Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2006 - 00681
COMMUNITY DEVELOPMENT
DATE ISSUED: 11/30/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113AB -01201
SITE ADDRESS: 16535 SW 72ND AVE BLDG F ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: OCE (5) branch circuits.
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: 4 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 TICE ELECTRIC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 15009
PORTLAND, OR 97224 PORTLAND, OR 97293 -5009
Phone: Contact #: FAX 503 - 872 - 8290
PRI 503 - 233 -8801
FEES
Description Date Amount Reg #: ELE 26 -126C
[ELPRMT] ELC Permit 11/30/200( $73.45 LIC 166
[TAX] 8% State Surcharge 11/30/200( $5.88 SUP 25865
Total $79.33 REQUIRED ITEMS AND REPORTS
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 or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: r Permittee Signature: S jam,
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:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
J iectrical Permit Application FOR OFFIC USE ()NIA'
City of Tigard '
y $ \ f 1. i t Date .�j Permit No /
13125 SW Hall Blvd., Tigard, j : :' �1 ° �� �/ ✓� {' t�� e4400 Ov K9
Plan Rev e w
Phone: 503.639.4171 Fax: -6 3 .1 ( � z "'�5;,0 `.)� hatc/1By Other Permit
Inspection Line: 503.639.4175 1 `1 3 O 2o'1VO V 3. �'!. -' ' l :.�l Date ReadyB Jv
y: ,ie: ' el See Page 2 for
A
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Internet www,ci.tigard.ors \ V Notified/Method: Supplemental Wm-antics
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C'' r 1'; ; r '' . S ING DIVISION PLAN REVIEW
❑ New construction '•' s ttion/alteration/replacement Please check all that apply:
['Service over 225 amps, conical ❑Hazardous location
❑ Demolition ❑ Other:
❑Service over 320 amps — rating °Bulldog over 10,000 sq. R,
CATEGORY OP CONSTRUCTION of 1- and 2- fancily dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi fatally ❑ Master builder ❑Caber: ❑Building over three stories :Weeders, 400 amps or more
❑Occupant load over 99 persons ❑lvlanufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
S. Job site ad dress: ❑Health -care facility ❑Other.
Job n
- g 9: 1 `o ®0 1 6 5 3 5 S W 7 2nd Ave Bldg d g F Submit 2 sets of plans with any of the above.
City /State/ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service.
Suite/bldgfapt. no.; l Project name: OCE — FEE* SCHEDULE
bgt+iption r Qtr. I Fea I Total I *'
Cross street/directions to job site New residential single- or multi- family dwelling milt.
Includes attached garage.
1,000 aq ft. or less 145.15 4
Subdivision: Lot no.: add' 1500 sq. ft. o�ortiora 33.40 1
- - -- Limited energy, residential 75.00 2
Tax map /parcel no.. _Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK • Each manufactured or modular
dwelling service and/or feeder 90.90 2
add (5) circuits Services or feeders installation, alteration, and/or relocatio
200 amps or less 80.30 2
❑ PROPERTY OWNER I [J TENANT 201 amps to 400 amps 106.85 _ 2
401 amps to 600 amps 160.60 2
Name: OCE 601 amps to 1,000 amps 240.60 2
Address' 16535 SW 72nd Avenue Bldg F Over 1,000 amps orvolts 454.65 2
Reconnect only 66.85 2
City/StatdZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
Phone: ( 503) 381 -5629 I Fax: ( ) relocation
200 amps or less 66,85 1
Owner Installation' This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 _ 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or erdenalon, per panel
❑ APPLICANT l ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: _ circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 46 . $ 5 2
each branch circuit
_ _ Each add'1 branch circuit 4 6.65 2 t _ e
City /State /ZIP: . MlsceLaneous (service or feeder not included)
Phone: ( ) Fax: : ( )
Pump or irrigation circle 53.40 2
Signor outline lighting 53.40 2
E-mail: Signal circut(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: ticks Electric Co.
Address; 5405 N Lagoon Avenue Each additional inspection over allowable in any of the above
Per inspection 62.50 t
City /State/ZIP: Portland, Oregon 97217 Investigation per hour (l hrmin) 62.50
Phone: ( 503) 233 - 8801 Fax: (503) 872 -8290 Industrial plant per hour _ 73.75 _
^
ELECTRICAL PERMIT PEES*
CCB Lic.: 166 Electrical Lic.: 26 -126C Suprv. Lic.: 2586S Subtotal 73 . 4 5
Suprv. Electrician signature, required: g'°j1 Plan review (25% of permit fee)
Print name: John J. Maloney Date: 1 1 / 0 / 06 State surcharge (8% of perrnit fee) 5 - $ g
TOTAL PERMIT FEE 79 . 3 3
Authorized signature: This permit appUcation expires if a permit is not obtained within 180
days sifter it has been oceepted as complete
Print name: Date: • Fee methodology set by Tri Building Industry Service Board
- . .. Number of inspections pa permit allowed.
i:\ A ritdmsVormim \ELC- Peetn(tApp•doe 13'03 4403613T(10/02/COM/wr8
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006- 00681
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1'l/30/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/18/2006 TIME: 7 PAGE: 28
SITE ADDRESS: 16535 SW 72ND AVE BLDG F CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OCE IMAGISTICS
DESCRIPTION: OCE (5) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503-233-8801
Inspection Request Scheduled For: Date: 12/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 041195 -01 503- 872 -8202 N
Corrections /Comments /Instructions:
R/v '
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N e 8 lh3 Date: If ' S ti (!i Phone #: (503) 718- 7A
... .,
CITY OF TIGARD
PERMIT #:
BUILDING DIVISION
A
DATE ISSUED:
13125 SW Hall Blvd., Tigard, OR 97223
Phone: (503) 639-4171 k
, A Z 7 ' 4::(3() (
Inspection Requests (24 Hrs.): (503) 639-4175
Aa
INSPECTION WORKSHEET FOR DATE: - TIME: --• 7----h- AGE:
- -CC
SITE ADDRESS: 1 10535 5lAi / 7- 4 " 1 CLASS OF WORK:
SUBDIVISION: LOT#: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: a s b ut -e4 5
OWNER: 0. C. . PHONE #: S03 43/ - 233
• CONTRACTOR: ii•oe ce_k_ _ PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/C mments/Instructions:
____---7-- _ ----
• i 4 PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
• FAIL 0 CALL FOR REINSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: C.5 1 t-t----- Date: \ rilm Phone #: (503) 718- 2,triv,-
013uilding\IVR\IVR-InspWorksheet-BlanIcForm.doc 03/0212005