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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00625 I DEVELOPMENT SERVICES DATE ISSUED: 10/9/03 „� Ii 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639 -4171 PARCEL: 2 S 112AA -00300 SITE ADDRESS: 14200 SW 72ND AVE ZONING: I - SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of (1) branch circuit for new conference room. 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: 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: GERBER LEGENDARY BLADES BECK ELECTRIC INC 14200 SW 72ND AVE 9318 SE CHURCH ST PORTLAND, OR 97223 CLACKAMAS, OR 97015 Phone: Phone: 656 -7396 Reg #: SUP 1326S LIC 00002629 FEES ELE 3 -5C Description Date Amount Required Inspections [TAX] 8% State Tax 10/9/03 $3.75 [ELPRMT] ELC Permit 10/9/03 $46.85 Rough -in Elect'I Final Total $50.60 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 th. • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth i • • R 952-001-6010 rough OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -80t 332 -2344. 411. Is Is ed By: ' •f.tA §.L l i 1 Permit Signature OWNER INSTALLATION ON The installation is being made on property I own which is not intended for sale, =- e, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: � � DATE: LICENSE NO: f 3 3 Call 639 -4175 by 7:OOpm for an inspection the next business day Electrical Permit Applicati �E on ° ' _ _ _- -. ,':,, ' Date received: 9/0 9 e5 Permit no.: eG C, .... ' - M r i n .� City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: . - TYPE OF : . ❑ 1 & 2 family dwelling or accessory $'Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial J ,'.�: ^'`r'Ili` �'`�:: ' is r - �.�"1•� ��,.'u�O {+ i irV v r-r;.MGtif'!tkV --2,'i 4..,vrv:,,.+K ,- ti; _J-tlt?,, y,.ea_'•,.....,V5a1. Job address: / a ©6 s ai 7n. gi ,d A 0e97 ," Idg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: Project name: Description and loc Lion of work on premises: / ei.irl// /(//,4 ( /4 4 ) Estimated date of completion/inspection: I-eJ - ,, , . AK,, O / —v y _4,.r .0p/. .e O /i.. ,,,. . ,., (ONTRACLOR:A1 UCATLON ,.' `. K ,..} .4 4 , .; . LEE SCIIEOULE Job no: % Fee Max Business name: bc,1 (.Lo c--1,,, i Description Qty. (ea.) Total no. insp New residential - single or multi - family per Address: c, j(_- (- k.ccrJ�V _ dwelling unit. Includes attached garage. City: G\rti i:rtvVl t::_, IState:0tE_ I ZIP: c {')pl5 Service included Phone: V 3 ,, 7 3t ii c, I Fax:I,-9 q3 - ? I E -mail: 1000 sq. ft. or less 4 CCB no.: �1. ;�,,. j I Elec. bus. lic. no: 3 —'- Each additional 500 sq. ft or portion thereof _ Limited energy, residential 2 City /metro lic. no.: ?5i' _ l0 l -- q Limited energy, non- residential 2 . /47( j � Each manufactured home or modular dwelling Signature of supervising elec ' an ( tred) Date Service and/or feeder 2 Sup. elect. name (print): I./- /4/-. -/�7 J . .,."4 - r •, a ji' v License no: / j L /r c. ^ices or feeders — itsfallation, alteration or relocation: PROPERTY OWN ER >> 200 amps or less 2 Name (print): i /,� , . 0i'i. - $ i �6 i' / 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: / ' a(kj ' i V - A 41 ‘e""" i`, 601 amps to 1000 amps 2 City: 7 ®ri I State: DdZIP:97d4e/ Over 1000 amps or volts 2 Phone: ' 63Q -6/4/ I Fax ;273-qp3 /.z3 E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to Installation, alteration, orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 � 201 amps to 400 amps 2 Owner's signature:, �' ' V ' - Date: / .5 401 to600am.s 2 — .: - -t - _ - ENGINE r• :1.::_- , _, :: 1.. --.,• -_ , Branch circuits- new, alteration, Nv or extension per panel: Name' A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase / i .$ ,�, • 2 Phone: Fax: E-mail: of service or feeder fee. first branch circuit: t! Each additional branch circuit: • PLAN REVIEW (Please check all that apply)} Misc. (Service or feeder not included): O Service over 225 amps - commercial 0 Health-care facility Each pump or irrigation circle 2 U Service over 320 amps - rating of 1812 0 Hazardous Location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel. O System over 600 volts nominal more residential units in one structure alteration. or extension' 2 O Building over three stories 0 Feeders, 400 amps or more *Description: . 0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan 0 Other. Per inspection 1 ( 1 ( Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other �/ Not all jurisdictions accept credit cards, please call jurisdiction for mare information. Notice: This permit application Permit fee $ J 0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ • Credit card member: - / / within 180 days after it has been State surcharge (8 %) .... $ _ ✓ 3 • 7 S Expires accepted as complete. TOTAL $ `J' O • (o /0 Name of cardholder as shown on credit card Cardholder signature Amount 440-4615 (6.V0iCOM) • Electrical Permit Fees: Limited Energy Fees: -- TYPE OF WORK INVOLVED - RESIDENTIAL ONLY C ompl e te_Fee_Schedulel3elow_ -- - - - -- - - - - - - -- Restricted Energy_ ..u._ ___-- _________ $75.00 - Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 El Burglar Alarm Limited Energy $75.00 Each Manuf d Home or Modular Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 Over 1000 amps or volts $454.65 _ _ 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 Check Type of Work Involved: 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, see' "b" above. n Audio and Stereo Systems • Branch Circuits El Boiler Controls New. alteration or extension per panel a) The fee for branch circuits Clock Systems with purchase of service or feeder fee. ❑ Each branch circuit $6.65 2 Data Telecommunication Installation b) The fee for branch circuits without purchase of service El Fire Alarm Installation or feeder fee. First branch circuit $46.85 • HVAC Each additional branch circuit $6.65 Miscellaneous 0 Instrumentation (Service or feeder not included) - Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting $53.40 • Signal circuit(s) or a limited energy Landscape Irrigation Control.' panel, alteration or extension $75.00 Minor Labels (10) $125.00 ❑ Medical Each additional inspection over the allowable in any of the zt.o�: Nurse Calls Per inspection $62.50 Per hour $62.50 El Plant $73.75 Outdoor Landscape Lighting' Fees: El - Protective Signaling Enter total of above fees $ ❑ Other I 8% State Surcharge $ Number of Systems 25% Plan Review Fee ' No licenses are required. licenses are required for all other installations See 'Plan Review" section on $ front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ i :\dsts\forms\elc- fees.doc 10/09/00 CITY OF TIGARD 24 -Hour BUILDING Inspection Lilie:.(503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested //— L( AM PM BUP Location 1 L 0 0 7 o" s '" `z( Suite MEC Contact Person 94L- i-v�-- Ph ( ) 'f OS 7S'' PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 3 -- 06 a-' Footing . ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Ina Sheath/Shear Framing / „� C �� � Drywall Nailing 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 S ET�I!AL Rough -In UG/Slab Low Voltage Fire Alarm PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call f. reinsp-ction RE: ill Unable to inspect — no access Fire Supply Line / ADA Date 7 6 Inspector � ■_■i 1 Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record fro the job sit . PASS PART FAIL