Permit CITY OF TIGARD ELECTRICAL PERMIT-
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2001 -00296
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/26/01
SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: LV for HVAC.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES D L HOWARD CO INC (26- 1020CRE)
15350 SW SEQUOIA PKWY #300 -WMI 5340 SW DOVER
PORTLAND, OR 97224 PORTLAND, OR 97225
Phone: Phone: 503 - 892 -3250
Reg #: ELE 26- 1020CRE
LIC 82769
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 12/26/01 $75.00 2720010000 Elect'l Final
5PCT CTR 12/26/01 $6.00 2720010000
Total $81.00
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 rul s are set forth in OA
952 - 001 -0010 through OAR 952-001-0080. You may obtain copies of these rules or ct estio, to O•U at (503)
246 -1987.
Issued by 6vasipt, 4,/rigt, Permittee Signature ,ez ,Q
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: �) �'.r�p��! C`C�7z, d1` DATE:
LICENSE NO: e
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
. A
Datereceived: // --d- 1-0 / Permit no.: - /,, // _.60,96,,
;:ii:
.. ,' I! City of Tigard Project/appl. no.: Expire date:
City ofrigard Address: 13125 SW Hall Blvd; Tigard, OR 97223 Date issued: : Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case tile no.: Payment type:
Land use approval:
•
TYPE OF Pl?HA91 "C
Nir
O 1 & 2 family dwelling or accessory 0 Commercial /industrial O Multi- family % enant improvement
0 New construction ❑ Addition/alteration/replacement ❑ Other: 0 Partial N
' JOB SITE INFORMATION , .
Job address: 0 w i %o a911111 Bldg. no.: Suite no.: '
Tax map /tax lot/account no.:
Lot: Block: Subdivision: p
Project name: i'44 66 • •Lid . ID - crip on and location of work on premises: v, L AIM b `7
Estimated date of completion/inspection: 1 Arlf c) Z
CON1l ACTOR ''ti, , FEE SCHEDUL1, ,
Job no: Fee Max
_
S�C r � Description Qty. (ea) Total no
New entbi. single orm°i Per
Address: 4- - s.J b ` tJ(t dwelUagunk .Inclades attached garage. '
®:1■ Statejn_ ZIP: 0 TZZ -s,> Serviceincladed:
Phone: a • Z - Z 5 Fax./ Z E-mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof __ 2
CCB no.: Z Elec. bus. lic. no:26 -td zv Gft
l.imitedenergy, residential ___ 2
Ci 1 /metro lic. no.:4 L c, , Limited energy, non- residential ___ 2
1 ' � ` . /_ Each manufactured home or modular dwelling
, 't',. of su. ' ing electrician ( i :, 1,7 Service and/orfeeder ■■ 2
Tr elect. name (print): A. _ - MGC t.At:,O License no:
, � � r r Services orfeeders— irstallatlo°,
alteration or relocation:
PROPERTY OWNER 20 0 amps or less 2
Name (print): 201 amps to 400 amps ___ 2
Mailing address: 401 amps to 600
amps 2
g 601 amps to 1000 amps ___ 2
City: State: ZIP: Over 1000 amps or volts MI OM 2
Phone: Fax: E -mail: Reconnect only IIIIII7� 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
installadterati
which is not intended for sale, lease, rent, or exchange according to on, ��'Or�O`gdO °'
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps __ _ 2
Owner's signature: Date: 401 to 600 am. ME IMO 2
. I:N G I N El :14 Brandi drtvits - uen, alteratlo°,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
Phone: Fax E-mail: service or feeder fee, first branch circuit: ■■ 2
Each additional branch circuit: __
PLAN ,REV) ENV (Please check all that apply) Misc. (Servkeorfeedernotineladed):
O Service over 225 amps - commercial O Health- carefacility Each . mp or irrigation circle ■ ■ 2
O Service over 320 amps- rating of 1&2 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 extensions' Ill.
O Building over three stories 0 Feeders, 400 amps or more spescri , tion:
.0 Occupant load over 99 persons O ufacturedw
, �ctn or RV p additional inspection over the allowable many of the above:
O Egrssllightingplan Other:� Vft C- (l r Each Per inspection MEN
Submit _ sets of 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 more information. Notice: This permit application Permit fee $
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
credit card number: / / within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit car
Cardholder signature Amount 440-4615 (6100JCOM)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested
,,
( , — ,/ 3 AM PM BLD
Location / SAO S / Z 'r eI Suite MEC
Contact Person Ph '2 — 0 7 0 Y PLM
Contractor D, L. 1-4 a a c Ph 5133 j '2 -3 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab LOGO uQ `7 0 SIT
Post & Beam v
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall 1-40i6a Fire Sprinkler . (f nb rf J
Fire Alarm �"
Susp'd Ceiling
Roof
- 4
Misc: v L�
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service •
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab.
w Volf
Fire Arum
PART FAIL
S E
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk 3
Other Date 3 _. 02 Ins 1— / lei 7 Ext
Final ,
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /2 '-' - AM PM BLD
Location 7 0 2 /1 ,Suite MEC
Contact Person Ph7 90 070 3 PLM
Contractor rd Ph SWR
BUILDING Tenant/Owner ELC qq
Retaining Wall ELR o / 2 d
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: —
Slab ��'I SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing o 4 2i -
Insulation
. Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
/4- Lo
Misc:
Final �.r+
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Slab ' '
Low Voltage
Fire Alarm
Fin
PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk t±,, d / c/ G
Other Date _ — 4� / Inspector / Lo c 7 rp Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from t e job site.