three stories - ° ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional Inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other. Per inspection I 1 Submit _ sets of plans'with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Permit fee $ /Oar Not all jurisdictions accept credit cards, please call jurisdietioo for was information. Notice: This permit application Plan review (at _ %) $ @° ❑ Visa ❑ MasterCard expires if a permit is not obtained Credit card numbs: / / within 180 days after it has been State surcharge (8%) $ Ex accepted as complete. TOTAL $ . Z ` Z ' 3 Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6/00ICOM) CITY OF TIARD • 24 -Hour BUILDING Inspection Line: (503) 639 -4175 - INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested g' 3 AM PM BUP -- Location 2 75'3 4y !tet' Suite 1 " 3 MEC Contact Person Ph ( ) ?`/ 1 Z 3 - r PLM • Contractor Ph ( ) SWR BUILDING Tenant/Owner 67 /11.4 4 847 ELC ,L Z - eia 4/o G 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 V v 1 L. L /> v � � Drywall Nailing �f� ll �YJ 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 CUE-CT-4 Service UG/Slab • Low Voltage Fire Alarm F ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. `Dd3S PART FAIL SITE ❑ Please call for reins•ection RE: ❑ Unable to inspect — no access Fire Supply Line AppP roach/Sidewalk Date O Inspecto Ext P Other: Final DO NOT REMOVE this inspection record from th Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639 -4175 - INSPECTION' DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested AM PM BUP Location 7 / ` S 6-, Suite MEC Contact Person Ph ( ) J 2 Z82 PLM '- Contractor Ph ( ) SWR / BUILDING Tenant/Owner ) VN ` / 7' n . ELC Q77 0,6 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam d VA d\/0 Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler \ Fire Alarm P°kA6� ` `1n0`P , / p U e� 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 S =. ice y UG/Slab l o' ``' � Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS FAIL SITE ❑ Please call fo reins•ection RE: ❑ Unable to inspect — no access Fire Supply Line Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record rom the ' - site. • PASS PART FAIL CITY OF TIOARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 M BUP Received Date Requested 9 / AM PM BUP Location a' S_ - _ SG/ 1 vl. s 4- 5 � /� A Suite C - 3 MEC Contact Person Ph ( ) Z 3 Z r PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC ' � Z�G 4(6 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 r 1�, L � r( Co V N(55‘0 Fire Sprinkler Fire Alarm liqot1241414-252'..- L--(7 IrV f& P*scss'n 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 •j Servlce ugh -ln (/',.., UG /Tar C arm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Q Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line / / • Approach/Sidewalk Date / 2 ' Inspect Ext Other: Final DO NOT REMOVE thisinspection recor ; from t e Job site. PASS PART FAIL • CITY OF TI 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST G� l BUP Received Date Requested < / / 7 AM PM BUP Location - / 7 s.� k) Suite MEC Contact Person Ph ( ) q- /3 7-F PLM Contractor Ph ( ) SWR �L • BUILDING Tenant/Owner T Q Q ELC .6 T Qo 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 l n y �, 6 Fire Sprinkler \ r �7 / 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 anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Cj f� Approach/Sidewalk Date / Inspector /1 X Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL