10575 SW CASCADE AVENUE 1 .
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10575 SW CASCADE BLVD 4a
ELECTRICAL PERMIT-
CITY OF T I GA R D
RESTRICTED ENERGY
-,4 DEVELOPMENT SERVICES PERMIT#: ELR2000-00224
13125 SW Hall Blvd.,Tislard, OR 97223 (503) 639-4171 DATE ISSUED: 10/3/00
SITE ADDRESS: 10575 SW CASCADE BLVD4* PARCEL: 1S135BB-00501
SUBDIVISION: ..n/ r te.e- ,:P- ).2.Z ZONING: I-P
BLOCK: /LO JURISDICTION: TIG
Prosect Description: Installation of data telecommunications system.
i
A.RFSIDENTIAL B.COMMERCIAL _
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS: 1
Owner: Contractor:
AMB PROPERTY L P CABLE RUNNERS
BY TRAMELL CROW NW INC 10500 SW BOONES FERRY RD
8930 SW GEMINI DR PORTLAND, OR 97219
BEAVE RTON, OR 97008
Phone: Phone: 503-245-3669
Reg#: LC 122854
ELE 26-951CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRrviT CTR 10,13/00 $75.00 2720000000 Elect'I Final
5PCT CTR 10/3/00 $6.00 7720000000
Total $81.00
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 perr,rit will expire if work is
not started withiri 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires yuu 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 `o OUNC at (503)
246:-1987. -
Issued by _�t kt';t�� .jZ�L_�'�-_� Permittee Signature
OWNER INSTALLATION ONLY
The installation is boing mane on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPQ. ELEC'N: _ DATE:
LICENSE NO:
Call 6394175 by 7:00 P.M.for an inspection needed the next business day
Electrical Permit AppHeation
Date received: /e,3-CU Permit no.:
City Of Tigard Project/appl.no.: Expire date:
City -17igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: 10- -60-C+d B VReceipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
7Newly dwelling or accessory Commercial/industrial U Multi-family U,tenant improvement
ruction U Addition/alferal ion/re lrlacement U Other: U Partial
Joh address: /0S7S' S&,) CASC Aev e,G t7 131t1g.nu.: Suite nu.: fax map/tax IoUaccount no.:
Lot: I Block: Subdivision: -
Project name: CSIi I Description and location of work on premises: OAT4
Estimated date of completion/inspection:
Joh uo� Pec Mar
Business name: r'Ae (' ��NN/:/f.; � — llexcription Qty. (ea.) 7utal r,rr.lns�
Address: p��t� S64NervresIder,tial-single or multi-familv per
/,�rrrJNf.S fid! drsellingunit.Includes attnchdgarage.
City: O✓ 'lt Staten. Z1P: 7 2/j Servkrinsluded:
Phone: t�o S ;'•'C• {ai Fax:S<)3 :Y:: ti Inai1: IOW sq.ft.or less 1
CCB no.: e.- Fach additional 500 sq.ft.or portion thereof
/Z,L$5 Elec.bus.lie.no: ZG- �/ L L'muedcnergy,residentiol 2
City/metrolic.no.: Od Limited energy,non-residential -- 2
Each manufactured home or modular dwelling
Signature f u ry, nTRr g electrician(required) Dole' and/or Serviceand/orfeeder 2
Sup.elect.name(print): �,',, l ,'.' License no: ���,�L� Services or feeders-Installation,
--j
alteration or relocation:
200 amps or less 2
Name(print): 201 amps to 400 amps 2
- "-- 40l amps to 600 am sMailing address:
2
601 amps to 1000 a rips 2
City: Stale: _ ZIP: Over 1010 amps or volts 2
Phone: I E-m.•.Il: — Rcconnectonly I
Owner installation:The installation is being,.,jde on property I own Temporary services or feeders.
which is not Intended for sale,lease,rent,or exchange according to Installation,slivrsilion,orrelocation:
ORS 447,455,479,670,701. 2r, eml.s or less -__ 2
Ops to 400 amps 2
Owner's si nature: Date: I io 600 strips ------ - 2
Branch circuits-new,alteration,
Name:
or extension per panel:
---- — ---- —_ K Fee for branch circuits with purchase of
Address: service or keder fee,each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
Phone: I ax: f? mail
_ of service or feeder fee,first branch circuit: 2
tach additional h,anch circuit:
ilin -Int Misc.(Service or feeder not Included):
UService over 225amps-cornmercial UHeald,-care facility Escpump orirritation circle _ 2
U Service over 320 amps-rating of 1&2 U Hazardods location Each sign or outline lighting 2
familydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited ene y p I, /
U System over 600 volts nominal more residenlialunits intine structure alteration,or extension" 2
U Building over three stories U Feeders,400 strips ormnre •I)escri tion:
U Occupant load over 99 per-.ons U Manufactured structures r RV park Pesch additional Inspection over rix allowable In any of the above:
U Fgress/lightingplan U either Per inspection �-
Snbcall--sets of plans with any of the sboi,e. Investigation fee --
The abo. a are not applicable to temporary construction zervice. Other - —
Not all jurisd eflons accept credit cards,please call jurisdiction for nwse fnformstlon. Notice:This permit application Permit fee.....................$ _ 7
U visa U Mastercard expires if a permit is not obtained Plan review(at ` %) $ _
Credit card mimbn, -- —1—/ within ISO days after it fins been State surcharge(8%)....$
expire' accepted as complete. TOTAL . $ $/
Name d cu Ides ass shown on c it c
Cwdholder Amount
--
440-4615(60"M)
4. Complete Fee Schedule Below: I TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
Number of Inspections per permit allowed Restricted Energy Fee...................... $76.00
..................
Service included: Items Cost Total (FOR ALL SYSTEMS)
4a. Residential-per unit Check Type of Work Involved:
1000 sq fl.0(less $147.15 4
Each additional 500 sq It or V E] Audio and Stereo Systems
portion thereof $33.40_ 1
I imited Energy _ $7`,,00 _ Burglar Alarm
Earn Manufd Home or Modular
[)welling Service or Feedei $90.90 2 Garage Door Opener'
4b.Servih.us or Feeders ❑
Installation,alteration,or relocation Heating,Ventilation and Air Conditioning System'
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems'
401 amps 10 600 amps $160.60_ 2
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 _ 2
Reconnect only _ _ $66.85 _ 2 TYPE OF WORK INVOLVED -COMMERCIAL ONLY
4c.Temporary Services or Feeder;
Installation,alteration,of relocation Fee for each system.............................................. $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps - $100.30 _ 2
401 amps to 600 amps $133.75 i 2 Che,.a Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. E] Audio and Stereo Systems
4d.Branch Circuits
New,alteration or extension pei panel j Boller Contmis
a)The fee for branch circuits
w1gi purchase of service or CIS^!;Gy.stems
feeder fee. v
Lach branch circuit $6.65 _ 2 Data Telecommunication Installation
b)The fee for branch circuits
without purrhase of service
Fire Alamt Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 HVAC
4e.Miscellaneous Instrumentation
(Servioe or feeder not included)
Each pump nr Irrigation circle _ $53.40_ _
Each sign or outline lighting $.53.40 v LIntercom and Paging Systems
Signal circuft(s)or a limited energy
panel,alteration or extension �_ $75.00 Landscape Irrigation Control'
Minor Labels(10) _ $125.00
Medical
4f.Lach additional Inspection over
tfhe allowable In any of the above ❑
Per Inspection $62.50 Nurse Calls
Per hnur $62.50 ❑
In Plant $73.75 Outdoor Landscape Lighting'
Jr'. Fees: u Protective Signaling
Sa.Enter total of above fees $
8%Surcharge(.08 Y.total fees) $ Other
Subtotal $
6b.Enter 25%of line 62 for Number of Systems
Plan Review I(_rbc uired(Sec 31 $ _
Subtotal $ ___ No licenses are required. Licenses are required for all other Instaltalin s
I
❑ Trust Account N_ FEES:
75-1
D -
Total balance Due $ _ ENTER FEES
-- / e"D
--� 81S SURCHARGE(.08 X TOTAL ABOVE) $ CO
ell
TOTAL. $
�f `
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blv;4., Tigard,f)R 97223 (503)639.4171
;ircu:'.. tc an existing cossercial bldg.
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v sit :s ;::;'_gid sjk.•�ject to the °'egulatiuns contaired i� tr,e 'igard Muricirai Code, State of Oregor 5pec;a:`.r Cc-r,
r". '; k will bF eorF it arcerdancE with ali,!r,ved ibis pet-oil, will expire it wo''
:., o, ;' e44 is suspended for sore tan 180 jaf,. p_ ' 'f: }dr/►OWe
law requires you X1.0
Ce't F!. Ns; -;Ie, a', W f. .i+ :1. 9
r ^-P?I e V 'ugh MIR W. -W,
i�+es'ior+s to OUK h1. calli
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd L
Tigard, OR 97223 Permit # — &ie
Date Issued
Phone (503) 639-4171
CITY OF TIOARD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: \ 4. Complete Fee Schedule Beiow:
Name of Development Number of Inspections per permit allowed
C1(,/
Addresn s �.� Service included Items Cost(ea) Sum
City/State/Zip- �►,.� 1.wL• _ 4a. Residential -per unit
1000 sq. ft or less $110 0o _ 4
Name (or name c. business) _ Each additional 50c sq n.or
portion thereof $2500 _
Commercial Residential ElLimitedEnergy $2500 1
Each Monurd Home or Modular
Dwelling Service or Feeder $6800 2
2a. Contractor in.stallatior only:
4b. Services or Feeders
Installation,alteration.or relocation
Electrical Contracto 200 amps or less 580.00 2
Addr se 8� k 201 amps to 400 amps $80.00 2
City "Trd1KaJT �oVt State--t-1`110�:--Zip–f,7 1 4. 401 amps to 800 amps 5120. 0 2
601 amps to 1000 amps 5180.00 2
Phone No. 4517- q41-3 Over 1000 amps or volts $340.00 _ 2
Job NO. Reconnect only $50.00 _ 2
contractor's license NO. � 4c. Tomporary Services or Feeders
Contractor's Board Rego. 4
Installation,alteration.or relocation
Signature of Supr. Elec'ng�-�s ter _ 200 amps or less 2
License No. Phone No. / 201 amps to 400 amps $5000
— 401 amps to 600 amps $7500
Over 600 amps to 1000 volts $10000 --
2b. For owner installations: see"b"above
P4d. Branch Circuits
Print Owner's Name
New..alteration or extension pir pane
Address a)The fee for branch circuits with
City State_
purchase of service or feeder fee.
Zip Each branch circuit $5.00
Phone No. _ b)The fee for branch circuits wlthoaf
The installation is being made an property I own which is purchase of service or feeder fee. 2
not intended for sale, lease Or rent. First branch circuit _ / $35.00 2
Each additional branch circuli _ $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
.7. Plan Review section (if required): Each pump or Inigatlon circle $40 DO 2
Each sign or outline lighting $4000
Signal circult(s)or a l mlted energy `
Please check appropr.-tt Item and enter foe in r fiction 5B. panel,alteraLm or extension $40 00
4 or more residential unRa in one structure Minor Labels(to, 51oo 00
Service and feeder 22F ^mns or more
_System over 600 volts ruminal 4f. Each additional Inspection over
Classified area or struc!ure containing special occupancy the allowable in any of the above
as described in N.E.C. Chanter 5 Per Inspection $3500
Per hour $5500
In Plant $5500
Submit 2 sets a plans with application where any of the above — —
apply. Not required for temporary con^truction services. 5. Fees:
5a. Enter total of above fees
NOTICE 5%Surcharge 105 X total fees) $ _�1S
PERMITS BECOME VOID IF WORK.OR CONSTRUCTION Subtotal 8
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review N required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ _
COMMENCED ❑ Trust Account a
Mme $ — -
Balance Due
RECEIVED
OCI 2 s 1997
,ommuNIPf pEVE!OPM{MT
49 If IL.1l SLWV.f?AGL AGLIJCY OF 1f/UNIIK.7UfV CCVJNTY
F 1 XTURE "�VNN I T RAT I M-5
TOTAL.
F 1 XTURE VALUE -- f; ) MIF40ER NIJM[lER
RAPT I;iTRY/FONT 4
BAT" - TUO/SPOWER 4
JACUZ/R}IPL 4
CUSP6MR/WATER ASP 1
D 1.%1MASHER — COMMER 4
LX)NCST 2
CR 1 NIC I NG FOUfYTA I N 1
FLOOR DRAIN — 2 INCH 2 /
— 3 INCH S
— 4 INCH 6
GARBAGE DISPOSAL
— DOM (TO 3/4 I(') 16
- CADW (Tl"?S HP) ]2
— IND (OVER S HP) 48
OIL SEP (GAS STAB 6 }
SI-IOWER —
— STALL 2 �(
s 1 Ix - BAR 2 a C-
- BRADLEY S
— CCaMERCIAL 3
— S:-RV ICE .1
WA-%IER, CLOTHES 6
WATER EXT 6
WATER CLOSET 6
L1R 1 NAS. 6
1
DATE ��% M �� INSP,—. gL � ` { •` _7 TOTAL
n+
r
EDU
DUSINESS
PERM I T NO.
ADDRESS _.i ,'✓ "/� _t _ (�/`�
COUNTED FROM
TAX MAP/LOT _
z:-7 �/b)
SieE�-t
td it 11A) SEWLRAGC AGLIiCY UI 11A5:4II403IUN CCXJNTY
F 1 XTURE VN IT _jjAT I IIGS
TOTAL TOTAL
NUMBER NUMBER
F I XT X4E Al UE
RAPT1STRY/FONT 4 _
AATI/ _ TUn/SHOWER 4
JACUZ/RHPL 4
CUSPIDOR/WATER ASP i
D I E14WASHER — OOMMER 4
L)omEST 2
DR 1 NIC I NG FOUNTAIN 1
F L.CX)R DRA IN — 2 INCH 2 "
s'
— ) 1 NCl-1 S
i
— 4 INCH 6
GARBAGE DISPOSAL
— DCJM (TC) 3/4 FI-) 16
+
— COMM (TO S HP) ]2
IND (OVER 9 HP) 48 I
O 1 L SEP (GAS STA) 6
S"--MER '" GANG 1
STALL 2
I
5 114K — BAR 2 r _
— BRADLEY s
— CC#AMERC SAL 3 _
— SERVICE 3
WASHER, CLOTHES 6
MATER EXT 4
RATER CLOSET 6
URINAL 4 _
lE
OA TE � 11'liP—
DOTAL T
EDU
BUSINESS s. _
PERMIT NO.
ADCRE.SS
COUrfTED FROM
TAX MAI•/LOT
��::;
�.,� rte,��., b
UN I f I,LI) 1f WXy4AGE AGj IgCY CW V^5H I fx:1t;N COLM4rY
r 1 xTUHE LN I T FIAT 1rlG&-
Q��►� '� c ��-oI�1�1%( TOTAL TOTAL
FIXTURC VALUE ?c. PI�IKI� MURMUR
i
BATiISTRY/FV4r • 1 I
BATH - T110/911t7MER + I —
JACULIVil-L •
Ct6P I DDR/ICA nJt ASP 1
D I fAM ASN" CIS IE R 4
I xv.4C S T 2
DR 1 NK I NG FOiLJraA I N 1
i
FLCXJFt t]ftA I N2 1 NCH 2
3 INCH 5
I NCIH 6
GARF3Ar,E DISPOSAL
- DOM (TO 3r4 1f 16
i
- aDk%w (TO 5 HP) 32
I
- IND (CHER 5 HP) 6•
O I L SCP (GAS STA) 6 �f
sHowclt _ C.4m 1 I
STALL :
S I W - BAR 2 .�
BRAD'-EY 5
CC74IERC I AL 3
SERV ICC 3
WASHER, CLOTHE_, 6 ---
VATLR UO' 6
WATER CLOSET
OR I NAL
iw1L ___-.IN •1 -
1 ry��,�� �,/J� �r
NUB I NE S S LVU��'���+- /?c '_/^
FM_M4 __._.- ..
TAX MAI•'1 1 _—._—
CITY OF TIGARD BUILDING INSPLC ION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: ` I I r ( l A.M._ _ P.M._ MST:
.y
Location: l L, /=_�� t� > _ BUR
Tenant: Suite: Bldg:
22 NEC:
Contractor., Phone: 3 7- 1/0/_„7 PLM:
Owner: Phone: ELC:4? T�7
ELR:
BUILDING BLDG(con't) PLUMBING MECHANICAL C.UECTRICAL_ _> SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In CeilingWater Line
Slab Framing Top Out Gas Line JQg -� ." UG Sprinkler
Foundation Insulation Sewer flood/Duct Reconnect Vault
Bsmt Damp Drywall Storni Furnace Temp Service misc.
Masonry Ceiling Rain Drain A/C I IG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Ileat Pump Low Vit _
Approved Approved Approved __Apj=ved_ ., Approved --
Appr/Sdwlk Not Approved Not Approved Not Approved Not A pproved Not Approved
FINAL FINAL FINALF1NA FINAL
0 Call for reinspection 0 Reinspccti r of S _required before next inspection D Unable to inspect
Inspector: '1 /C t,i #� _ Date: Page_ of
---
" 4
CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00066
13125 SW Hall Blvd., Tiqard, OR 97223 (503)639-4171 DATE ISSUED: 2/27/03
SITE ADDRESS: 10575 SW CASCADE AVE PARCEL: 1S135BB-00501
SUBDIVISION: ZONING: I-P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description:Job no. 083-14932-02
Burglar Alarm For Entire Bldg. PANEL IS LOCATED IN SUITE 150
A.RESIDENTIAL _ B.COMMERCIAL _
AUDIO & STEREO: AUDIO& STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL. is
INS1 RUMENTATION: OTHER:
TOTAL#OF SYSTEMS: 1
Owner: Contractor:
AMB PROPERTY L P ADT SECURITY SERVICES, INC
BY TRAMELL CROW NW INC 2815 SW 153RD DR
8930 SV'GEMINI DR BEAVERTON, OR 97006
BEAVERTON, OR 97008
Phone: Phone: 503-419-7244
Reg#: LIC 59944
I'.LL: 26-209CLE
_ FEES e Required Inspections
Description Date Amount Ceiling Cover
ILLPRIVITI ta_R Permit 2/27/03 $75.00 Wall Cover
F_lect'I Final
ITAXI State Tax 2/27103 $6.00
Total $81.00
I
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicdble 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 throuc
Issued by �'- ' Permittee Signatur
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:
L ICENUE NO:
Call 6394175 by 7:00 P.M.for an inspection needed the next business day
r
4
Electrical Permit Application
Date received; ;J( -(" Permit no.
City of Tigard Projuct/appl.no.: Expiredate:
City ofTlgard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dale issued: By Y'' I Receipt no
Phone: (503) 639-4171 --- --
Fax: (503) 598-1960 Case rile no.: Payment type:
., Land use approval: —
. t
U I & 2 family dwelling or accessory L' Multi-lam-ly U Tenant improvement
U Now construction U Addihott/allr,,ration/rcplacentcnt U Other U Partial
.1011 SITE INI.-oll0iMON,
Job address: �} ite Bldg.no.: Suno•a Tax map/tax lot/acccunt no.:
Lot:' Clock: Su hrision:
Project name.-Tr j1h=1 Gkr w I Description and location of work on premises: {, _
Estimated date of completion/inspection:
Job no: LILJ 2--U2- _ — Fee MAX
_Business frame: A L. � r -- -- IOescriptlon eti Total no.!-
Nen resW ntlal-single or multi-family per
Address: �i _ awewngudl tnet■aes■tt■eheag.rage.
City: _� Wma- State:QK ZIP._g� Serdtxbrdarlet
Phone4�• •7 E-mail: 1000 sq.t4 or leas
61ec.bus.tic.no: Bach additional 500 sq.It or portion thereof
CCB no.:
�- Unuted energy,residential 2
City/me lie.no.: _ Umitcd energy,non-midendal 2
��
Each manufactured ed home or modular dwelling
- ---
§Ignatu of eupervis-g elcetricia_n�rcguirad) _ _ Dat Service°n'i/°rftxcier_ 2
Services or feeders-Insta l l■don,
Sup.elxt.narnc(prinQ: (,IJ AVL ueenaeno:C,EA389 alteration or relocation:
200 amps or less 2
Name(prin _ zi;1 amps l0 400 amps—---- 2
Walling address: — 401 amps to 600 amps ----�� 2
60'snips to 10(10 amp+ 2
City: _ State: ZIP: Ovct I000;<mps or volts----_ - 2
Phone: Fax: -JE mail: Reconnecuml _- I
Owner installation:The installation is being made on properly I own Tempor■rysetrvicesorfeeders
- -
wluch Is not intended for sale,lease,rent,or exchtu+ge according to hrstalladna tuertflon,or relocation:
ORS 447,455,479,670,701. 200 amps or less _ _ 2
201 amps to 400 amps 2
Owner's si nature: Date: 1 401 to 6W amps 2
Branch circuits-nevv,alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: Y service or feeder fee,each branch circuit 2
Cit S talc ZIP: B. Fee for branch circuits without purchase
-" --� '------- - -- - - - —' _ of service or feeder fee,first branch circuit: 2
Phone: I nx: Ii-mail: -- -
Each additional branch circuit:
KVIKIWIU�i11113 Mise.(Service or feeder not Included):
U Service over 225 amps-conunemial U lloalth-care facility Each pump or irrigation circle 2
U Service over 120 amps-rating of I Rr2 U Hazardous location Each sign or outline lighting - 2_
fami ly dwell ings U Bu.Iding over 10,000 square feet four or Signal circuit(,)or a limited energy panel, �}� �+
USystem over 600volunominal more residential units in one structure alterstici,orextension• ' S 77 2
'ea
U Building over three stories U f +ers,400 amps ormore 'Description:
- -- _
U Occupant load over 99 persons U Manuhclur,x)structures at RV park tach additional Inspection over the-llcvable In any of the above: _
U Egress/lightingplan CI Other ---f
-- ---------- ------ Perinapection
Submit.—-sets of plans vd1h any of the above. Investigation fee
the above are not applicable to temporary construction service. Other —
--- ----— —_.__ Permit fee.....................$
Na dl iurixtictione accept crcdlt cods,please call Jurisdiction far mese infonnatlon Notice:This permit application
U Viii U klssterCard expires if a permit is not obtained Plan review(at -_ %) $
eau tarn number: L__1 within 180 days after it has been State surcharge(8%) ....$ •�
`p1e1 accepted as complete. TOTAL .... ..........$
Name o c o t o shown on credit
-
_ -
c"holder slputute Amount 44: 1515(tiAOrONI)
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP _—
Received /2:b9_a '30 Date Requested AM PVO* BUP
Location _ 112-G-15- ��3G�/1 /Tl/ Suite 1 S'D MEC _
Contact Person i Ph( ) ��� t, 3- _ PLM
,/.�-97' _ Ph ) 41 b 2 72 Silo swR _.
Contractor
BUILDINGTenant/Owner / �� -���`'�"� ELC
Footing ELC -
Foundation Access:
Ftg Drain ELR ��
Crawl Drain SIT
Slab Inspection Notes: --
Post&Beam - -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing -- -
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler r ,, 1
Fire Alarm (( l� 5•�( �o Vey_ 0 )W 1 x
Susp'd Ceiling -f
Root ) r, �yCt �• Dn -_
Other:
Final -
PASS PART_ FAIL
PLUMBING - --
Post&Beam 1 _
Under Slab - -
Rough-In 1 Y_-
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 '-
Service
Rough-In -
UG/Slab
Low Voltage ----- ---
Fir la
Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
A PART FAIL.
SITE F] Ple&:e call for reins ction RE: �__- _ Unable to inspect-no access
Fire Supply Line
ADA Inspector _ 6," Ext.----
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record rom the site.
PASS PART FAIL