Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00589
�i� DEVELOPMENT SERVICES DATE ISSUED: 9/22/03
;--° 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 25101 DC -00200
SITE ADDRESS: 13535 SW 72ND AVE 155
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING. C -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install (2) branch circuits.
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 NW PROPERTIES LTD PTNSHP RC COSTELLO
9665 SW ALLEN BLVD STE 115 PO BOX 336
BEAVERTON, OR 97005 AURORA, OR 97202
Phone: Phone: 503 - 982 - 7400
Reg #: LIC 87402
ELE 3 -344C
FEES SUP 3934S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/22/03 $53.50
[TAX] 8% State Tax 9/22/03 $4 Rough -
Elect's Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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: Ali Permit Signature: �-�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: .3 ? 3
Call 639 -4175 by 7:OOpm for an inspection the next business day
1i
P 3
• Electrical Per �
Jn
r
Date re �3 it
cetved : Permno. �'V 3 -6)Q5 8'9
, j;t' :ill City of Tigard Epp ((j� 9 Projc ct/appl. ❑o.: Expire date:
Ad dr s e: 13125 SW Halt Blvd YR ∎-z-s
Phone. ($113) 639-4171 -- — -
Ciry'n�Tiearti Date issued: Bytip Receipt no.:
- - -- ---- —
lax' (5031 59 -1960 CITY OF TIGARD Case file no.: Payment type:
BUILDING DIVISION `,�y
1 And use approval: — _ ----- - ------ - - - - -- o F 3 '/ �O
TYPE OF PlN II l<1I f -
O 1 & 2 family dt.t.e :link or accessory .1 Comrnercial /indusui;.l ❑ Multi- family ; enant improvement
j .=f Nen constnt:uun J Addition /alteration/repla.:ernent I] Other: - J Partial
.. . :" JOH SITE INFORMA PION
• Job address: /3 5 S — 22 .. • •..' — Bldg. no Suite no /5.5 Tax map /tax lot/account no.:
Lot: B1 i_ck: Suhdtvi.,ion• _
_ project name. - _ - - 1 Description and location of -.'.ark on prer,iises: — — --
Estimated date of cut tplet wait r:pectitHi:
• .CONTRACTOR APPLICATION FLY S(:'IILDUI.: • • •
f
! Job no: - Fee Max
�': n - f Description ttty. (ea.) Tout) no. ins
I Business l:arne: • • ( . L e t?
1\en residential - single or multifamily per
Address: _- - -- —
. t�j• e_ 3 -- dnelLng unit. Includes attached garage.
Iler VR)( ✓. - [State:0 a1 /IP. C 7oc) w Sallee Included:
Phone:Ci _ i�OJ i i _t'`!1.32.3/40 / 1 F. -mail: - — - 1 •UCU sy. !t or less — -- I - 4
Each additional 500 s ft. or p.•riun t c.°•.f
i.imitedener •
CCB no. Uec. bus. lie. no: - -
• e - 1 _ �� 7 g), residential 2 _
Cit AMMO no:. L Q - Limited energy, corrresidertt , a -' - j '
_ sue - - - - - - Each mi•nufacturcd hume Jr ino - . u ;.t tl.. ell , n; I
... ' Signa:ur: of sop,: •. f . electrt,:w. 1 rrq _ _ 1 tare q 431c,,, 3 — S:rviee al. ca Led, - -- 2 —
Sup. e!ea. aar:,r tpr.nt — 1�• , _tt,rsr no. %, Set sic or feeders- installation.
alteration or relocation:
_ . • PROPERTY OW NI?R 200 al ps or less 2 • Name (print) 01 amps to 400 turps -- -- - I ,
- - -- - -- - -- :01 runs :o G00 am s 1
p r
Mailing addre.,s: rUt amps to 1000 amps
__ _ - - -.- - _ -_ —
1 City: ' -- - - - - `S tate: ZIP: - Ovrr : o0 amps orvo — 2
Phone.: (l-a> : 1 )airil l: Reconnect only 1
e m
Otmer installation! The. insta:latn>n Is bring made on property 1 0'411 T p" ra n' ser or f eeders -
n
' i which is not inter :kJ for sale. lease, rent, or exchange according t instatlation,alteration , orrelocation:
■ it
200 amps or less 1
\ ORS 447, 4.5.). 479, 670 701
201 amps to 400 amps 2
Owner's signature. Dan, -- :01 to b00 amps - - -- 2
• • • . ENGINEER
I R ` : Branch circuits - new, alteration, t
or etttt nsion per panel: 1
L Vame: _ _ -- - - _ A Feeforhr :nchcircuitsHithpw_laseo`
1 Address: i see, ice or fe :der fee, each branch circuit _1 . 2
— — - - - — -- —�� B. Pee or branch circuits without pu.chasc - 1 --
City: State: . LIP_
____ - - -- -- --- - -_ - -_ of service or feeds fie, fast branch citrouu /a . � � � ' D 2
Phone: _ _ Fax: b marl: Each additional branch circuit Q • ,
.. PLAN. RI :VI[ % (Please check; all that •apph•) : • misc. (Service or feeder not included):
O Service over 22 amps-commercial O He :tlth- carefacility Each pinup or trtigaucn , ircle - - 2
1 --
3 Services uvrr 3'(I antp , ..ni,p of 1.a 2 J : (a :u - doua Icc_ttinn Each oign Or Outline ltgr ^.irg _ - -- ___ - _ __ -- 2 _.-
! °, I family sc i.tnh, _I building eser lo,00o s P - f -our i Signal r-ncuivs f or a limited energy pa- e!, 1 l 2
3 S•istem..ver btKI , on; nmr. 2 mole resident,,. Eras 1a one sin elut alteration, or cvtenstoc' - -- -- i .. 1 -
a kiufidtag eve: du r sn•nr , Feeees. rips •rmcrc •thscnplton. -_ -- -- -- - - - -- ______ -
O Occupmu Tie. +d u et J) it:: .+ M r: t: wr ! - racrar., .•r RV park Each additional irtspeclfun oter the allowable in any of the elate: I
4''..
i 0 Egress /li J f)•ht r -- — - - -- ----- .. _ Per inspecton _ i l ■
\.
Submit - __ _ sets of plans with any of the above. Investigation fee - -- _
The above are not app to temporal y cons service. Other - , ^- 1 '
I Penn Not an jurisdictions et.,xpt er,:.+'t nods, please cal juriulicaon feu trove ir�ormanun + Notice: l'his permit application
s fee $ 5�
3 Visa U MasterCard — expires if a permit is not obtained
Plan review (at — %) $
Credit card number' -- - - - -- within 180 days after it has been State surcharge (8 %) .... $ L( • )6
Expires TOTAL $ ' 7 7 S
accepted as complete.
Name of cardholder as shown on credit card
$
Cardholder signature Amount i 440-4615 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:. (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / - D _ —� cf AM PM BUP
Location 1 3 5 3 5 7a Suite / S 5 MEC
Contact Person Ph ( ) � PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 - d o 5-E27
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 +�
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
1
t& PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call f• r reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 0 _ Inspector/ L t� /� Est
Other:
Final DO NOT REMOVE this Inspection record from t e Job site.
PASS PART FAIL