Permit C'TY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00677
DEVELOPMENT SERVICES DATE ISSUED: 11/13/03
A IS 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S112AA-00900
SITE ADDRESS: 14160 SW 72ND AVE 110
SUBDIVISION: NELSON BUSINESS CENTER ZONING. I -H
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install (1) branch circuit.
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: SIGNALJPANEL:
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: 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:
SPIEKER PROPERTIES LP ROBERTS ELECTRIC INC
4380 SW MACADAM AVE STE 100 5759 SW 48TH
PORTLAND, OR 97201 PORTLAND, OR 97213
Phone: Phone: F - 244 - 0560
Reg #: 5.4.4244- 7754886S
LIC 9388
FEES EL 34 -23C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/13/03 $46.85
[TAX] 8% State Surcharge 11/13/03 $3.75 Wall Cover
[ELPRMT] Investigation 11/13/03 $46.85 Elect'I Final
Total $97.45
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules ordirect questions to OUNC at (503)
246 -6699 or 1.800 -332- 344.
Issued By: Z4 L Permit Signature: ,/ iA,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: ag6
Call 639 -4175 by 7:OOpm for an inspection the next business day
i
FROM : ROBERTS ELECTRIC INC FAX NO. : 5032440560 Nov. 10 2003 06:29PM P3
USE ONLY
`l
Electrical P =" 1: ► 4I i I . tiOl l Received 9 FOR Uk FTCE Electrical USE SS
L. 1 ' V ' DateBy: // Z D3 d Permit No.: �� (� �v F'i7
Planning pp vat Sign
City of Tigard . Permit .^
13125 SW Hall Blvd. NOV 12 1003 ' pl Review Other
Tigard, Oregon 97223 Date/By. Permit No.: -
Phone: 503 -639 -4171 IQgV5 F E agb Post - Review Laud U se
Internet www.ci.tigardtJ1LDING DIVISION i�ti.' r � ' II 't` Contact C Caseo
Contact s -: ® See Page 2 for
24 -how' Inspection Request: 503- 639 -4175 -- Name/Method: / / Supplemental Information.
.K;. =. - q ..- :�.M ;r - � ` p �; _:� ,•r� a-s.,., R . �, .� :;;�.�r,..: �: 7.�^CYN`$;i:1% "T � �
p •s, ,,,. .f -*�P. �3, •i Ty •,-;- ic' 4 .. �� ,'i:, ` -I L
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* s'a � i: � ��i' � e _::S� 3 ��.. _��.I +.�.' : 'Y.�"a�'at� n•a''F . s � ..;KF r i..,�,s�'k u � �^ ,�� J��:'.:.:� ..Y.!fi �"'��_.?: -�..� ;:..,r �.. � l..J •. °•?Cv,, v
2i !..k.t.'F a1.�4 n+ a^ _ice •.�.�.... i tAV -
• New construction 0 Demolit on ■ Service over 225 amps- ❑ Health-care facility
commercial CI Hazardous location
r
Addition /alteration/r • lacement ❑ O ther: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
'd'•'.? - 4 1 ..0.' _4 i∎ tir "M+ - I M ry -Z- • ,+:"1115ins 1 & 2 fatrdlY dwainSa four or more residential Ulu laill
❑ 1 & 2-Family dwelling [I Commercial/Ind atrial O system over 600 volts nominal one structure
- ❑ Building over three stories [] Feeders, 400 amps or more
❑ Accessory Building Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
• Master Builder p Egress/lighting ❑ Other •
s 7 , O Other: r Subunit sets of plans with any of the above.
y� d 1'wY�T� yf °_ 5 ; _ i :i `"'�, ,,�, ta;,�IKI.�.---;,:; � t�':' "�J.���.':.'
9'b�;5':& 1i t' N4. C ai t W:i .. , : ��F;;:I�A?'•;j : 1:. �.; ti".
r., ' -�- >J •^.� = :w^ -� � - The above are not a likable to rem o construction service. Job site address lap t,�-7Z -40 C. ' f , �� , 7 . el , ; r+ , , u� t "
Suite #: /10 Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: Description _ Qty Bee (ea) Tout i
Cross street/Directions to job site: New residential�fnple or magi- family per
dwelling unit. Includes attached garage.
Service included:
D s� 1000 sq. R or ices 145 -15 4
p0 t• 34-- + 71 Bach additional 500 sq. t. or portion thereof 33.40 1
Subdivision: I- Lott Limited energy, residential _ 75.00 2
Limited energy, non residential 75.00 2
Tax ma ./. arcel #: Each manufactured home or modular dwelling
.� } - �°' c�t-^r '""" :.,;- .• service and/or feeder 90.90 2
�� d`.r"t.:., .-` iiii; {13.x'• V� t_2.,? a . : ' ; .a, %!:�P r i m , . ' Y - Services or feeders - iastallarioII,
alteration or relocation: •
/1, -24-) 1 JN T 200 or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps. 160.60 2
it "± ei' a 'i'r; ; ^ ' x ^�,r w:�11. 1 I a 1 ". A' . x 'w . �,'b - = E N 601 .... to 1000 era + 240.64 2
I �!� 'iii' ,. "- r�:' .yt • '':"" Over 1000 amps or volts 454.65 2
Name: Reconnect only _ 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City/State/Zip: 200 amps or iess 66.85 1
Phone: _ Fax: 201 amps to 400 axons 100.30 2
7� ^ .�� •pi + s?."�.'ti ; Vii .a 401 to 600 amps 133.75 2
S�FLL i'dd;:�!,I�, rake '"f=.''.i1',b74,1U•l'?dalt;�' I4.. „+ .3a x.:i -T U ° .x.•-,',14 . 7
�. �:: �..�� _•� ��- - - �r -��;- Branch circuits -new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first Phone: I Fax: Each additional branch circuit ranch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
, i c C T.N r F r c J/ {Ci 19 `fl, .�, .; '7 A r� � ar 4 r - r-'•%c ... - Each pump or itrigatton circle 53.40 2
a1 k ...i!J.�.t.! i�.l.n rJhI,Y .,. .e.a.i..• r. i o �U_ l Bch4 r._: Each sign or outline lighting 53.40 2
Job No: Signal cinctitis) or a limited energy panel,
Business Name: go SC,"---g. e-<- e. to _ .L+.,c,4 aiteration, or extension __ Page 2 2
Descripdon:
Address: _5? s S.. W ' - k L --
City/State/Zip: po X D/L 47 7-7.- ( Each additional ins • ction over the allowable in an • of the above:
Per inspection per hour (min 1 hour) ,
Pho
' . 11 , r ne T : 4 A 4 -31.2 5 Fax: 214 q - {:LS( l - Investipptioc , fee:
(. il( CCB Lic. #: q3V 3 - Li #- 3t{ `r--- : J i_.'� l ��•+c .., M .� a .' t � c : �„" r � � � ;�i.TS •1'.� '�' •t
T lfl'77 U ' I :� :: A �: ''• C .�' c , : 1 .�{, �,. y t � ^ 1 1 4yp fi t' ;,.� f { �I .Z y .'. .'<.W';'": - �:� it 'r - _ ;f'.+'r '`'y l,°1. P , c
_ Supervising electrician • lb - v 'k 'Subtotal •g6 }
"d signature required: �s �t eti: td 4_6 Plan Review (25% of Permit Fee) $
Print Name: e_o_Beer /Zte arAt ,ic. #: 3 f 3 I.,..3 State Surcharge (8% of Permit Pee) $ -3. )$
• TOTAL pERMI T FEE $ ,9j . l00
Authorized , /� Notice: This permit application expires if a permit is not obtained within
Signature: 1c2.a� Date: f(_ 3 iso days after it has been accepted as complete. 4- 4 - I'' 5
/� *Fee methodology set•byTri- County Building industry Service Board.
Ae� e Ou44
(Please print name) 91- T
i:Tsts\Perm it Forms\EicPetmitApp.doc 01/03
1
1( OF TIGARD 24 -Hour
BUILDING Inspection LiOe: 45 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ` / ( — / AM PM BUP
Location / `1 / 606 — 7 3, ril Gi Suite I /o MEC
Contact Perso • Ph ( ) 5 7a- —3,3 PLM
Contractor ■ A O It Ph ( ) SWR
BUILDING Tenant/Owner ELC -o d
Footing ELC
Foundation Access:
Ftg Drain •1 ELR
Crawl Drain
Slab Inspection Notes: , 41111 _ =MPS SIT
Post & Beam
Shear Anchors l —
Ext Sheath/Shear _ _
I nt Sheath/Shear
Framing _
Insulation --
Drywall Nailing % ' / � sh �" S /91(7,./ 7347)
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof PZ, C JL 4
Other �+
Final 8 l d C7' eA 1, az S a
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
Gal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
s 0 Please call for reinspection RE: 0 Unable to inspect – no access
Fire Supply Line
ADA NOV, 1 I
Approach/Sidewalk Date Inspector
• 4 Ext
AP
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL