Permit • - - '`CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00016
Aka' M iI DEVELOPMENT SERVICES DATE ISSUED: 1/12/2005
' � II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 113AA -01100
SITE ADDRESS: 16584 SW 72ND AVE B -11
SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L
BLOCK: LOT : OOD JURISDICTION: TIG
Project Description: Hardwire UPS machine. Wire to (5) plugstrips. Job # 83980.
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: SIGNALJPANEL:
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: 1 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 OREGON ELECTRIC CONST /GROUP
15350 SW SEQUOIA PKWY #300 -WMI 1010 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 503 - 535 - 2652
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/12/2005 $53.50
[TAX] 8% State Surcharge 1/12/2005 $4.28 Rough -
Elect'I Final
Total $57.78
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: f Permit Signature: -e.
0
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 639 -4175 by 7:OOpm for an inspection the next business day
MN -11 -2005 05:30PM FROM -OR ELECTRIC _: 5035352763 T -040 P.001 /002 F -665
L1ect ! rer ,!ii : !J11; `! JJ ;
City of Tia>I'd �. Received / a 1).0 1Z-1— Perini' No.6 (C./,D0 .08/1/4
13125 SW Ball Blvd„ Tigard, OR P lat R ev iew
Phone: 503.639.4171 Fax 503E 5 601 2005 %•, :., , .;
Dat Other Permit; Inspection Line: 501639.4175 _ ' , '1 �� Date Ready
infix www.ciaigard.or.us Nte i&ed/Medeod &1 See Pane I For
CITY C7F "['IGAIZD I" IC �PPlcmoamllerormarion
�� �1oN FLAN �v� w
❑ New construction 130 '.: 4 clitt Picric check all that apply:
❑ Demolition _ 0 Other: ❑Service over 215 amps, Comm'l ❑Hatudous location
CATEGORY OF CONSTRUCTION of over 320 amps - raring ❑Bulldog over 10,000 sq. ft„
of 1- and 2- fatuity dwellings 4 or more new residential
❑ 1- and 2 - family dwelling ® Commerci&Yndusniial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Focders, 400 amps or more
❑ Multi - family ❑ Master builder 0 Other;
JOB 317'E INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑Manufactured structures or
DEliressiliSftting Pim RV park
Job no.: 83980 Job site address: 16584 SW 72nd Ave. ❑Healthy facility ❑Omer: _
Submit 3. sets of plans with any of the above.
City/State./ZIP: Tigard, OR 97224 The above arc n of applicable to temporary construction service.
Suite/bldg./apt, no.: Bldg. 11 I Project name: Flight Dynamics FEE SCHEDULE
Desmipdan ) Qty. I Fes I mist I ..
Cross street /directions to job site: - New residential single -or multi - family dwelling unit.
Includes attached garage.
1.000 sq. & or less 145.15 4
Subdivision: f Lot no.: Ea. addl 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limned energy, residential 75.00 2
Limited energy, am-residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Hardwire UPS machine. Wire to five new plagstripa dwelling service and/or feeder _ 90.90 2
Services or feeders installation. alteration, and/or relocation
200 amps or less 80.30 2
• ❑ PROPERTY 'OWNER 1 , .", TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Namer Flight Dynamics 601 amps to 1,000 maps 240.60 2
Address: PO Boa 230609 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Portland, OR 97281 Temporary services or feeders lastanatlon. alteration, and/or
Phone: (503)684 -4384 I Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 10030 2
intended for sale, lease, tent, or exchange, according to ORS 447, 449, 670, and 70L 401 amps to 600 amps 133.75 1
Owner signature: Date: _ Branch circuits- new, alteration. or extension, per panel
• ❑ APPLICANT 1 ❑ CONTACT pERSSON k Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch twit
Contact name: B. Fcc for branch circuits
without service or fcedcr fee, /
Address: each branch circuit 1 46.85 IT6 . gS 2
Each add', branch circuit 1 6 G, (25 2
City /State/ZTP: Miscellaneous (servke or feeder not included) _
Phone: ( ) f Fax:: ( ) Pwnp or irrigation circle 53.40 2
Sign or oudine lighting 53.40 2
E-mail: Signal circuit(s) or limited-
CONTRACTOR , energy panel, alteration, or
Business name: Oregon Electric Construction =tension. Describe: Page 2 2
Address: 1010 SE 11th Ave. Each additional inspeedou over allowable in any of the above
Per inspection 62.50
City /Statc/ZIP: Portland, OR 97214 investigation per hour (tit min) 62`50
Phone: (503) 234-9900 Pax (503) 535 -2763 Industrial piing per hour 73.75
ELECTRICAL PERMIT FEES" •
CCB Lie.: 203 Electrical Lie.: 26-9SC I Suprv. - .: 4460S
Subtotal S. SO
Suprv. Electrician signature, required: ,, Li*? Plan review (2596 of permit fcc)
g
Print name: MARK J J. KENNEY 1 Da : 01/1 State surcharge (8•/. of permit fix) ! f e 2.
TOTAL PERMIT FEE 5 7 , g
Attthesiud signature: This Per+md a aoa nee its emit f9 not Obtaobtained withiq la0
. / w . days after it bas been accepted as complete
Print name: MARK J _ KE EY ! s : , 1/05 • Fee methodology sat by Tri.Com Building uy Build Industry Service Board
' •° Number ofiasaectimis Der =n it Ahmed, 05A A
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION B Line: (503) 639 -4171 MST
BUP
t 2 t
Received 3 Date Requested AM PM BUP
Location CS - 7 7r;-, Suite �/ / MEC
Contact Person Q Ph ( ) / — PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC (D d (o
Footing ?Q S = 0026f
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam `
Shear Anchors / `L 1 � t 1 /
Ext Sheath/Shear / C
Int Sheath/Shear \
Framing c�--
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
the (5C
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
PASk PART FAIL
EICAL c. L C 0 G S- V O U i
Service L 0 6' 44 s c) a 8 n
Rough -In
UG/Slab
Low Voltage
F' = larm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Cr PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA CC 1 / 4 7
Date — a() — D `� Inspector v \Z J O N Cf Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job slte.
PASS PART FAIL