Permit A CITY OF TIGARD . ELECTRICAL PERMIT
PERMIT #: ELC2003 -00144
,� r DEVELOPMENT SERVICES DATE ISSUED: 3/19/03
s .,� II 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639-4171
PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 401
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING. MUE
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: TI Install 14 branch circuits and 2 low voltage systems. (Fire alarm and Data telecommunication)
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: 13 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 GREENWAY ELECTRIC COMPANY
4650 SW MACADAM AVE STE 220 15145 SW GULL DR
PORTLAND, OR 97201 BEAVERTON, OR 97007
Phone: Phone: 503 - 579 -8054
Reg #: LIC 153421
ELE 34 -617C
FEES SUP 4210S
Description Date Amount
Required Inspections
[TAX] 8% State Tax 3/19/03 $22.66
[ELPRMT] ELC Permit 3/19/03 $283.30 Low Voltage Inspection
Low Voltage Inspection
Total $305.96 Rough -in
Elect'l Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800 -33� -2344.
Issued By: �t�, ,,,42 Permit Signature: (n7 Q he,� j yt
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N• DATE:
LICENSE NO: t /l7 S
Call 639 -4175 by 7:OOpm for an inspection the next business day
03/18/2003 06:12 FAX 5035798056 V1001
,
Electrical Per lieation FOR OFFICE USE ONLY
R ece iv ed Electrical
D DateB • - i e // Permit No.: .",,3 - oo /'ye/
City of Tigard Da : Approval Permit No.: •
13125 SW Hall 131vd. M AR 1 8 DI 2003 Plan Review Other
Tigard, Oregon 97223 Date/I3 : Pcrnit No.:
Phone: 503 - 639 -4171 Fax: 5% §f9 . 64�GA - Post - Review Land Use
., :
B UILDING :_�y l''` DtdB : Case
Internet www.ei.tigardor.tls n.: 1; : � � !
. Contact Juris.is -• ® sec Page 2for
24 -hour Inspection Request 503 - 639 -4175 '" - Name/Method: Supplemental Information.
:...:::,; , :,: _$ :• •.; ; « :. <:. ; - =y: -_- :�I:ANtF.�'i�IFhV(tEal'ease4'c ill' "R`aP1o1Y)
...E- :0�,rifr.OR��t :�- '' :'.,... '•� ..:' - �-
New construction ❑ Demolition Service over 225 amps- — ❑ Healthcare facility
corranereial 0 Hazardous location
Additilm/alteratio lacement ❑ Other: Service over 320 amps-rating of Building over 10,000 square feet,
1 . :.... _:......_ ... .
_ ... .; ; C�, ' �( ��p1+' CQ1 :; :=�= :' , :, -• .. •.`': ,.4 ::: 1 & 2 family dwellings four or more residential units in
J D 1 & 2- Family dwellins Commercial/Industriai El System over boo volts nominal one structure
Accessory Building D Multi-Family Occ Occupant l oad ore slo ❑ M d fa wr l stru or more
n
y ❑ Occuant oad over 99 persons ❑anfactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other
,~ >
Submit sets of plans with any of the above.
,_,; ^ }. :•,....�. :ihT��! .• �4 .. � The 'able to lean ra coastruexlon sec
32. a./ sr, '
ar! not a
- • • �� PAW T/ X23 •' - .. �; • :� === :' :� -' •
Job si te address: l�� � / �' er9� :�t_—; :.' :.' :- := :���. > :, =• : .
. ,..•; ' :'k�E•.�� ........_. _ ...- .. _..
Suite #: `/ Fi- ' 911 B1dgJApt. #: Number of inspections per permit allowed
Project Name: "1•o//cam/ 2A./ i•'esrm 1r t/esve5 Deuriptio J Qty J Fee (ea.) Total I
New residential- single or multi -family per
Cross street/Directions to Job site: dwelling unit- Includes attached garage.
Iyell.ie 3 e 'ee A.r.1Li•!t Service included: 145.15 4
v 1000 sq. R. or less _
Each additional 500 sq. ft. or portion thereof 3140 1
Limited enentyLresidentinl 75.00 2
Subdivision: Lot #: Limited enemy residential
75.00 2
Tax map/parcel #: Each manufactured me or modular dwelling 90.90
,_ „„ 7.• n• : = =s ; }: r service
,-' =.r'. "_'._�:�°'`h►', w la IVO -• 1 :r :.•_ . :,. . rvites - installation,
m 2
Sl
�acu =�; 5 L k J,. ec feeders ,
L' JC -T-r► ,wi+ vt LI .-'l alteration or relocation:
J� 200 amps or less 110.30 2
201 aims to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
:' 41+- !f;1 P r7W— `5 :.. r j :: '-=y. . 64)1 ail ta_IM amps _ 240.60 2
-`� T •+ - Over 1000 amps or void 454.65
Name: . Reconnect only 6615 2
_ Address: Temporary services or feeders - installation,
. alteration, or relocation:
City/State/Zip: 200 amps or leas 66.85 - 1
201 amps to 400 amps 100.30 2
Phone: • Fax: 401 to 600 amps 133.75 2
. ° s lIg :::_ ,5• a: ng nl 1 �.- 0 ._c - -�.i. '' Branch circuits - new, 9lterntlou, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 6.65 2
Address: service or feeder fee, each branch circuit -
City/State/Zip
B Fee for branch circuits without purchase of ' y f • $S 2
- service or feeder fee, first branch circuit -
Phone: I Fax: Each additional branch circuit 13 6.65 .YS 2
•
E -mail: Misc.(Service or feeder not included):
Eaehtpump or irrigation circle 53.40 2
x•._ • " : _tk *ai • ur ��:t -' , -....
-. • ._. a = . . . -`•`.z 0it f
. sa 11 • Each sign or outline Iighting 53.40 , 2
Job No: - 032 - - J Signal circuit(s) ors limited energy panel, a page 2 ; 1. D 2
alteration. or extension r
Business Name: ,/4)4y' Elm c of a Description: At . ' r s 1 1 I
Address: j..57 ,, _ SA) <rd // c/,�. •w nl�f«• 7�
Each additional inspection over the allowable in a of the above:
City /State/Zip: F ac%R ion: ae q 7 Co 7 Per inaction per hour (min. 1 hour) - 62-50
Fax_J'd3 - - QO5 Phone: 0,g 7`j - 006-4( T `1 investigation Other:
CCB Lic. #: j 53 it 3-/ , Lic. #. 3f- !./7C : , _ .:,.,. ..= ; :: 1 "':'r, ±•.- :
Supervising electric' - • - Subtotal $ a -I .3o
'
signature rel} - L. "' ' - Permit Plan Review (25% of Pse Fee) $ •
-
uilced: '
Print Name: a ,e, a .1e1 3 . Lic. #: 4Zl a S State Sufchatc18% of Permit Fee) $ • a . & 6
TOTAL PERMIT FEE $ 1 D„S • g 6 .
Authorized Notice: This permit t+ppliention expires if a permit Is not obtained within
Signature: Date:: 180 days atter it bas been accepted as complete.
Fee mediodolot y set by T l- County Building Industry Service Board-
-• • (Please print name) g
i :\Dstss\Permit Fotms\ElePermitApp.doe 01/03
CITY OF TIGARD 24 -Hour _
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 41.5 AM PM BUP
Location Z < ' ` N" Suite 9'd / MEC
Contact Person 1'C / Ph ( ) � 0 4 J 0 Q 1 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC LA 3.
Footing CS -- 0 O .141,E
Foundation Access:
Ftg Drain / -2 ) 0 0 0
Crawl Drain
Slab Inspection Notes: T L2
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 C
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab ° La
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
(LECTRI9L
Service
Rough -In
UG/Slab
Low Voltage
Fire
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SS P T FAIL __ - _
SITE El Please call for reinspecti•n RE: El Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date O Inspe .r �� � # l — Ext
Other:
Final DO NOT REMOVE this Inspection reco ' . rom the job site.
PASS PART FAIL