Permit C I TY OF T ELECTRICAL PERMIT
PERMIT #: ELC1999 -00614
s i DEVELOPMENT SERVICES DATE ISSUED: 10/18/1999
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S136DA -00100
SITE ADDRESS: 11308 SW 68TH PKWY
SUBDIVISION: ZONING: MUE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install 10 branch circuits to existing commercial building.
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 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:
BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP
KEYLLC,THE 1010 SE 11TH AVE
BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214
WORCESTER, MA 01615
Phone: Phone: 234 -9900 ORIGINAL
203
SUP 1302S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT KJP 10/18/1995 $85.65 99- 319127 Elect'I Final
5PCT KJP 10/18/1995 $6.85 99- 319127
Total $92.50
. 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE..0 2 ISSUED BY: /Y. -
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• 071- 6 i 7 Ca- DATE: w/ / d/ P
LICENSE NO: Z 8 ` , 'f -
Call 639 -4175 by 7:OOpm for an inspection the next business day
OF TIGARD �C��v�O
CJIY R lectrical Permit Application " -
13125 SW HALL BLVD. 1 \'5" °
TIGARD OR 97223 00 k Date Redd
1" Date to P.E.
Phone (503) 639 - 4171, x304 ���tl �
0 EV t �1 Date to DST
Inspection (503) 639�175� Print of Type Perml p. FL e / 5f y - 00(9/y
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Tigard Data Center Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum •I'
Address 11308 SW 68th 4a. Residential -per unit
1000 sq. tL or less , $ 117.75 4
City/State/Ip T i gar d Each additional 500 sq. R or
portion thereof $ 26.25 1
Commerdal ® Residential 0 Limited Energy $ 60.00
Each Manufd Nome or Modular
2a. Contractor installation only: Dueling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicant must provide contractor license _ 4b. Services or Feeders
innn
foatlon tor GOT data lase} - installation, ataafan, or nrlacationn
ElectricaIConttador Oregon Electric Group . 200 amps otless $ 8425 2
Address 1 01 0 SE 1 1 th A. V P 201 amps to 400 amps E 85.50 2
401 amps to 600 amps $ 128.50 2
City P t l d State OR Zip Q7 2 1 4 601 amps to 1000. amps $ 192.50 2
Phone No. 234-9900 Over 1000 amps or volts $ 363.75 2
Job No. 82863 Reconnect only $ 53.50 2
Elec. Cont. Uce. No. 26-95C Exp. Date 101 + 0 0 e'h' .4c. Temporary Services or Feeders
OR State CCB Reg. No. 203 Exp.Date 7 /iJ oO r'i'l Installation, alteration. or relocation
COT Business Tax or Metro No Exp.Date 200 amps or Tess $ 53.50 2
201 amps to 400 amps S 80.25 2
-
a �r 401 amps to 600 amps S 107.00 2
Signature of Supt. Been _, e ,)%r Over 600 amps to 1000 volts,
2 8 41 S see "
License No. Exp.Date / b
Zoo i 01.`� b" above.
234 -9900 4d. Branch Circuits
Phone No. New, alteration or extension per panel
a) The fee for branch circuits -
2b. For owner installations: with purchase of service or
feeder fee.
Each branch dre lit $ 5.35 2
Print Owners Name b) The fee for branch circuits
Address without purchase of serrke
City State bp or feeder fee. 1
Phone No. First branch circuit
Each additional branch drcuit -9-- $ $ 37 5.35 .50
4
The installation is being made an property I own which is not 4e. Miscellaneous '
intended for sale, lease or rent. (Service or feeder not Included)
E.ad'i pump or irrigation circle _ $ 42.75
Each sign or outline lighting $ 42.75
Owner's Signature Signal cirha,lt(s` or a limited energy
panel, alteration or extension $ - 60.00
3. P l a n R e v i e w section ( i f required):' Minor Labels (l o) $ 107.00
-
Please check appropriate item and enter fee In section 5B. 41. Each additional Inspection over
4 or more residential units In one abudure the allowable in any of the above
Per inspection $ 50.00
Service and feeder 225 amps or mote Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as Jr . l=ees:
described in N.E.C. Chapter 5 $
85. 6 5
6a. Enter total of above fees
e Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ 6 - 8 5
Not required for temporary construction Services. Subtotal $ 92.-5/ ' .
lib. Enter 25% of line $a for
NOTICE Plan Review if required (Sec. 3) $
Subtotal $ 9 2,---5 /
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # $ 92.5./
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due 1
O .y�.hr.....,.h.h.,..:e rr.r
Z 0
ta Q2id9I,L d0 A.LID 098T 985 EOB %VII 4T OT fIH,L 66 /Li /90
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�� / BUP
Date Requested d`i ( AM PM BLD
Location I( 3O 5 a) (4 Suite MEC
Contact Person 61 I�' Ph c" Se PLM
Contractor Ph SWR
BUILDING Tenant/Owner eliU ex ELC /
Retaining Wall ELR
Footing Access:
Foundation s FPS
Ftg Drain SGN
Crawl Drain Ins ecti otes & (`� L
Slab QS� N �,t? �c 'av`�� - U0-1 SIT
Post & Beam
Ext Sheath /Shear 40c SCA..
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
l ? 14 4 Ste
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL (�
ELECTRICAL \ /
Service
Rough In .e\
UG /Slab
Low Voltage
Fir rm
ASS P RT FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA C� / / I
Approach /Sidewalk Date 1 2-1 - ?F t ( « Ins �� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1