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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00091 DEVELOPMENT SERVICES DATE ISSUED: 2/16/2005 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 - 4171 PARCEL: 25101 DA -00102 SITE ADDRESS: 13221 SW 68TH PKWY 500 SUBDIVISION: TRIANGLE CORPORATE PARK ZONING. MUE BLOCK: LOT : 002 JURISDICTION: TIG Project Description: (4) branch circuits - receptacles for computers. 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: 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: 3 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: TIGARD TRIANGLE I LLC HILLSBORO ELECTRIC 4650 SW MACADAM AVE STE 220 21185 NW EVERGREEN PARKWAY PORTLAND, OR 97201 HILLSBORO, OR 97124 Phone: Phone: 503 - 439 -9666 FEES Reg #: ELE 34 -4399C LIC 134481 Description Date Amount SUP 4941S [ELPRMT] ELC Permit 2/16/2005 $66.80 [TAX] 8% State Surcharge 2/16/2005 $5.35 REQUIRED ITEMS AND REPORTS Total $72.15 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: /Cet cL Permit Signature: J,r ,e, C 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 From:HILLSBORO ELECTRIC LLC. 5036013680 02/15/2005 12:20 4934 P.001 Electrical Permit Application roll OFlie_:k: U`F: ()NI .1' City of Tigard RECEIVE* . ? /6 "di j) Permit No: '' C,2,/ ' ° 'D0' / 13125 SW Hall Blvd. Tigard, OR 97223 Plan Review , Phone: 503.639,4171 Fax: 503.598.1960 w . � . �: c . . ' 'I .`' Date/13 Other Permit: . inspection Line: 503.639.4175 FEB v 2U - ,L " r � II Date Ready/By: • luris: El Sce Page; for Internet: wvw.ci.tigntd.or,us Notified/Method: . 1 (r Sapplemental Information • • TYP 1C6RT - PLAN . ..REVIEW. ❑ New construction l •Addis)a �t3144 §ba rat • Please check all that apply: ❑Service over 225 amps. comml ❑Hazardous location CI Demolition ©��� ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., . • CATEGORY. OF CONSTRUCTION.: :' • :'`... ''':::::!.,.:',..-:;;•.....::%.... of I- and 2- family dwellings 4 or more new residential 1- and 2- family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories [Weeders. 400 amps or more ❑ Multi- family. ❑ Master builder 0 Other. Occupant load over 99 persons ❑Manufactured structures or • JOB SrfE INFORMATION: AND: iI:OC!�TiON :::•::::..,.::''.' Pgressnighdng plan RV park • • . • : .:;:,.: . • ❑Health ate frtciiiry ❑Other. Job no.:3 Job site address: ♦ j I ' ._ • Submit sets of plans with any of the above. • City/Statt/ZiP: The above are not applicable to temporary construction service. ' �•E:..... ... EEE'' •SCHEDUL1l:;� >,:__ ., _.:: ;.. • Idg. /apt. no. r 6'+ 6 Project name: • y t _ GAWK p �,,, Qt,. Fec Tool 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 4 • Subdivision: . Lot no_: E. add'I 500 sq. ft. or portion • 33.40 • I Limited energy, residential 75.00 2 Tax map/parcel no.: ` Limited energy, non - residential _ 75.00 2 • ° :a DESCRIPTION OF WOR)(t": , • •• • • .., "' .. '� Each n _ _ i ' •; ;;; `i �• °�;;: ac manufactured or modular dwelling service and/or feeder - 90.90 2 � ♦ i_ .4 I:: ° LS tt. & ..:' tt+ Gn Services or feeders installation, alteration, and/or relocation • 200 amps or less 80.30 2 • -- R ::_ •?::r;:ctt.:,,,.i i. „ ,. c;:.Y: ' ;., r::., ❑i 7 ...„ N7 `i:r ri::- 201 amps t0 400 amps 106.85 2 ❑PROPERTY.. ... • . OW1!11E l . _.. , . ,. 401 amps to 600 amps 160.60 • 2 Name: 601 amps to 1,000 amps • 240.60 2 Address: Over 1,000 amps of vohs 454.65 2 • , Reconnect only 66.85 . 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 l own which is not 201 amps to 400 amps 100.30 2 intraidcd for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 401 amps to 600 amps • _ 133.75 - 2 , • Owner signature: Date:_ Branch circuits - new, alteration, or extension, per panel Q . :APPLICA'lN T °'• <; `s` : '::: ;:.., pi"- : a `.; `:0: cgr12'ACr :PERSOPI+; ;`•: , A. Fee for blanch circuits with service Of feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits I Contact name: • without service or feeder fee, I 46.85 4 2 ' each branch circuit Address: Each add'I branch circuit q 6.65 , Jcl,S,S 2 • • • City /State/ZIP: Miscellaneous (service or feeder not Included) Pump or irrigation circle 53.40 , ` 2 Phone: ( ) • . • I Fax: . ( ) Sign or outline lighting 53.40 2 , E -mail: Signal circuit(s) or limited- .: NTRACTO energy pane alteration. ! ... , .. extension. Describe. Page 2 1 •CO R' or ............: Businessname:Hillsboro_Electric L.L.C. Each additional inspection over allowable In any of the above Address: 21185 NW Evergreen PKWY Ste #110 Per inspection 62.50 L . E City/State/ZIP: Hillsboro, OR. 97124 Investigation per hour (1hrmin) 62.50 Phone: (5 0 3) 439-9666 F ax: (503 )6 01- 3 6 8 0 Industrial plant per hour 7 .-..:: :�:. °� �:;..EL:ECTRiCA1r :PERMIT FEES!" S !" • ..... CCB Lic.:1 3 4 4 81 Electrical Lic.:3 4— 4 C Suprv. Lic.: 4941 S Subtotal Lip , $0 r Suprv. Electrician signature, required: 1- _ Plan review (25% of permit fee) ..--� i � - - _ State surcharge (8% ofpermit fee) st 3,5- . Print name: Joey Vitacco Date: TOTAL PERMIT FEE 3a l r Authorized signature: This permit application expires Ira permit Is not obtai within 180 . days altar It has been accepted as complete Print name: Date: s• Number of inspects per perm t el allowed Industry Service Board iitioadiot \Pcrmit -Pa thAppax 121U3 440 -46 I T11W02/COM/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 I DIVISION Business Line: (503) 639 -4171 MST 7 3 , S' BUP Re wed L • 1 6 Date Requested D c PM 0" BUP Location (3 22/ ‘ ( 4 Suite � v MEC Contact Person J � 11 0 lam-{ Ph ( ) PLM Contractor ' 4 M 4 / Ph ( 03 ) 4 c�.y a 6 SWR BUILDING Tenant/Owner \A AA; � ✓ • d OA rt) ■ O d S 600 I Footing ELC Foundation Ftg Drain Access: 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 LE/ Susp'd Ceiling Roof • Other: Final PASS PART FAIL PLUMBING ) ----.V. 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 PA ART FAIL EC AL Service Rough -In UG/Slab Low Voltage Fire Alarm fir 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. '' - " PART FAIL SITE ❑ Please caljfor reinspection RE: E] Unable to inspect — no access Fire Supply Line 7- ADA , Approach/Sidewalk Date — m .5' Inspector Other: Final DO NOT REMOVE this Inspection record from the J , • site. PASS PART FAIL r-