Permit LITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00395
,11 i DEVELOPMENT SERVICES DATE ISSUED: 6/30/03
13125 SW Hall Blvd., Tivard, OR 97223 (503) 639 - 4171 PARCEL: 2S113AC
SITE ADDRESS: 16655 SW 72ND AVE 200
SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING. I -P
BLOCK: LOT : 029 JURISDICTION: TIG
Project Description: (6) branch circuits, installation of (2) power poles and (1) outlet on to steel column in service area.
Job No. 75592
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: 5 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 - 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/30/03 $80.10
[TAX] 8% State Tax 6/30/03 $6.41 Rough -
Electl Final
Total $86.51
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 -2 .
•
Issued = : �;:_ / ' 14 / ' Permit Signature:
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
JUN -24 -03 12:52 FROM- T -299 P.001 /004 F -913
• I r cti-ical Perm ppca
it Alition
OFFICE USE ONLY
A of Tigard Date received:, qty 63 Permit no.:-39
13125 SW Hall Blvd Proiect/appl. no.: . Expire date:
. _1.4 !!!':_.. Phone: (503) 639 -4171, I=AX: (503) 598 -1960 Date issued: _ By: Receipt no.:
Internet address: www.ci.tlgard.or.us Case file no.: Payment type:
24 -Hour Ins - ' ction Re • uest 503-639-4175
• 18r2 famiy dwelling or : - -- • • ry p Commen:iaUaniustrial' • • Multi- family In Tenant improvement
❑ New coru m:don , .',J,L >1' O addliontaiteratlotireplaoement , ❑ Other: ' , ❑ Partial
JOB SITE INFORMATION
Job Address: " ..•;•,.: S 72nd' Ave : . Bid ._ No.: Ljm= Suite no.: ;IOO Tax map/tax lot/account no.:
Lot: 1 &'(6 5 Block: Subdivision
Project Name: Flight Dynamics , Description and !Creation of work on premises: (natal, two power poles and one outlet on to steel
Estimated Date of completionflnsuection: column In service
Will au call for ins • - ction within 24 hours? Yes ❑ . • No ❑ Project Contact Steve Ho. be . (509) 535 - 2631 Phone
CONTRACTOR APPLICATION = EE SCHtDULG
' nv
Job No.: 75592 oescaipllon Qty Fee (ea.) Total msp
Now rasndonnaG8T0918 Of -
mul6•tamlty per dwelling unit •
Business name: Oregon Electric Group includes attached garage.
Service InCluded:
Address: 1010 SE 11th Ave. 1000 so. R er less S 145.00 $ - 4
City: Portlan JState: OR Zip: 97214 Ea Addl 500 SF or Penton $ 33.40 $ -
Phone: (503) 234 -9900 Fax: (503) 234 -1001 1E-Mail: united Ertergy.1 8 2 Faeny $ 75.00 $ - 2
CCB no.: 21 - ,.,/ El . b lc. no.: 26-95C undyed Energy IASI-Family _ S 75.00 $ - 2
City /me J,. , _
Each manufactured home or
modular dwelling. Service
s other • . rdemro• n. dr Date" , 1 03 and/or feeder. S 90.90 $ - _ 2
'� Service or Feeders -
S • . Elect. Name • rint :Mark Kenne License no: 4460S Ineudiada+. Atmratten or
Rebcatloe:
PROPERTY O\4JN 1; 200ampsorloss 5 00.30 $ - 2
Name (print): _ 201amps • 400amps 5 106.85 $ - 2
Mailing Address: 401amos- 000amps $ 160.80 $ - 2
City - State: (Zip: 601amps- 1000ampe 5 240.60 $ - 2
Phone: Fax: E•mail Over 1000A or Volts 5 454.65 $ 2
Owner installation: The installation is being made on property I own which is *�0n"� services - S rrs as $ - 1
not intended for sale, tease, rent, or exchange according to ORS 447, 455. Feeede mama
479, 670. 701. Alteration or Relocadon:
Owners nature: Date: 200 a sorloss 3 68.65 $ 2
201amps- 400emps 5 100.30 $ - 2
Name: Over 401ampe -60 21npa S 133.75 $ - 2
Branch Circuits - New,
Address: Alteration or Extension Per
Panel: A. Fee for brands
City: State: Zip: circuits with porrhaaaofservice
or feeder fee. each branch
Phone: Fax: E drwit E 6.65 $ 2
B. Fee for branch drags w /out
PWrhasa or Service or Feeder.
let ashen OA _ 1 5 46.85 , $ 46.85 2
❑ Service over 225 ampa -coma O Health - care facility Each additonal branch draat 5 5 6.6. $ 33.25 _
0 Service over 320 amps-rating of 0 Hazardous location Mlscelhaneous - (service w
feeder not Inciudad)
182 family dwellings ❑ Building over 10,000 seuare feet four or Each name or Iodation circle s _ 53.40 $ - 2
0 System over 600 volts nominal more residential units In one structure Each Skpl or outline ughdeg 5 53.40 $ - z
0 Building over three stories ❑ Feeders, 400 amps or more signal circuil(s) or UMW! Energy
Panel Alteration ar Exmnrnan-
❑ Q0c>pant load over 99 persons 0 Manufactured structures or RV park $ 75.00 $ - 2
D Egress/lighting plan ❑ Other: - Description,
Each Addldonal /nspec6on over
the Allowable In any of the
Above. Per insyodion
$ 82.50 $
Submit 2 sets of plans with any of the above- investigation fee:
The above are not - • • linable to tern • • ra construction service. Other
Permit Fee 580.10
(Voice: This earnit application Plan review 25% $0.00 i
expires if a widths v 6 a e� armrn ate Surcharge El% 6.41 T
hoe been accepted se complete. Total 586.51
24-Hour
Inspection Line: (503) 639 -4175 MST a •
Business Line: (503) 639 -4171
BUP
Received Date Requested r7 AM PM BUP
Location /''9 C 5 + ( Suite MEC
Contact Person T4.- Ph ( ) 53 ' x4 3 / PLM
Contractor . Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
•
Crawl Drain •
Slab Inspection Notes: g // SIT
,Post & Beam
/Q. (.) pb ,z),e-7�
Shear Anchors o t 71, A L m n,
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler F
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 PART FAIL
<Egg=ZAL
Service
Rough -In
UG/Slab /
Low Voltage /t 0
F' larm
PAS ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
- SITE 0 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Apppp 7 - 7 -
roach/Sidewalk Date o Inspector � .L � Ext
Other:
Final DO NOT REMOVE this inspection record from t - ob site.
PASS PART FAIL