Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00067
IA DEVELOPMENT SERVICES DATE ISSUED: 2/11/04
.' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S112DC -00100
SITE ADDRESS: 15675 SW 72ND AVE
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: (2) 200 amp or less services and (42) branch circuits for epoxy equipment.
Job No. 24 -35
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: 2 W /SERVICE OR FEEDER: 42 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
PACIFIC REALTY ASSOCIATES CAPITOL ELECTRIC CO INC
15350 SW SEQUOIA PKWY #300 -WMI 11401 NE MARX ST
PORTLAND, OR 97224 PORTLAND, OR 97220 -1041
Phone: Phone: 255 - 9488
Reg #: LIC 048748
SUP 3132S
FEES ELE 26 -496C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/1 I /04 $439.90
[TAX] 8% State Surcharge 2/1 I /04 $35.19 Low Voltage Inspection
Elect'I Final
Total $475.09
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 da . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in O. ' • 2 -001 -• a 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or
1- 800-3• -2344.
Issu By: � S / � " Permit Signature: y
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: / 39
Call 639 -4175 by 7:OOpm for an inspection the next business day
Electrical Permit Application OFFICE USE ONLY
Wit Date received: ,/ffni Permit no.: , „_ -60Z
Projectlappl. no.: Expire date:
• -4I� City of Tigard Date issued: gnu Receipt no.:
mini
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR 97223 Case file no.: 'ayment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dewlling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
• J013 SITE INFORMATION
Job address: 15675 SW 72ND AVE City: TIGARD Bldg. No.: Suite no: Tax map /tax lot/account no.:
Lot: (Block: N/A (Subdivision:
Project name NIKE GOLF (Description and location of work on premises: EPDXY EQUIPMENT
Estimated date of completion/inspection:
Job no: - 35 Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. insp
Address: 11401 NE Marx New residential - single or multi - family per
City:. Portland State: OR ZIP: 97220 - 1041 dwelling unit. includes attached garage.
Phone: 503 - 255 -9488 (Fax: 257 -7121 IE -mail: darrell @cepdx.com Service included:
CCB no.: 48748 IEI c. bus. lic.no: 26 - 496C 1000 sq, ft, or Tess $ 145.15 4
Cit /metro lic.no.: N/A Each additional 500 sq. ft. or portion thereof 5 33.40
2/11/04 Limited energy residential S 75.00 2
Signature of supervising electrician (required) Date Limited energy, non - residential $ 45.00 2
Sup. elect. name (print):0 \ License no. 1(3 a•S Each manufactured home or modular dwelling
Service and/or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: I State: (ZIP: 200 amps or less 2 $ 80.30 160.60 2
Phone: Fax: IE -mail: 201 amps to 400 amps S 106.85 2
Owner installation: The installation is being made on property 1 own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 1
ENGINEER Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less $ 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E -mail: 401 amps to 600 amps S 133.75 2
PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps- commercial 0 Health -care facility or extension per panel:
O Service over 320 amps- rating of I &2 0 Hazardous location A. Fee for branch circuits with purchase of
family dwellings O Building over 10,000 square ft. four or service or feeder fee, each branch circuit 42 $ 6.65 279.30 2
❑ System over 600 volts nominal more residential units m one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress/lighting plan 0 Other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel,
alteration, or extension* S 75.00 2
*Description:
Each additional inspectionover th allowable in any of the above:
Per inspection I I $ 62.50 I I
Investigation fee
Other
❑ Visa O MasterCard Permit fee $ 439.90
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained State Surcharge 8% ) $ 35.19
Name of cardholder as shown on credit card within 180 days after it has been
$ y TOTAL $ 475.09
Cardholder signature Amount accepted as complete.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 63 171 MST
BUP
l 2 >
Received `� / 3 ' ✓ 7 Date Requested J/ e' AM PM BUP
Location (O 7 5 '7 zk ,46) Suite MEC
Contact Person / .U (_17_ 0 () Ph ('� ) 506 -- 30 ''/ PLM
Contractor Ph ( ) SWR / /
BUILDING Tenant/Owner 40 V d6 7'
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing N ∎ \(I /
Insulation (�
Drywall Nailing ) r _
Firewall f ,.y- �� 0 Vv \
t
Fire Sprinkler 'v V
Fire Alarm 1- ± Q 0 Jo- S (
Susp'd Ceiling 1 � O �
Roof /(yl ""
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam C \N t \ \C� J , , l P i 6
Under Slab W
Rough -In J
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 /% ' f i /
v e l ar
PAS PAS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SIT fl Please call for reinspection RE: • Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date - .2 " 0 y Inspector,
Other:
Final DO NOT REMOVE this Inspection record f . m the Job s e.
PASS PART FAIL