Permit CITY OF TIGARD ELECTRICAL PERMIT
' V PERMIT #: ELC2007 - 00618
. COMMUNITY DEVELOPMENT DATE ISSUED: 9/11/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101A6 02703
SITE ADDRESS: 07450 SW BEVELAND RD 120 ZONING: MUE
SUBDIVISION: MCA OFFICE BUILDING LOT : 027 JURISDICTION: TIG
PROJECT: WESTSIDE SLEEP CENTER
Project Description: TI elec. Medical
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: 1 W /SERVICE OR FEEDER: 30 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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: X
Owner: Contractor:
MCCAFFERY & ASSOCIATES TIMBERLINE ELECTRICAL CONTRACTORS • 7450 SW BEVELAND RD. #100 PO BOX 918
TIGARD, OR 97223 LAKE OSWEGO, OR 97034
Phone: NA Contact #: PRI 503 - 459 - 4089
FAX 503 - 254 -4227
FEES
Description Date Amount Reg #: ELE 26-1211C
[ELPRTI ELC Permit 9/11/2007 $279.80 LIC 160037
M
[ELPLCK] ELC Pln Rev 9/11/2007 $69.95 SUP 45185
[TAX] 8% State Surcharge 9/11/2007 $22.38
REQUIRED ITEMS AND REPORTS
Total $372.13
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 s.' - - 180 d. s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rul are set forth i 0 3 • R 9 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of thes ule or direct questions to OUNC at
503.24 .6699 or 1 .800.3 +3•
Issue By: _ _4 _i ,e,,, ; L' Permittee 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:
a . Vii+' OR INSTALLATION ONLY �y
SIGNATURE OF SUPR. ELEC'N: 1 .., DATE: 5 /1 /7
• LICENSE NO: / g5 g9
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.
•
Electrical Permit Ap,phcatl ,c . . - F OR.OFFICE USE ONLY
�
�' • City of Tigard it, r � t r R'ceiBed . ' . o � l>4 �O r
; � :t eB . D
a 13125 SW Hall, Blvd., Tigard, OR 97223 N ' /By :40 � Per mit N.
>
' ° ; •
• Phone: 503.639.4171 Fax: 503.598.1960(' L , D Other Permit:
TIGARD Inspection Line: 503.639.4175 Jl• 05 Zoo;
Date ReadyBy:9>/o Sufis' .- ® See Page 2for
Internet: www.tigard- or.gov -I '•'' Notified/Method/ / Supplemental Information
TYP 9: t ' I �'A ' /
❑ New construction . 2 Addition altera '71 M,' i,(} ' , . / PL •
i t7o s ireplaSie t
�. a e " " " / P1 ase check all that apply (submit 2 sets of plans w /items checked below):
i I ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or . ID Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for-all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE.INFORMATION AND. "LOCATION ❑ Emergency system. larger separately derived system.
❑Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "I - 3 ",
y Sv 100HP or more. occupancy.
Job no.: Job site address:
�. �C vEC� V • ) ❑ Six or more residential units. ['Recreational vehicle parks.
Gi /State /7_,1P: ealth -care facilities. El Supply voltage for more than
ty �r ` 7 Z �3 Ll Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: AsW 1 Project name: 111 S ;o
e , . 5(e . 47% , wit., ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add't 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF. WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
" r , . / • or-el Yfl tt ' cm. , residential (with above sq. ft.)
Services or feeders installation, alteration. 2 nd/cr .relocation
200 amps or less I 80.30 80.30 2 ::
❑ PROPERTY OWNER ❑TENANT° 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 ICI %i0 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: . Each add'l branch,circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service.and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
• Business name: Signal circuit(s)'or limited -
T.v► 6e CrUt.isc-Z energy panel, alteration or
Address: P0. / gig extension. Describe: Page 2 2
City/State /ZIP: �,K 05W ets 0 oft • 1768c/ Each additional inspection over allowable in any of the -above
Per inspection 62.50
Phone: (r ys5 , ypsf Fax: G9, ) zr yi_2,7 Investigation per hour (I hr min) 62.50
CCB Lic.: j(,co3 -) Electrical Lic.: 2 _ 2.41 L Suprv. Lic.: (.,15/ i3S Industrial plant per hour 73.75
`ELECTRIC_ AL P ERMIT FEES
Suprv. Electrician signature, required: Subtotal: ea 1. 15 0
Print name: Ce14-1—
c i t7,T Date: Plan review (25% of permit fee): 69• g,5"
State surcharge (8% of permit fee): 22. 3 8
Authorized signature: TOTAL PERMIT FEE: 312. 3
Print-name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per pennit.
I'\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 46t5T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - ..Supplemental Information
LIMITED ENERGY PERMIT FEES:
'RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
n Garage Door Opener* s y'
n Heating, Ventilation and Air Conditioning System* •
❑ Vacuum Systems*
TI Other:
COMMERCIAL WORK,ONLY:; •
Fee for each commercial $75.00
system , • ..
(SEE SOAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
E . ,Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
'n Nurse Calls ••
❑ Outdoor Landscape Lighting* •
❑ Protective Signaling
❑ Other ' -
•• _ number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I\Building\Permits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00510
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/7007
Phone: (503) 639- 4171 u�l"I
Inspection Requests (24 Hrs.): (503) 639-4175 U_
INSPECTION WORKSHEET FOR DATE: ti/15/2007 TIME: 7:01AM PAGE: 34
SITE ADDRESS: 07450 SW BEVEL .AND RE) 120 CLASS OF WORK:
SUBDIVISION: MCA OFFICE BUILDING LOT #: 027 TYPE OF USE:
PROJECT NAME: WEST SI SLEEP CENTER
DESCRIPTION: Ti elec. M edical
OWNER: IMiCCAFFER`( & ASSOCIATES, PHONE #: NA
CONTRACTOR: 'TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 603 - 459 -4089
Inspection Request Scheduled For: Date: 11/15/2007 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 059714 -01 \ 503 N
Corrections /Comments /Instructions: ,)
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6 te '% Mf 54 ma
3 53
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mO 410 E► NaL.
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I
(i ' ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
"_ ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i (0 (e LPL- Date: t'VI I� f alai Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007..00G18
13125 SW Hall Blvd., Tigard, OR 97223 :: , DATE ISSUED: 9/11/2007
Phone: (503) 639 -4171 �i�vd�in��ih1� �
Ins Requests (24 Hrs.): (503) 639 -4175 L.. �f .
INSPECTION WORKSHEET FOR DATE: 11/8/2007 TIME: 7:00AM PAGE: 34
SITE ADDRESS: 07450 SW I3EVELAND RD 120 CLASS OF WORK:
SUBDIVISION: MCA OFFICE BUILDING LOT #: 027 TYPE OF USE:
PROJECT NAME: WESTSIDE SLEEP CENTER
DESCRIPTION: TI elec. Medical
OWNER: MCCAFFERY & ASSOCIATES, PHONE #: NA
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS pAv_, PHONE #: 503 - 459.4009
Inspection Request Scheduled For: Date: 11/8/2007 Pour Time:
Code # Inspection Description Contact # Message
130 Ceiling cover 059273 -01 503. 849.9453 \ Y
Corrections /Comments /Instructions:
911 S L5
1 AV 1 ikM
MTG., 3a...0N,O.7,-, Pz-t -t a Z ?
Nt•,G®N 4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr 0 �d Date: , S/ J S' Phone #: (503) 718- 1— 1-1111A7
........; . ,.• ,
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELC2007•00618
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: ati1/2007
Phone: (503) 639-4171 '
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/27/2007 TIME: 7:00AM PAGE: 54
SITE ADDRESS: 07.150 SW BEVEL RD 120 CLASS OF WORK:
SUBDIVISION: MCA OFFICE. BUILDING LOT #: 027 TYPE OF USE:
PROJECT NAME: WESTSIDE SLEEP CENTER
DESCRIPTION: 11 elec. Medical
OWNER: MCCAFFERY & ASSOCIATES, PHONE #: NA
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 5034159
Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
----,,..,...
130 Ceiling cover 0- J6452-0 03.313-0331 Y
Corrections/Comments/Instructions:
\-\ ■A(L. Ct p .
PASS I I PARTIAL APPROVAL fl CANCEL I I NO ACCESS
I I FAIL 7 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: G N616 LE Date: c t '1_)j Phone #: (503) 718- .i)____
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007•00618
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2007
Phone: (503) 639 -4171 , �4
Inspection Requests (24 Hrs.): (503) 639 -4175 �.' W F:_..
INSPECTION WORKSHEET FOR DATE: 9/26/2007 TIME: 7 :01AM PAGE: 61
SITE ADDRESS: 07450 SW I3EVELAND RD 120 CLASS OF WORK:
SUBDIVISION: MCA OFFICE BUILDING LOT #: 027 TYPE OF USE:
PROJECT NAME: WESTSIDE SLEEP CENTER
DESCRIPTION: TI elec. Medical •
OWNER: MCCAFFERY & ASSOCIATES, PHONE #: NA
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 5034534088
Inspection Request Scheduled For: Date: 9/26f2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Will cover 056360 -01 503 -313 -0331 N
Corrections /Comments / Instructions:
wAL eye, 1e R ieNtO _
'At=4 ins ` V R c.AV fSc e
te:k W.T304--
cs� N ci'•/ \idUal 0 4 A
N c(au-
1A PASS H PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION . I I ADDITIONAL FEES ASSESSED
Inspector: ► `up E-G Date: 91 01 Phone #: (503) 718- 7,1446