Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00533
DEVELOPMENT SERVICES DATE ISSUED: 8/26/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113AD -01900
SITE ADDRESS: 16600 SW 72ND AVE B -10
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: JOB NO 76267 Install one new power pole & add 400 hz outlet
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:
PACIFIC REALTY ASSOCIATES OREGON ELECTRIC CONST /GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 503 - 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/26/03 $53.50
[TAX] 8% State Tax 8/26/03 $4.28 Wall Cover
Elect 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 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: / ,1.1 Permit Signature: i AP -AP
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:OOpm for an inspection the next business day
AUG - 25 - 03 08:11AM FROM - Oregon Electric Estimating 5032313587 T -251 P.001 /001 F -134
,A•.x'-1 -1 ll:id r ermi P,.ppt1c;ataton
. - — ;OFFICE U 1
RECEI '1 SE, ; ON LY F
City of Tigard I D recei d. Permit no.:
+ _ ,. 0 , 13125 SW Hall Blvd Project/appl no.: Expire date:
645? , Phone: (503) 639-4171, FAX: (503) 5atit1612 5 5 6 Date issued: By: Receipt no.:
Internet address: www.ci.tigard.or.t UU 2003 Case fife no.:
24-Hour Inspection Re • uest 503-639-4175
Payment type:
Et 18.2 family dwelling or accessory ri Co Y
❑ New crorlstNebon e D • Y p lame t
R i multi - family L7 Tenant im ro n
a �5J , . e ; tr 0 Other
1. ,`+ i JOB SITE INFORMATION Partial _ •,
Job Address: 16600 SW 72 Ave Bid • No.: Suite no.: • Tax ma . /tax lot/account no.:
Lot Block: Subdivision
Pro ect Name! Flight Dynamics Description and location of work on premises; Install one new power pole and add 400 hz
Estimated Date of com •letion/iins • action: outlet
Will ou call for ins. ectlon within 24 hourb7 Yes • No ❑ Pro act Contact
'y *` :L „ -' '' ; CONI- RACTOR'APPLICATION 'd
Steve • - be (503) 535 -2631 Phone
- < -, ';' :' FEE SCHEDULE' -7';i'',- T . ..
Job No.: 76267 Description of Fee (ea.) Total kill
' owre8• e • a•ing 0
Business name: Oregon EteCtric Group multi - tamlry per dwelling unit.
Includes attached garage.
Address: 1010 SE 11th Ave. Service Include&
f000 •, ft. orleaa $ 145.00 $
Ci : Portland State: ORZi• ;97214 Co Addi500 SFor Paton III 5 33.40 $ NI
Phone: 503 234 -9900 Fa 1) 234 -1001 E -mail: umlvey Energy,! 8 2 Family 5 75.00 $
u °.'1°� �13r= b us. ! no.: 26 -95C umitne Energy, Minas- Family .E $ 75.00 , III
I" each manulacturcd home or
� � 8/25/2003 modular dwening. Service
�,•++o o ., ..;.,n,, •Ar r r r , and /or feeder, $ 90.90 I II
Servico or Feeders •
l . �., - Licens no: 4460S Installation, Alteration or
z i�1 i, � _ ' . ,, ,
PROPERTY - OWNER I Relecavon:
2003m.sorfess 5 60.30 $ _ Ill
Name •lint : 201amps -400 .n $ 106.85 $
Mailing Address: 4otaMps -eooa 1 $ 160.60 $
City State: 'Zip; 6olamps- t000amps I 5 240.60 $
Phone: Fax: 1E Over 1000A or volts 5 454,05 $
Ownerfneta /letlon: The installation is being made on property l own which is cc Reconnoct $ 66.65 $ a
not intended for sale, lease, rent, or exchange according to ORS 447, 455, T ed' Serw or
479, 670, 701 • Feed • k
Ol4nters signature: date Alteration or Retocagon:
200 ant. s or loss I 3 66.65 $ - 1111
(' " .. ENG INEER II
, 201 •r -400a ,.s III 5 100.30, $ _
Name: I?ver4olemps-600amps 111 5 133.75 1 $ El
Branch Circuits - ew,
Address: Alteration or Extension Per
City: State—
Zip: Panel: A. Fce for branch
circuits with purchase of service
Phone Fax: E fee, each branch
'1". circuit $ 6
r a
It $
r a, B. Fca for branch circuits W /put
Purcnsso ar Service Or Feeder.
PLAN REVIEW 1staranchokt
$ 46.65 I $ 46.85 ill
❑ Service over 225 amps•comlr 0 Health -care facility Each additional branch circuit 1 $ 6.65 $ 6.65
❑ Service over 320 amps - rating of ❑ Hazardous location Miscellaneous - (service or
feeder not included)
1&2 family dwellings 0 Building over 10,000 square feet four or Each • , . or i . Lion ctrdo g 63 $
In System over 600 volts nominal more residential units in one structure Each Sign or OuOinet Lighting 5 MAO $ 2
- 2
❑ Building over three stories ❑ Feeders, 400 amps or more Sisal arcuit(s) or Limited Energy
Panel Alter8don or Extension -
❑ Occupant load Over 99 persons ❑ Manufactured structures or RV park 5 75.00 $
O Egressllighting plan ❑ Other.
•Deeexiption:
Submit 2 sots of plans with arty of the above.
The above are not applicable to temporary construction service. Each Addlilmar inspection avow
Nor er0uzr4 cc
rtcaons Aept v cW
eer 0& please can Pls. set more Info. the Ani/owa0fe In any of the
® VISA 0 MASTERCARD Notice! This permit application Abova Per
Card No 4246 0400 - 0977_7063 04106 p , tsin its parmlrra not
E szso $
obtained within 180 days *twit hWeshgation fee: IIM
A firmite _ oxptres nes been accepte4aa compote. Other
357 76 Permit Fee $53.50
Plan review 25%
Signature or cardholder Amount $0.00
r State Surcharge 8% $0.28 N.
Total $57.7$
CITY OFTIGARD 24 -Hour _ - .
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested � AM PM BUP
Location 1(0 �� a ��1" Suite MEC
Contact Person . Ph ( ) S y 1 - z133 PLM
Contractor Tic', -� - ali en � l �
°�•. rh C ( ) SWR
. � —,— �..i
BUILDING Tenant/Owner - ... I CI 1 ELC 3 — o &5 -3 3
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 — - J �t ! �—
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
Fire Alarm
Ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S PART FAIL
Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line
ADA D ate tJcv S f v Inspector ��� Ext
Approach/Sidewalk f
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL