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-- 7105 SW HAMPTON ST
' CITY OF TIGAR�`u �—ELECTRICAL PERMIT
PERMIT#: ELC2004-00658
DEVELOPMENT SEFlWOES DATE ISSUED: 10/13/2004
13125 SW Hall Blvd ,Tioard, OR 97223 (503) 639-4171 PARCE;.: 2S101AC-01300
SITE ADDRESS: 07105 SW I IAMPTON ST ZONIwv: MUE
SUBDIVISION: DFVFLAND NO.2
BLOCK- LOT: 018 JURISDICTION: TIG
Project Description: RF,work existing receptacle in new rec3ption desk.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS ^A` 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.IPANEL:
MANF HMI 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 WIO SRVC OR ; DR: 1 PER HOUR-
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
"OUO+ amp/volt: >=4kUNITS: >600 VOLT NOMINAL:
Reconnect only` _ SVC/FGR>=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KAISER FOUNDATION HEALTH OREGON ELECTRIC CONST/GROUP
PLAN OF THE NORTHWEST#838 1010 SE 11TH AVE
ATTN: PROPERTY ACCOUNTING PORTLAND, OR 97214
PORTLAND, OR 97227
Phone: Ph-me: 503-535-2652
Reg #: LIC 203
SUP 44605
_FEES _ ELE 26-95C
Description Date Amount Required Inspections
(ELPRMT]ELC Permit I n 1 121!1)• $53.50
I'AX 18%State Surcharge 10 13'200, $4.28 Rough-in
F
_ Elect'l 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, o if work Is
suspended for more t,ian 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(508;
2466699 or 1-Pr;-332-2344.
Issued By: Permit Signature: e. p io 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 _
SIGNATURF OF SUPR. ELEC'N: ____—_____---_—. DATE:
LICENSE NO: — — — ------ -- - ---- - - -----
Call 63q-4175 by 7:00pm for an inspection the next business day
OCT-12-C4 0209P FROM-Ureguo Electric Estimating 6032313587 T-692 P 00i/002 F-697
1:ilC►.as/LA■ ■ A S 11llL C1J./�.I aaa.■e■.AV AA ( ■
Cit of ,ill at'd eK Received
�t I D�tcJ13 , PcnrdtNo,! '
13125 SW Hal'Blvd., Tigard,OR 97213 v 1 C1 C,f`.
Plan Rovicw
Phone' 503,639.4171 Fax: `03,598,1960 DAMB , OthsrPermit:
Inspection Line: 503.639.4175 In,Mimsrale Read/B taxis —
Y Y� 9a Page 2 for
Inlc ict: w•ww.ci tigard.or.us Nou icNMcWod:
— I Supp(emantnllnfurmntinn
T*kTE OF ,sex ----— — PW REvl�w
[3 New oonstruetion ®AduitiotU.Iteration/replacr vert — � Please check all that apply:
❑Service over 225 strips,contm'l Hazardous location
[]DefttOlitigrr E]other. ❑
CATEGORY OF CONtirkv('noN ❑Service over 320 amps–rating ❑Buildng over 10,000 sq.ft.,
_ of'-and 2-family dwellings 4 or more new residential
❑ 1-and 2-family dwelling ®CornmeIcial/industrW Accessory building ❑SYstem over 600 volts nominal units In one structure
Multi•fhrrtil❑ ❑Building-)ver three stories ❑Feeders,400 amps or rmrc y [�Master huildcr Other; Qer
Occupant load over 99 ponc ❑Manufactured structures or
JOB 9M INFORMATION ANO LOCATIONOligress/lighting plan RV dark
Job no.: 1.9985 Job sire address:7105 SW Hampton St I MIealth-care facilltr ❑Other:
Submit?sets of plans with any of the above.
City/State/ZIP Tigard,OR 97223 The above are not applicable to temporary coiatruction service,
Suite/bldg./apt,no.: Project name: Kaiser Permanente Tigard Dental FEE` SCREDULE
—..__�.._ lltrerlptlon Qty. T..]
New
••
Cross StTeer/direchOn�t0 job site: New residential sio�llr�or multi-family dwelling unit.
Includes attached garage.
1.000 69.P, or less 145.15 _ 4
Subdivision: Lot no. ba.add't 500 sq.ft.or portion 33.40 1
Limited energy,residential 75.00 2
Tax map/parcel no.-
Limited
a Limited energy,non-residential 75.00 2
DESCR:Q'TION O:F WOR1K --_ Each manufactured 6r modular
Rework existing receptacle ir new reception desk. dwelling.service and/or feeder _ 90,90 2
gelryicas or feeders Installation,alteration.and/or relocation
200 amps or less 80.30 2
I iiF6R711 OWIsiER. 201 amps to 400 amps 106.85 2
� — Y r [J.TENANT 401 amps to 600 umps 160.60 2
Name:kaiser Permanente Tigard Denial 601 amps to 1,000 amps 240.60 2
Address:same Over 1,000 ams or�.,hs 454.65 2
Reconnect o-:;y 66,55 2
I City/State/ZIP: --
Temporary se•v'.;a or feeders installation,alteration,and/or
Phone:(503)687.-9274 pa,:( ) reksaden _
Owner installation:This installation is being m200 amps or less 66.85 1ade on property that i own which isnot 201 amps to 400 utrrlts _ 100.30 2
int-ndcd for sale,lease,rent,or exchange,according tc ORS 447,449,670,and 701, 401 amps to 600 rtps 133.75 2
0 net signature: bate: Branch circuits-ncw,alteration,at extention,per panel
O APPLICANT —� ❑ CUNTACr PERSON A.Fee for branch cireults wfrh -�
service or feeder fee,each
Business name: branch circalt e.65 2
Contact name: B.FCC for branch circuits
without service or Ile--der fee, x36,85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/StatdZlP: _ Miscellaneous(service or feeder not Included) _
Phone: Pump or irrigation circle 53.40 2
E-mail: _
-- Sigel or outline lighting 53.40 2
CONTRAt:IOi2 - Signal circuit(s)or hmiied-
Y— ergs panel,alteration,or
Business name:Oregon Electric Group extension.Describe' PAge 2 2
Address: 10108E 11th Ave Each additional Inspection over allowable In any ofthe■hove
j
Ciry/Statc/ZiI': Portland,OR 97214 Per intion 62,50—_ Investigation per hour(I hr ricin) 62.50
Phonc:(503)535.2692 Fax:(503)231-3587 Industrial plant per hour 73.75
_ELEC171MAL PERMIT FE1;S*
CCB LIC: 7.03 ElecMCal I.ic.: S Lic._ 4460S _ Subtotal
Supry Electrician signature,required: - — ` '•��
_ Plan rcvfew(25°h ofperrttit tLro)
Print name: t1i ��(- arc. G j State surcharge(8%ofpermit fee) x
Authorized signature TOTAL PERRIIT FFE
Thh pernut owle don expire If a perndt li not obtmned nfthin 180
Print name: / C: t7/ / day■anrr It has been■eet,pted an complete
Dat
✓-- c r/ 7 V • F"methodology bot by Tri-County Building Industry Service aosrd
"Nttmher or insp■ttions pet permn allowed
i.�9ulldingUkm�:u1EL�.PenJupp.Ooc 103 s1o.eGl?rllao!i�oMnvEB
r
CITY OF TIGGA RD 24-Hour
BUILDING Inspection Line: (503) 639-4175
RAST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received _- _Uate Requested_ }._ � AM___ PM _ BUP
Location _____ 1���TY'�_- _ Suite h1EC -----._-_—______ _ _
Contact Person Ph( ) PLM
Contractor—__-. __ _ Ph(_____) c 'cr— a g -� GWR ``''
BUILDING Tenant/Owner 1 61 �' A J ELC ��1,/) � OJ
Footing ELC
Foundation Access:
Ftq Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
------ ------- ---
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation
Drywall Nailing -
Firewail
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - -
Root
Other:
Final - -- - -
PASS PART FAIL
PLUMBING
Post& Beam -
Under Slab
Rough-In
Water Service - ---------- - --- --
Saniten Sewer
Rain u,,. - - - -- - --- ---- —
Catch Basin Manhole
Storm Drain
Shower Pan
Other: - - ---
Final
PASS PART FAIL
MECHANICAL_
Post 8 Beam �_. ----- - ---------- - --
Rough-In
Gas Line
Smoke Dempers -
Final
PASS PART FAIL_
ELECTRICAL
Service
R,D gh In
UG/Slab
Low Voltage
Fire Alarm
na _ ART FAIL.PReinspection fee of$ required befoie next inspection. Pay at City Hall, 13125 SW Hall Blvd.
�ASS
SITE Please call for reinspection RE: __ -__ U Unable to inspect-no access
Fire Supply Line
ADA
Date _. - Inspector _- �" -`' - Ext
Approach/Sidewalk ---
Other:
Final DQ NOT REMOVE this Inspection record from the J6b site.
PASS PART FAIL
CITY OF TIGARD ___ ELECTRICAL PERMIT
PERMIT#: ELC2004-00577
DEVELOPMENT SERVICES DA'TE ISSUED: 9/14/2004
13125 SW Hall Blvd., Tigard. OR 972217# (503) 639-4171 PARCEL: 2S101AC-01300
SITE ADDRESS: 07105 SW HAMPTON ST
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT : 018 JURISDICTION: TIG
Project Description: Compressor change out.
_ RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG:
LIMITED ENE,",GY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 6014amns- 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: WISERVI 3E OR FEEDER. PER INSPECTION:
201 400 amp: 1st WIO SRVk- OR FDR: PER HOUR-
401
OUR401 - 600 amp: EA ADD'L 6RNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+amp/volt: -4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect on!r: — SVC/FDR>=225 AMPS: CLASS AREA/Sr'EC OCC:
Owner: Contractor:
KAISER FOUNDATION HEALTH CHERRY CITY ELECTRIC
PLAN OF THE NORTHWEST#838 8100 NE ST JOHNS ROAD D-104
ATTN: PROPERTY A000UN11NG VArICOUVFR.VIA 98865
PORTLAND, OR 97227
Phone: Phone: 3i30-571-441 1
Reg #: ELE 37-620C
r- --- —
LIC 91668
_ FEES SUP 1486s
Description Date Amount
Required Inspections
I I.f RMT] ELC Permit 9/14,21)04 $53.50 --
� FAX]8%State Surcharge 9/14/2004 $4,24 i Low Voltage Inspection
E'ect'I Final
Total $57.78
1 his Permit is Lssued subject to the regulations contained in the Tigard Municipa 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 N 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 throuah OAR 952.001-0100 You may obtain coplea of these rules or direct questions to OUNC at(503)
248-RFQ9-r 1300-332-2344
Issued By: ��/� ,� _ — 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: _ ^� DATE:
LICENSE NO: —
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Prrmit Am) `i�,.� OR OFFICE USE ONLY
City of Tigard ` Received -
13125 SW Hall Blvd.,Tigard,OR 97223 1 Plan Review
Other Permit:
Phone: 503.639.4171 Fax: 503.596.196f� i� Date/By:
Insprstion Line: 503.639.4175 J� G 1CjPA Date Ready/By: Judy 0 See Page 2 for
ntemer www.ci.tigard.or.us �C ��`t4 Notified/Method: Supplemental Information
T 1 f _..PLAN REVIEW
--- ---- s
l _-- - Pleae check all that apply
New construction ❑ A ittori,'alteiation repacement pp y
F1 Demolition - CS
ervice over 225 amps,comm'1 []Hazardous loc^tion
❑Other: ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft.,
CATEGQR`i• OF CONSTRUCTION of 1-and 2-family dwellings 4 or more new resident,ai
-❑ r�ommercial/industrial Accessory building [:)System over 600 volts nominal units in one structure 1• and 2-family dwelling �1 ❑Feeders,400 amps or more
❑Building over three stories rrrp
❑ Multi-family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
2fi 1i bili SIFF INFORMATION NND Ltif A1ION ❑Egress/lighting plan RV park
[]Health-care facility ❑Other:
Job no.. L^ Job site address: 1 f/1,Y V` Submit 2 sets of plans with any of the above.
r- �1 The above are not apalicable to temporary construction service.
City/State/-LIP: __ - .
-- 1 _ / --- - -FEE*. SCHEDULE _
Suite bldg./apt.no.: Project name: 1�V .- A ••
Uescriptlon Qty. Fee. Total
Cross street/directions to job site: New residential single-or multi-family dwelling unit.
Includes attached garage. _
1,000 sq,ft,or less 145.15 u 4
Subdivision - Lot no.: - Ea.add 1 500 sq.ft.or portion 33.40 1
-- - - - Limited energy,residential 75.00 1 2
Tax map/parcel no.: _ Limited energy,non-residential 75.00 2
1 r %I.s(1t I PT It iN nl N',ORK Each manufactured or modular -
_ - - -
dwelling,service and/or feeder 96.90 2
Services or feeders installation,alteration,and/or relocation
-- 200 amps or less 80.30 2
- - 201 amps to 400 amps 106.85 2
❑'PROPERTY OWNER ❑ fl.'�A�I l+' "`-` 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: - Over 1,000 amps or volts 454.65 2
_ ____ - - ------ --- Reconnect only 66.85 L2
Citv/State/ZIP: Temporary services or feeders Installatlnn,alteration,and/or
-- �-- relocation
Phone:( ) Fax:( ) 200 amps or less _ F 66.85 1
Owner installation:This installation is being made on property that 1 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 600 amps 133.75 1 2
0,,Amer signature: _ Date: Branch circuits-new,alteration,or extension,per ponel -
-r-;r, --' AFee for branch circuits with
APPLICANT ❑ CONTACT 1 F.RSUN service or feeder fee,each
- '- _ = --=, . 6.65 2
Business name. branch circuit. _
--------—--- ---- - B.Fee for branch circuits
Contact name: withour service or feeder fee, I 46.85 L11$ 2
--- - - - --�-"- -"-- -- each branch circuit _
.Address: Each add'I branch circuit 6.65 L 2
City/State/ZIP: - - Miscellaneous(service or feeder not included)
-- --- _ Pump or irrigation ciicie 53.40 r 2
Phone: ( ) -_ I Fax: ( Sign cr outline lighting 53.40 2
E-mail: Signal circuits)or limited-
�1U*,C:TCdt - 4r.. I energy panel,alteration,or
-
0 _
extension.Describe: Page 2 2
Business name: � � � ---- � ----
Address: r 1Each additional Inspection over allowable in any of the above
V v` r. Per inspection 62.50
City/State/ZIP V Investigation per hour(1 hr min) 62.50
Phone: ) L Fax:(VU) S 7l Industrial plant per hour 73 75 -
r ELECT171CAI PERMIT FEF,S`
CCB Lic.: a Electri al Lic.: r Suprv.Lie.: - -! Subtotal
Suprv.Electrician signature,required: Plan review(25%of permit fee)
State surchistge(8%of permit fee) ,2
Print name: J 7 Date - ��
TOTALPE FEE
Authorized signature: This permit application expUn If a permit is not obtained within 180
days after it has been accepted as complete
Print name: — Dat" Fee methodology set by Tri-County Building Industry Service Board
•'Number of inspection per permit allcwed
i\BuildingiPtnttiulttLC•PerrmtAppdoe IVD3 aae•a61�T(IOro2rr01.VWEH
\ CITY OF TIGAR D ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: ELC2003-00730
13125 SW Hal! Blvd., Tigard. OR 97223 (503) 639-4171 DATF ISSUED: 12/18/03
SI1 E ADDRESS: 07105 SW HAMPTON ST PARCEL: 2S101AC•01300
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 018 JURISDIUTION: TIG
Project Description: Install.'branch circuits for computer work stations.
_RESIDENTIAL.UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: _ PUMP/IRRIGATION:
EAf.H ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE I_TG
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+arnps - 1000 volts: MINOR LABEL (10).
SERVICE/FEEDER --_-� BRANCH CIRCUITS _—_ _ ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: I=E12 INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDF:: 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:
KAISER FOUNDATION HEALTH OREGON ELECTRIC CONST/GROUP
PLAN OF THE NORTHWEST#838 1010 SE 11TH AVE:
ATTN: PROPERTY ACCOUNTING PORTLAND,OR 97214
PORTLAND,OR 97227
Phone: Phone: 503-234 j900
Reg #: LIC 20
FEES ---A--- — SUP 4460S
--_---- ----- -_ ELE 26-95C
Description Date Amount
�1:LPRM"I'i I:LC'Pcrmit i� u, Required Inspections
$53.50 --------
1TAXI 8"N.State Surcharpr $4,28 Rough-in
--- - ---- Elect'l Final
Total $57.78
This Pe is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and all other applicable laws.
All worts w,l!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 1-000-3,3 2344. '
Issued By: _�� � r t�C �— Permit Signature:_ el7
OWNER INSTALLATION ONLY
The installation is being mane 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: /-1 L/(�,C'j
Call 639-4175 by 7:00pm for an inspection the next business day
Y
DEC-17-03 03:47PM1 FROM-Oregon Electric E6tlmatlnQ 5032313587 T-666 P 001/002 F-530
�_- �- -- IE1�:r,tric::;tL P�:rrriit Apj.�li4::attvc>t
City of Tigard Bate rpceived:/ G' 77��7
�J
13125 SW Hall;slvd Prp"Ect/2 I.no.: Cx ice date:
Phone:(503)69-417 1,FAX:(503)598.1960 Date issued: By: Receipt no,:
IntPmat addres I' www.ci.tigard-or.us Case fila no.: Pa ment
2,4-Hour Ins ectlon Request_503-639-41_75 -
LT 18,2 family dwelling or access II Commercial/induatnal '_ --Q nAuKi family ❑ Tenant Improvement
17 New construction C1 switlorvaltilinown/mDiacemont LJOther: O Partial
RE •- r
—Job address: 7106 SW Ham ton Bldg.No.: Tax mapl:ax lotlaccount no.
I-ot: Blocky Subdivision -- - — _ -- -
Pro'oct Name: KaiaerT and Uai )Cation of work on prilirniges. circuits for(8)computor work Stations
Estimated Gate of oompletionrinspection:
Will vou call for ins eetion withal 24 hours? Yes 0 No t7 Pro'e A ranted
Ron Collins507 331-7005 P!xane
�no
Job No.: 19705n"•cdpdqn city roe(ea.) local wp
W6T
ererl iiURA1111w 1 —�—
muld-family per nwouing
9qLlrto�ss name:Oregon EhI ok jrrgyp __ unit. Includes attached
dd garage.Sarvico Incicdod.
Address: _ 1010 SE flltn Ave. _ loan .rt orless �_ ,4F,,5 f
C&: State QR y 4 __ Ea Addl 500 SF or Portion 33.40 S
Phone:(509)234.9900 Fax: 903 234-1001 E•mall __- _ umurM knq G 1 Fan S - 7500 $ a
CCB no,:203 Elec,bus.Ila,no,:26-95Cum1led Ffttgy,AAuni-Fame s 7,,00 S
-
-- - E.acn manufactured home or
maelu:ar dwnlltng. Survica
,.
rints A711712003 androrfeeder_ S_ 90.90 S 2
Service or Fonder*.
Su act.Name t:M tknna L'ttensn no:44605 Installation,Alteration or
Rolec3tion;
200 3m :or le', S t10.J0 f 2
201amps-4005mpe _ g 10B as S - 2
Melling Address: 4016mps-900amps $_ 150.00 $ :
City Sbh: Zi : — `--u-- — tlolam -1ao0amps 8 240.e0 f
Phone: F x; Email over boon a vats $ 454 r:s S z
Ow ler Insfallarh,a: The Installation Is being made on property I own which Is R0ro"^oet poly - E ee.as f t
not intended for sale,lease,rerit,i or exchange according"to QRS 447,455, Temporary 8e Feeders-Installatesn,
or
atlo
479,670,701 Alteration or R4locadon.
Owner's s' nalure; Dater oo amp_,V1 RnA $ ee.e5 $ z
c 2�11ampa-40oamo5 +0030
Name: ; Cner401 620am: _ S —t�3,78 $ - 2
- -- - - cinch mcu Is-, etv, -
Addfos9: Aletradon or Extension Per
Panel: A. ree for branch
City; '). A), CIrCUIIa with purchase of service
t
at Golder fee,each branch
FaX: E-mail: circ,lt am $ a
9 f ee for branch cimults -
Wlfhd Purthoao of Borvico or
Fender.tat branch Cut 1 3 46.9; 48.E6 l 2
❑Service over 225 amps-comate ❑ Health care facility each nddt onai txanch droult 1 i o.od S 6.55
O Service over 320 amps-rating dl ❑ Hazardous Incetion 141scallanoou-•(sorvlca or
feeder notlneluded)
18,2 family dwellings O Building aver 10,000 square feet four or Fach pump or I"Alan arcs 63.40 _ $ -`
0 System over 600 volts nomidal more residential th:m In one structure Each sign or Ouume a nun S 544,40 $ a
D Building over three stories 0 Feeders,400 ompS or more Slpna;Cl;callca)or Llmlled Fretoy
Panel r tmU-n m FAtentlon-
(3 Occupant load over 90 person 173 Manufactured structures or RV park - - 6 ;s.oe $_
❑Egrc aeAlghting plan ❑ Olhor:_ -__--__. •Oescnpdon:�—
Submit 2 sets of plana with any of the above. _
The nboys are n_ot itEEncabls:o_tempPrary COnetf1 Cd19 serlce_-_ Each AdOMlonal/napecfPon over Y
Me Allowable In eny-i1 the
reouce:Thee permit rppecstron Above. per IruDmilen
t rprnls 113 pnrmlr Is nal
obM1nad within tao day':after It Investl¢ftltx,Ibo:
hat hun Aeeeprso 6r OUnh• ---�- -
romplote — — -- 50
Permit gee
a !�Plan r=view�: f0.00
% '�j►
h Stale Surcharge 8% i!_-28 7►
Total fb7-i7B
r
r
CITY OF T'IGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
�. [� • BUP _ - ----- -
Received _ —__--Date Requested .���r �_L_AM PM ___ _._- BUP
Location _— U�_ �/ .��ty�-J Suite— MEC
Contact Pelson — Ph ) ' G!ss PLM
Contractor __ _ Ph( ) — SWR
BUILDING - Tenant/Owner - - >� _ Dir T �� _. ELC
Footing ELC
Foundation Access: --
Ftg Drain ELR
Crawl Drain _--_
Slab Inspection Notes: SIT
Post&Beam -
Shear Anchors - - —
Ext Sheath/Shear _
Int Sheath/Shear
Framing — - - -- --- -
Insulation
Drywall Nailing — —- -- -
Firewall
Fire Sprinkler ---- ------ � —
Fire Alarm
Susp'd Ceiling -- -
Roof `
Other: -
Final
PASS PART_FAIL_
PLUMBING
Post& Beam
Under Slab —
Rough-In
Water Service
Sanitary Sewer
Rain Drains -- -- -
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other. -- _
Final -----
PASS PART FAIL
_MECHANICAL
Post&Beam
Rough-In --—---____-- _-•
Gas Line
Smoke Dampers ---- ---- - — --_-- --- --- —
Final
rASS PART FAIL -- - - -- -- -- --
ELECTRICAL
Service -- - - -----! - - -
Rough-in - ----- ------ ----- --- -- ---
UG/Slab
Le,,vVoltage
Fire Alarm
❑ Reinspection fee of$_.—_ ^required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
_ _ Q Please call for reinspection RE:—. Unable to inspect--no access
Fire Supply Line //6 ,
ADAK Cy
Date _ ` O Iris ector
Approach/Sidewalk �-- --- �' _..--------- ------------ _.._ EIIt._
Other:
Final DO N61' REMOVE this Inspection record from the Jost site,
PASS PART FAIL
CITY OF TIGARD 24--Hour
BUILDING Inspection line: (503 ) 639-4175
MST
INSPECTION DIVISION Business Line: (503) Aga 4171 -
BLIP - --- -
Received -__—_. _Date Requeste
/d
'_�1 '� 3 AM PM BLIP
L
Location - .z� � � �0 l�-+Otis _Suite MEC ---.._.-...-.._--
Contact Person ___— -� �— _ Ph(_� �) G $ '� PLM _--_—
Contractor _ _ V Ph(__ ) _— SWR
_BUILDING _ Tenant/Owner _ l c'k ( 1.!/��i ELC 66,577
Footing ELC
Foundrtion --- --
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 I
Fire Alarm
Susp'd Ceiling - -- -- - -- -- -------._...- -------------
noof
Other: - ----- - ------------ -
Final
PASS_PART FAIL_
PLUMBING
Post 8 Beam ----- ------ ----------- --- - - ----_--.__—_
Under Slab --
Rough-In
Water Service
Sanitary Sewer
Rain Drains ---- - -- -- --- ---- ------- — - --
Catch Basin/Manhole
Storm Drain --------- _... _--- -- _--- — --
Shower Fan
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 Voltago
SPART_ FAIL
OSITE ElReinspection fHe of$ required before next inspection. Pay at City Hall, 13125 SW Hall B!v(1.
J reinspection[] Please rail for reiion RE: _ Unable to inspect-no access
—_- �-
Fire Supply Line
ADA / c
Approach/Sidewalk Data.._�-2 `a �- _-- Inspector `.�1�1_ y��r� `'�! Ext
Other:
Final DO NOT REMOVE this Inspecison record from the,fob site.
PASS PART FAIL