Permit -„ QJ(j 0,60) iJ �+'..
�° 'CITY O ��.� D
PERMIT #: ELC2007 -00675
COMMUNITY DEVELOPMENT DATE ISSUED: 9/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD
SITE ADDRESS: 11565 SW HALL BLVD ZONING: C -
SUBDIVISION: METZGER ACRE TRACTS LOT : 026 JURISDICTION: TIG
PROJECT: DR. JOHNSON DENTAL
Project Description: Circuits and controls for X -ray machine. Low voltage.
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: SIGNAUPANEL: 1
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:
PANG, KEIKO TR E C COMPANY
46 -442 HOLOLIO ST PO BOX 10286
KANEOHE, HI 96744 PORTLAND, OR 97296
Phone: Contact #: PRI 503 - 220 -5377
FAX 503- 295 -3012
FEES
Description Date Amount Reg #: ELE 26 -45C
[ELPRMT] ELC Permit 9/27/2007 $128.50 LIC 49737
[TAX] 8% State Surcharge 9/27/2007 $10.28 SUP 3924S
[ELPLCK] ELC Pln Rev 12/6/2007 $32.13
REQUIRED ITEMS AND REPORTS
Total $170.91
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: �/5 Permittee 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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical. Permit At Mica . � �� x ` � � , „.-.:. ` z �o 1c. 1 `til t,�i:i tom :z ,�; ;, :` t
' City of Tigard r _
.` ` 7 l N EVe ce�ed , . - if/ 7-
a 13125 S W Hall Blvd., Ti OR 97223 x ti plan Review
t 613 Phone: 503.639.4171 Fax: 503.598.196 ” Date /B : ,� Other Permit:
T.I G A R I l
) Inspection Line: 503.639.4175 U ` � 2007 Date Ready/By: Jw;s:
t . +.•:L• Internet: www.tigard- or.gov ('`„ V Notified/Method: Supplemental Information VI See Page 2 for
TIM I '� I R Ur 11O f . PLAN REVIEW
❑ New construction " Ad. :' Alt,, i- d IN -VISIO Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling "Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
['Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: � 1 0 6 � , jg Job site address: , 1 Six or more more. occupancy.
U
\ vc
�'w �` t4 `� � ❑ Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: -- Ta ❑ Health -care facilities. ❑Supply voltage for more than
\ A� 1 } ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: h,. . 0 ',,, , ,,,, , (fie ,,' \ _ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
a s k \ \ c...- C. ,, , \, . C. 0 ., v u 1 s •t residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
x'' `e 1`/ ''0 c,‘ ` ( J 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps . 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
' each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: witho service or feeder fee, l 46 85 t..\(... 2
first branch circuit
Address: Each add'( branch circuit 't 6.65 (,,(,,c 2
City/State/ZIP: Miscellaneous (service or feeder not included)
tY Each manufactured or modular •
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( )
Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: C C p 1 to - \ energy panel, alteration, or
S
Address: >(j G 6 k t () -, (. P \ l) extens Describe: \ Page 2 'rl - 2
City/State /ZIP: D 0\ _ Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (S c's ): c _ y -\ Fax: ( S ) :_,30 3 O; . Investigation per hour (I hr min) 62.50
CCB Lic.: L,C\ i, Electrical Lic.: ) C .A.‘ S C Suprv. Lic.: 4 75 - 6 - 5 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ../�-a-e',,, ,,,4,,,,,&(_,,, Subtotal: i .3 .LQ
Q r
Print name: Plan review (25% of permit fee): .
�� i
PG , ( 7 'S Date: 9/z4/07 State surcharge (8% of permit fee): \ O 'g,......,
Authorized signature: TOTAL PERMIT FEE: VA u,.' \\
Print name: This p ermit application expires if a permit is not obtained within ISO
Date' days after it has been accepted as complete.
• Number of inspections allowed per perm'
1 :\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB
CITY OF T GAR® ELECTRICAL PERMIT
PERMIT #: ELC2007 -00675
COMMUNITY DEVELOPMENT DATE ISSUED: 9/27/2007
TIGARu 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-01800
SITE ADDRESS: 11565 SW HALL BLVD ZONING: C -
SUBDIVISION: METZGER ACRE TRACTS LOT : 026 JURISDICTION: TIG
PROJECT: DR. JOHNSON DENTAL
Project Description: Circuits and controls for X -ray machine. Low voltage.
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: SIGNAUPANEL: 1
MANF HMI SVCI 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:
PANG, KEIKO TR E C COMPANY
46-442 HOLOLIO ST PO BOX 10286
KANEOHE, HI 96744 PORTLAND, OR 97296
Phone: Contact #: PRI 503 - 220 - 5377
FAX 503 - 295 -3012
FEES
Description Date Amount Reg #: ELE 26 - 45C
[ELPRMTI ELC Permit 9/27/2007 $128.50 LIC 49737
[TAX] 8% State Surcharge 9/27/2007 $10.28 SUP 3924S
Total $138.78 REQUIRED ITEMS AND REPORTS
. 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: jjeze W �� Permittee Signature: e � 2
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
0'/26/2007 01:38 5032205347 PAGE 01
,
• s y F ; , ,a , A i J m�� I� n, ,Y,: t� l .r" ` �� + ri
r ¢ , r � � �i�
lectr>tcal Permit Apply 1 � �1 1tZ , } rid.`,1.10.0%61,,' a n: 6 T1 , j; 1 ace()I 1 q{ 1 t'' 1 r .. 1 . !" 1 1 �, � � � In,,l`' , 4 , 1.'
7,4 , . cit o f Tig ' „ � ' nate/B .q_ • . _.,
tt e i31xs sw>Ieil Blvd., Tigard, OR v�223 `. jr 5
rl . en v Pmt:
kl r � i Phone: $03.639.4171 Fsx: 503.598Sep 2 6 2007 y
°; r<l -,° it4'{ Inspection Line: 503.639.4175 D R eady/Br lurk: in sae rage 3 for
' .ir `,, k r Internet www.tigard•or.gou Y - °, Noti6od/Method: L Supplemental Inferounlon
� , '`` climb ELAN REVIEW
i t , �.a tl � 1 y ( : Please all tbat apply (submit Ames of Plans w /items checked below):
CI New construction go; .11 .1 +- 1
0 service or feeder 400 mops or more 0 Bending over rove stories.
❑ Demolition ❑ Other where de available faith current O Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
less to ground. or exceeds 14,000 0 Commercial -use agricultural
0 1- and 2-family dwelling ontmercial/lndustrial ❑ Accessory building amps tar all other installation` buildings.
❑ Multi roily 0 Master builder ❑ Other ['Fire pump. ❑ lmtallatiaa of 75 KVA or
1 d011 iSffE INFORMATION AND LOCATION 0> Y system. larger separately derived system -
Addition anew mbar toed of ❑ •'A". "E". °1 -2 "1 -3"
Job no.: - 0 - 1 o 0 q. s.1 Job site address: \ 1 $ C S 1„ I loo( or more. occWVaoar.
�,. !� a 11 ❑ snr or more residential units. CI Recreational vehicle Pules,
City/State/ZIP' 7 \ - ` t .- Q t2 [] ttasmdaw loeseivos 0 600 volts ncroinai, more than
Suite/bldgJapt no.: Project name: p• - 5 u.r iv, Ve 0 \^ A \ 0 Service or feeder 600 amps or more.
-- FEE SCHEDULE
Cross street/directions to job site: Deval wrap _I Qtr. J Bee, 1 tea 1 •
-----� . New residential single- or mull .-family dwelling unit,
Includes attached garage.
Subdivision: I lot no.: 1,000 sq. ft. or Ices 145.15 __ _ 4 --
- Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 _ 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (whb above sq. 81
Limited energy, multi-family 75.00 2
I d , s k e \\ C t r C N % \/ ),`, C .t 4 r u \ s ' J' residential (with above sq. ft)
Services or feeders Instellatton and/or reloc alteration, -
X— 'sue/ Vs. a C N ' t ) _ 200 amps or less 8030 2
PROPERTY OWNER 0 IENAN T 201 amps to 400 mops 106.85 2
Name! 401 amps m 600 amps 160.60 2
- - 601 amps to 1,000 amps 240,60 2
Address: Over 1,000 amps or molts 454.65 2
City /State/ZIP: . Temporary services or feeders installatdoa, alts adoo, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.35 1
Owner installation: This installation is being made on property that 1 own which is not 2 amps to 400 mops ,. 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 maps 133.75 2
Breach circuits - new, alteration, or extension, per panel
Owner signature: _ Date: _ . - A. Fee for branch circuits with
. 0 APPLICANT 1 C1 CONTACT PERSON above service or feeder few
645 2
each brmadt circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 1 4b.85 AL s 2
Contact IM MO: first brunch circuit
Address: — Each add'1 branch circuit v _ 6.65 ,C,v 2
- - Miscellaneous (service or tEeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2 ,
E Pump or irrigation circle 53.40 2
1 CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
13usiness name: t C C co.-- rip r, . energy panel, alteration. or pJ
Address: p 0 a, 1 o a k t 9 extension. Describe: \ Page 2 NS, 2
City/State/ZIP: 4 t ovl . Each additional inspection over allowable In any of the above
a - - Per inspection 62.50
Phone: (561 ).ao - 5y1- 1 Fax: ( Sul ) ac'N S- 3u; 1 Investigation per hour (1 br min) + 62.50 _
CCB Lic.: 1.‘00 3 1 1 Electrical Lic.: a c A s c 1 Suprv. Lic.: 13 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 4) ,.,t't Subtotal: 1 .S0
a 8 name: '/ P - Date: Plan review (25% of permit fee):
Priest n —
Gr PGo� -� •� i 1/4 _ _ • /� /� State =charge (8% of permit tie): \ c) ,Dg
Authorized signature: TOTAL PERMIT FEE: 1'a % .) 8 ,
Print name: !Date: This permit application expires Ifa permit Is riot ebtalned wit too
days after It pas be accepted ■a anmprets.
° Number of inspections allowed per permit.
tsidnildinstrionAup . doc 05123)06 atoret5T(1U05/CVMFWEE
CITY OF TIGARD
BUILDING DIVISION i f PERMIT #: EL.C2007- 0x1675
' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: g / 27/2()07
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �_' '"' ��
INSPECTION WORKSHEET FOR DATE: 10/912007 TIME: 7:O0AM PAGE: 14
SITE ADDRESS: 11565 SW HALL F3LVD CLASS OF WORK:
SUBDIVISION: MET7.GER ACRE TRACTS LOT #: 026 TYPE OF USE:
PROJECT NAME: DR JOHNSON DENTAL
DESCRIPTION: Circuits arid controls for X -ray machine. Low voltage.
OWNER: PANG, KEIKC) TR, PHONE #:
CONTRACTOR: E C COMPANY T PHONE #: 503.220.5377
Inspection Request Scheduled For: Date: 10/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 nestrical final 057227 -01 503.577-9134 \ Y
Corrections /Comments /Instructions:
Rt svo ruk OA. cwtt• fot • w$to •
n PASS ❑ PARTIAL APPROVAL (� CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION / ❑ FEES ASSESSED
Inspector: fir N Oa L Date: )011(6 1 Phone #: (503) 718 -l
1
: ,, i A 0 �` � i ELECTRIC RMIT
u CT 0 I D
ip
'' :° - COMMUNITY DEVELOPMENT PERMIT #: ELC2007 -00675
K DATE ISSUED: 9/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD -01800
SITE ADDRESS: 11565 SW HALL BLVD ` • ZONING: C -
SUBDIVISION: METZGER ACRE TRACTS LOT : 026 JURISDICTION: TIG
PROJECT: DR. JOHNSON DENTAL
Project Description: Circuits and controls for X -ray machine. Low voltage.
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: 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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PANG, KEIKO TR E C COMPANY
46 -442 HOLOLIO ST PO BOX 10286
KANEOHE, HI 96744 PORTLAND, OR 97296
Phone: Contact #: PR1 503- 220 -5377
FAX 503 - 295 -3012
FEES
Description Date Amount Reg #: ELE 26 -45C
[ELPRMT] ELC Permit 9/27/2007 $128.50 LIC 49737
[TAX] 8% State Surcharge 9/27/2007 $10.28 SUP 3924S
[ELPLCK] ELC Pln Rev 12/6/2007 • $32.13
REQUIRED ITEMS AND REPORTS
Total $170.91
•
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: - .„2 Permittee 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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: ELC2007 -00675 REQUIRED ON GREEN INSPECTION CARD.
Code Inspection Description I PASS;Date By ✓ ";Code ;l Inspecpon:Description; I ;PASS Date 3y
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing X 125 Wall cover
210 Foundation walls X 130 Ceiling cover
215 Footing drain X 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
•
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up _ MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling _ 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final •
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: • 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit _ 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
\Building \Forms \InspCard- AOP- Blank.doc 02/02/07
' CITY OF TI G /� ®D ELECTRICAL PERMIT
I
C OMMUNITY DEVELOPMENT PERMIT #: ELC2007 00675
DATE ISSUED: 9/27/2007
T I G A R D� 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-01800 •
SITE ADDRESS: 11565 SW HALL BLVD ZONING: C -
SUBDIVISION: METZGER ACRE TRACTS LOT : 026 JURISDICTION: TIG
PROJECT: DR. JOHNSON DENTAL
Project Description: Circuits and controls for X -ray machine. Low voltage.
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: 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:
PANG, KEIKO TR E C COMPANY
46 -442 HOLOLIO ST PO BOX 10286
KANEOHE, HI 96744 PORTLAND, OR 97296
Phone: Contact #: PRI 503 - 220 - 5377
FAX 503 - 295 -3012
FEES
Description Date Amount Reg #: ELE 26 -45C
[ELPRMT] ELC Permit 9/27/2007 . $128.50 LIC 49737
[TAX] 8% State Surcharge 9/27/2007 $10.28 SUP 3924S
Total $138.78 REQUIRED ITEMS AND REPORTS
•
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:h l Permittee Signature: �yl�a
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
• This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
INSPECTOR'S SIGNATURES ARE NOT •
Inspections Required for: ELC2007 -00675 'REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ • Code Inspection Description PASS Date B
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing X 120 Electrical rough -in
805 MFG- Structure grading /footing X 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab . 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -m
305 Plumbing underslab
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915 Fire alarm rough -in
920 Suppression trip test
310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing - 399 _ Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
1: \ Building \ Forms \1nspCard- AOP- Blank.doc 02/02/07