Permit ciTy TIGARD ELECTRICAL PERMIT
'� PERMIT #: ELC2002 -00385
,01 - DEVELOPMENT SERVICES DATE ISSUED: 8/9/02
Ill
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S113AA-00500
SITE ADDRESS: 16100 SW 72ND AVE B -18
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : OOA JURISDICTION: TIG
Project Description: Installation of 12 branch circuits for equipment and cubicle wiring.
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: 11 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 STONER ELECTRIC
15350 SW SEQUOIA PKWY #300 -WMI 1904 SE OCHOCO STREET
PORTLAND, OR 97224 MILWAUKIE, OR 97222
Phone: Phone:
Reg #: -4 3
SUP 4025S
ELE 26 -122C
FEES Required Inspections
•
Type By Date Amount Receipt Rough -in
PRMT CTR 8/9/02 $120.00 2720020000( Elea! Final
5PCT CTR 8/9/02 $9.60 2720020000(
Total $129.60
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 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Permit Signature: ¢ Issued By:
4 -4 ,■■
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: �1 ^-�� —f DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
08/07/2002 WED 15:42 FAX 5036592824 STONER SERVICE Ij001
.
A Electrical Permit Application
Date received: i� �' Permit no: •
r .:i'I! City of Tigard 1 Project/a 1. no.: • sip � ' •
�ur. q' ' ' - t .fC�li r'' pP Expire
City of Tigard Address: 13125 SW Hall Blvd; Tig ar d , O IZl�,7 2 3
Phone: (503) 639 -4171 " g'* Date issued: Bye Receipt no.:
Fax: (503) 598 -1960 ZOOZ 4 0 911V Case file no.: Payment type:
Land use approval:
TYPE OF PERAIIT
O 1 & 2 family dwelling or accessory Commercial/industrial 0 Multi - family ❑ Tenant improvement
O New construction 0 Addition/alteration/replacement 0 Other: 0 Partial
JOB SITE INFORAIATIO\'
Job address: / B ld a
oh ; /p ( e Q Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: ,4 Description and location of work on premises: N_ M M 7 1103/,
Estimated date of co " I ' ii,■01
.._____..__ CONTR 1CTQILA EPLICATION -___ _ ..._.______. -FEI SCI IEDL!,G.
Job no: 3 al 3 5 Fee . Max
Business name: o,,, ,--;,"_--c. -7irer Description _ -Qty. (ea.) Total no. imp
-
New residential - single or multi - family per
Address: /c�p,r� .St= �iTeltoLO
dwelling unit. Includes attached garage, •
City: MrLwh4 I State:q,e I ZIP: 97z 2-2 Service included:
Phone $3.. f(„Z_(,sou I Fax:1 8 I E -mail: 1000 sq. ft. or less
4
CCB no.: y 'Elec. bus. lic. no: 110 —1 2-7-- - Each additional 500 sq. ft or portion thereof
City/metro lic. no.: 44/ 4 umi 2
Limited energy, non - residential 2
•
/ Each manufactured home or modular dwelling
Sig • Li , ?_ .: LirfRr' :. elan • !' : D Service and/or feeder 2
Sup. elect. name ( print): Mute' e' r7 License no: 3494,5 Services or feeders- installation,
PRO 01�'N ER • alteration or relocation:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address:
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E-mail: _ Reconnect only
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 accordins to Installation, alteration, orrelocation:
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 .s 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel:
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 1 h A J
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: t'}6 6S ilk g; 2
Each additional branch circuit: 1 ( 1e.(oi,'N •I e i
I'LAN 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
O Service over 320 amps - rating of 1 &2 0 Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10.000 square ;ce four or Signal circuit(s) or a limited energy panel.
❑ 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:
O Occupant load over 99 persons 0 Manufactured structures or R V `art: Each additional inspection over the allowable in any of the above:
❑ Egress/lighting O Other. _ Per inspection 1 1 I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other i n
Not all jurisdictions &apt credit cards. please call Jurisdiction for more information. Notice: This permit application Permit fee $ IO�t/ • 00
O Ysa ,rvlasterCard expires if a permit is not obtained Plan review (at _ %) $
Credirctd number: _�7, /zD / 9 Y4`�7 d f 6i /0,3 within 180 days after it has been State surcharge (8%) $ I �JI
g / 8 �bk 'C- '/ a1 Expires accepted as complete. TOTAL $ (a
,,d�iame of cardholder sb on credit z •
i if t , t'an o _s Jd4.1OO
Cwdholder signature Amount
440-4615 (6/00/COM)
CITY OF TIGARD 24 -Hour
Inspection Line:
BUILDING= 503 p ( ) 639 -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested AM PM BUP
Location /6(00 7?.- 17 ' Suite - 1? MEC
Contact Person Ph ( ) 7 0 1 1 — q3 % PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner r ELC .= e-5-4 3 gs'
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam _
Shear Anchors
Ext Sheath/Shear I ' /
Int Sheath/Shear DU PS - -C SD W p LL Y � S/�) IW6 r 4,01
Framing
Insulation ( V n - G '( > �l �,14 - C? {�A)
Drywall Nailing /
Firewall V v.\4: C� H r,) t4 -- 3 V y1 I J V cc300 =
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof NI)/ FI L tS
Other:
Final j C 1FIN& [)*Ip • iDML a7.--C112, 1_6 - i P1. ■G 1 '0 \16►Dst
PASS PART FAIL D L� 2 )
PLUMBING 1 1 �
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
PART
111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. IZ
SITE El Please call sr rein .section RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / -2 ---- Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from th job site.
PASS PART FAIL
CITY OF TIGAI1D 24 -Hour
BUILDING - Inspection Line: (503) 639 -4175
INSPECTION DIVISION e Business Line: (503) 639 -4171
MST
BUP
Received Date Requested /�t AM PM BUP
Location / /60 7 c?, -'77 Suite MEC
Contact Person Ph ( ) 7e t f' 43 ?c PLM
Contractor Xh ( ) SWR
BUILDING Tenant/Owner ELC — 3&_S
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain Aro V
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall on
Drywall Nailing
Firewall L V 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 -T FAIL
Rough -In
UG/Slab
Low Voltage
Fire Alarm
na ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7//"2-- Inspector LLi / / --�.� Ext
Other:
Final DO NOT REMOVE this Inspection record fro e job site.
PASS PART FAIL