Permit CITY O F TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT H PMENT r SERVICES O � 639 -4171 DATE ISSUED: 3 -00332
13125 ED: 2% 8/04
SITE ADDRESS: 10575 SW CASCADE AVE 120 PARCEL: 1S135BB-00501
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Relocate (2) thermostats.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
AMB PROPERTY L P MCKINSTRY CO.
BY TRAMELL CROW NW INC 5400 NE COLUMBIA
8930 SW GEMINI DR PORTLAND, OR 97218
BEAVERTON, OR 97008
Phone: Phone: 503 997 - 0234
Reg #: LIC 40981
ELE 26- 1190CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 2/18/04 $75.00 Elect'I Final
[TAX] 8% State Surchar 2/18/04 $6.00
Total $81.00 MKPOlr11LSD
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 throuc
Issued by Permittee Signat e , tie e
6 -
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 7:00 P.M. for an inspection needed the next business day
, - OC1-22 -2003 14 45 MCKINSTRY CO 503 331 6906 P.03
Electrical PermitApplication I. 1:
Date received:r 0 J 44 Permit no. : ,r 03 0D
"'
.!, city of Tigard P roject/appl. no.: Expire bate:
City of Tigard Address: 13125 SW Hall Blvd, TigREGEIVE IF ate issued: M Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
OCT 27 2003 �� �` //z//03
Land use approval: `.
611111•L•1illlreF_\ :1!
'1 Pt 0: Pl. : :: 111
❑ 1 & 2 family dwelling or accessory Irrommercial /industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial N
.1011 .si I I. 1 \FORM \111)i\
Job address: /0515 k, $CA( , LV f) Bldg. no.: Suite no.: Z) Tax map /tax lot/account no.: 1)
Lot: Block: Subdivision:
Project name: C . Ave Bt-D(. Description and location of work on premises: ► EL,p T 2 T I 11O STA -TS.
A Estimated date of completion/inspection: /0 -30 -03
- ('0 \.I R A IOR \I'I'i l VI ION 11.1. S('11I:1)1 I,1.:
V ' Job no: G /- I �F Q
. � Business name: kiNg Cy. PRI n)
-r Total
Newreeldent l- slogleormultl- budlyper
C n � \ Address: .r Al/E ' • Ai Q A s, _ • dwel11o6mtLIncleareattacLedptage-
City: PO .t- 714 State: ONCHN,111 &niceleckded;
<` phone: ` I(x;' Fax :33 / 406 E -mail: CCB no.: Elec. bus. lic, n0: ZCm' e L�'l Each additional 500 sq. R. or • •rtion thereof �_
!/ O t;,m ;red. rea;derteal __ 2
' c) City /metro l ic, no.: / / : • /o - l - 0,,i' Unshod energy, noon- rts;deoaal MEN 2
__A _ - e ,, . j, .►s., i 10 - z-o 5 Each manufaerwnd home or modular dwelling
gna . o a ,.!' stn_ el- .'clan .aired Date Service and/or feeder .1.1 2
?
Sup. elect. name (print):. • gs/17O./ $ lieeoae no:227441FR Servlcesor feeders - ImtalLttoo,
alteredon or relooairm
I'IlO1'I':R`I'1 u11 i\l'k 200 amps or less 11111 2
Name (print): 201 amps to 400 em., ___ 2
Mailing address: 401 ■ ,. to 600 am ___ 2
601 amps to 1000 sm•< _MI _ 2
City: State; ZIP: Over 1000 am•s or volts ___ 2
Phone: Fax: E -mail: Reconnect on1 11711111 � 1 l ` -
Owner installation: The installation is being made on property I own Temporary services origami -
which is not intended for sale, lease, rent, or exchange according to idd lre1d'0°�6rre1ee dot : .
ORS 447, 455, 479, 670, 701.
201 to 400 , IIMMIN _ 2
Owner's signature: _ Date: __ 401 to 6i00 em•s ___ 2 ,
1 \(.I\L: ,lt Broach clrculb- new, atrentloa.
or extenrloaperpeneir
Name: A. Fee for breach circuits with purchase of
�1 Address: service or feeder -- each branch circuit 2
, \ y City: State: ZIP: B. Fec for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit ■■ 2
Each additional branch circuit: __
I'L\I\ Ith.\'It:IV(lyc ;t.' clncrl, all Ihal apply) Mtge. (Service or feeder oat Included):
a ❑ Service over 225 ampeeomrnertial ❑ Heolth•eare facility Each pump or itri • . ∎ • n oink ■■ ■
O 2
CI Stmvioe over 320 rungs raring of l&2 O Iiazerdo location ware s'! or outline lighting ___ 2
\
fam ily dwel lings p B uild i n g over 10,000 arc feet four or Signal circuit(s) or a limited energy panel, _■ ■
❑ System over 600 volts nominal mom residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more •Dcacri.tion:
O Occupant toed over 99 parsons ❑ Manufacturod anuctsunt or RV perk Each additional lmpecdoa over the allowable loamy stale above:
❑ Egress/lighting plan 0 Other:
Per ' _ — _�
:. -lion
Submit _ sets of plans with any of the above. loess: aeon for
The above are not applicable to temporary construction service. Other
Not ell ituitdiaiona accept credit Permit fee $
•ccep ands, *am all )udadktion for more Intbrmation. Notice: Thus permit application
❑ visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ a /e) S
•
Credit rant number: / / within 180 days seer it has been State surcharge (8 %o) ..--.S _
entree accepted as complete. TOTAL $
Name oft ffeatdIsoldor as shown on credit card
S
Cardholder signature �imount 440.4615 (6/00 /CAM)
CITY OF TIGARD 24 -Hour `"
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • ,Business Line: (503) 639 -4171 MST
Received Date Requested BUP AM PM BUP
Location /6595 J--A-4-d-01-66--- Suite / �O MEC
Contact Person Ph ( ) PLM
Contractor [ ��l.t� Ph ( ) 5 7-- �� SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR 3'3.
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Sr Anchors
Sheath/Shear
Ext eah/h
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall -/ s
C_O
Fire Sprinkler 1 `- /
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
E ` e :1 L
S
Rough -In
UG /Slab
Lo jolt -•e
Fi - arm
fi nal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• SS PART AIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL