Permit CITY . OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00587
s DEVELOPMENT SERVICES DATE ISSUED: 11/22/02 r
13125 SW Hall Blvd.. Tislard. OR 97223 (503) 639 -4171
PARCEL: 2S113AD-01900
SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: ZONING: I -L
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Electrical tenant improvement, addition of (60) branch circuits. Job No. 7990.
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: 59 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 JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERRACE
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Phone: 503 - 698 - 3417
Reg #: ELE 3 -243C
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/6/02 $439.50
[ELPLCK] ELC Pin Rev 11/6/02 $109.87
[TAX] 8% State Tax 11/6/02 $35.16
Total $584.53
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
suspen r more n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification C. ter. Those
rules re set forth in OAR • - 001 -00 • t • . gh OAR 952 - 001 -0100. You may obtain copies of these rules ordirect questions to 0 • 03)
2 -6699 or 1-800-332-2344. /
J
I sued By: . i •; % /FA- ,/ Permit Signature: -111, 4114
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 1141ST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 1/4-)41 DATE:
LICENSE NO: g05
Call 639 -4175 by 7:OOpm for an inspection the next business day
From: Charlynn J. Leifsen To: City of Tigard Date: 10/24/2002 Time: 9:01:46 AM Page 2 of 3
t
Electrical Permit Application (, I I I t,
D received: / Permit no.: . - „t„, .
" �� City of Tigard Project/appl. no.: Expire date: —
City oJ>< Add 13125 SW Hall Blvd, , LtIlk 9 2 Date issued: II Receipt no.: ,-(-)
Phone: (503) 639 -4171
Fax: (503) 598 -1 960 ® �• 1 fin, Case file no.: Payment type:
c l j
Land use approval: Ai eloo a - 6
1 \ I'1 (,I 1'1 It \11 I
O 1 & 2 family dwelling or accessory 1ommcrcial/industrial 0 Multi- family 0 Tenant improvement C
0 New constriction 0 Addition/alteration/replacement 0 Other: 0 Partial
. 1 4 1 I I ".1 1 1 . 1 \1 1)4.Z11 \ 111)\
Job address: , , 0 ,,, A'. i Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision: ,``
C _
Project name: MS I Description and location of work on premises: 1 Q 4 J f lw. 0,4 Q, kkA.- , -\s
Estimated date of completion/inspection: ff
(()\II( \s I(1K 11'1 I( \II()\ ._11.1 'NUM .U1-11..
Job no: 7990 Fee Meat
Business name: Spd)a'1Sl pr iG Qty. (m.) Total no. Imp ,
n , ' Ttewralimedd -�ieor Description
per
Address:l0`�tj Sc U th'& l )ff./1' er.tel�Iasu.taeWes uledca e.
City: (2J,C,&7rl7js st ate I ZIP: q70 /6 seniteimiderb
Phone :40g-t// 7 1 Fax: t#f E -mail: 1000 sq. R err less 4
CCB no.: r /! 1ec. e-l bus. lic. no: 3-• ,74(..c
Each additional .500 sq. 0 °r portion thereof
!/ limited eoagy, residual 2
meta 1C • 7 Limited energy, non-residential 2
.49,4 jOZ Each macu1 eu,cd home or modular dwelling
Signature of su inn electrician (required) • Date Service and/or feeder 2
sup. clout name (saint): License no: 5 S Serried or feeders- lastaBatba,
alteration or reloeatlo a:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 601 to 100(I
> 2
City: 1 State: I ZIP:
O ver 1000 amps or molts 2
Phone: fFax: E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary makes orfeeden -
which is not intended for sale, lease, rent, or exchange according to 10a '' ti0° ' OrrellO°
ORS 447, 455, 479, 670, 701. 200 apps a less 2
201 amps to 400 amps 2
Owner's s' Date: 401 to coo 2
Brandt circuits - new, alteration,
or exteastoa per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fox, each branch circuit 2
City: State: ZIP: B. Fee for bunch circuits without purchase 1l'� .� p
Phone: Fax: E-mail: of service or feeder foe, rust branch circuit: 1 1 11189f � t1A ,9f ' V5 2
Each additional branch thecae T' (D.Ua'i�iZ -4i
1 ' 1 \\ R I : IL1\ II'Icu'c• ih•cL ,ill 11,31 .1)1,h) Mlat ,(Serdee feeder path:eluded):
0 Service over 225 amps- commercial C1 HealtMme (Irilih'
Each pump err irrigation circle 2
0 Service over 520 of i&2 U Hazardous location Each sign or outline lighting 2
family dwellings U Building over 10.000 squire feet four a S ignal circuits) or a limited cagy panel.
0 System over 600 volts nominal more residential units in one structure alteration, a extension* - 2
0 Building over thee stories U Feeders, 400 amps or more •Description:
0 Occupant bad over 99 persons U Manufactured structures or RV parts Each additional fas ped6a over the allowablela any of tile above
U Eggess/Iighting Plan 0 Other: Per inspection f I 1 1
Submit _.. - -sets of pleas with any of the shore. Investigation fee
The above are sot applicable to temporary coratrucdoe service. Other
Not a0 jtaedatioes accept a .edit cardu, please call jwisdiedon for more information. Notice: This permit application Permit fee $
Cl Visa 0 MasterCard expires if a it is not obtained Plan review (at L7S %) $ 4442_
1 / within 180 days after it has hem State surcharge (S %) $ • 1i 0
Expires me accepted as complete. TOTAL $
Na of car older as shown on credit card �� 0 q I
S
.. _ ...- - - - Cardholder sign Amount 4404615 (6A0 /COM)
. dege 53..7 76/-/-c--3Y
CITY OF TIGARD 24 -Hour w
BUILDING Inspection Line: (504639-4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / AM PM BUP
Location /d (0 7 7A ' n 1 Suite MEC
Contact Person
D4 Ph ( ) l —5a Ce PLM
Contractor Ph ( ) SWR o
BUILDING Tenant/Owner ELC So
Footing ELC -
Foundation Access:
Ftg Drain 04-0 ELR -11 !e) ,zzsl
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler /
Fire Alarm Jr te ) a-,5 br Jl
Susp'd Ceiling / ( Roof /' 111 0/ 'W (� 1)°`-3
Other: C�
Final rwcs /`� a ;I ihot
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab � � ��C _ - -- Rough-In
'
Water Service /- r Cfr
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
. e/A
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
F - larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
1 .1.r 4. PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date` ■ p � / Inspector /- `�r� /c� Ext
Other: v
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
10)- BUP
Received Date Requested AM PM BUP
Location / t 14-u -e— Suite MEC
Contact Person ; .:� • • Ph ( ) ] le - a- (Q Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC c2 - 0 so o 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
Insulation
Drywall Nailing
Firewall J'
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final • ,j-A4
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 PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
(-
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk DateC T ad'1 a RI) D-- Inspector ��d Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL