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Permit !' CITY OF TI ARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00350 DEVELOPMENT SERVICES DATE ISSUED: 7/13/2004 13125 SW Hall Blvd., Tictard, OR 97223 (503) 639 -4171 PARCEL: 2S 110 DC -02400 SITE ADDRESS: 11565 SW DURHAM RD 100 SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING: C - BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical TI for medical clinic. 8/10/04: Add 200 amp subpanel & (6) branch circuits. 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: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 0 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 48 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: DOUGLAS FRY BOONES FERRY ELECTRIC INC 2423 REMINGTON CT PO BOX 628 WEST LINN, OR 97068 WILSONVILLE, OR 97070 Phone: 503 - 348 -2237 Phone: 682 -4936 Reg #: SUP 3170S LIC 88482 • • FEES ELE 3 -223C Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/14/2004 $319.50 [ELPLCK] ELC Pln Rev 6/14/2004 $79.87 Ceiling Cover [TAX] 8% State Surcharge 6/14/2004 $25.56 Wall Cover (additional fees not listed here) Underground Cover Elect'I Final Total $511.33 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 am 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: / Permit Signature: n 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 7:00pm for an inspection the next business day EIAug, 10. 2004n11:37AM�iic FERRY ELECTRIC No. 1236 P. 1 j FOR OFFICE SE ONLY City, oCrigard Received Date/B : Penni = No. :EL 12.125 SSW Ilan Blvd., Tigard, OR 97223 G , 2 O 0 4- - F6 5 Phone: 503.639.4171 Fax; 503.598.1960 Pla Review _ j��yP "' j I.. Date/ R Other permit: Inspection Line: 503.639.4175 �■i 1 Internet www.ci.tigard•or.us - .+ Date Ready/13y; ady/9y; 7ur r. See Page 2 for Notified 4ethod: rz43x ^tiir �r't,:i'*?� :� r °; r* ., .. i, .s:y _ Suppternentat Information .sti Wri ,ti.l' 7j.i i3aa� 77.47 l ' :•`:* i.0 , ;`4 y i,f . , i Si• ., 1 ,1 � 11 ',�?�.', i 7 �' t 3 .. '�j"iM'ci.. ;:; ti 4 i7,Mi PC,74t " iT i l l ' w , ru`Rj LT"Lyvs' r.T. �. :,n.m N eons Rz._.,. •.. - ..,::1��:.g A t'�' u . . kY ,6 ?�£ der .nl1:;.g '147 ;;;1. ' S } ? w tS i dt t, ;F- ,., • Q construction Addition/altera ch '? 3 '� { `; Uon / replacement Please cheek all that apply: � I:] Demolition © O ther: _+, ❑Service over 225 amps, comm'1 ['Hazardous location + iS'I4, •ri t7r x � 4. P.• t f : rY)7 d . \� tS d" rra i , g r, 1 M ri r • , " /, 4: � ❑Service over 32 c.i:21.4'..i`,T.44t .r..l}1:;i 4.� 3 rife 211 1 "`a5 �v2 n' A'S . atv •Q.r tntl•.f t �, :fLOA v'trv of 1- and 2-fa 0 Fs rating ❑ or more over residential sq. l 1- and 2 - « &.. zttily dwellings 4 or more new residential ❑ amily dwelling CommerciaUindustrial 11 Accessory building [JSystem over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ['Building over [1 O ther. 8 three stones ❑Feeders, 400 amps or more h tt ,� .' - a �i :v4` < c9ttld �� ty. �, # ('re�0 �e� k ' i,�s:p Ta �F 3 &"", .* vk "r4 .. DOccupant load over 99 persons ['Manufactured structures or i ryry�1 ° t y ,[ } 111 : . i S iCS .,�. noS.W x Sq.a t , !!.r $ � � ', , lta� �Li h 1 ,7 7 )S i t FA ,:} y k� �NF 3 t 4 P ❑ £aC2Ured s llC • , c -... 5.�sa 'a'`:.s: ln+sf s` , {..�z: t''�lalii� :�1.� D A. plan RV park Job no.: 6 Si Job site address: / / s6 S 574 Vttir u , Sri -e bo ❑Health -care facility ❑Other: City/State/ZIP: ' Submit 2 sets of plans with any of the above. ' Tile above are not applicable to temporary construction service. Suite/bldg./apt. I: ] r w �-1...... ;I r i:. X07 �. �a . n , ,: ,. ilo.: Project na s � � �;�"�` a:, t '" S - Lr c A (I Cross street/directions to job site: Des crtptr0" Qb Fee. Tote New residential single- or multi- family dwelling unit. • Includes attached garage. - _ 1,000 sq. ft. or less 145.15 4 Subdivision: E a. a dd'l 500 sq. ft. 33,40 or portion Lot no.: 1 Tax map /parcel no.: Limited ell h ,.. energy, residential 75.00 2 i �>M' F 'at�l�v i£K� r H 9 i ,.. r +: -;r: re /yS J,f L ,ds# :` l K, w •x Li m i ted 75.00 rY ..� - ..l �.. a'li s,w? ril, �{ r 2T. y �tli a�. tin ...:.,: v. to ` ;: is P * i v ` �i ✓ M , , k r z e nergy , ed o r eS o L 2 � ' - -•• -E5; G t x �:: t ..c i.,.Jf,1gr „/,, �,:�,y Each manufactured or m � `� �` G"" 1C+5 �or - ! J _ dwelling, service and /or feeder u4 ( `06r .°4.4 4i 011' 1 90.90 2 Services or feeders installation, alteration, and/or relocation b rte. (ce� S3ongs 200 „-. r£ ,,, �;c���r," - #"'`' -' �'t''t. .;:�'*.` �^ ��� amps or less Q a: t`''` �.;�?.:S]: }'.� ':�] •i.�7 � .e..., n�;t }�ti S;'.,eT ^i? '�2.','T�re� : _��y;;. r.;�r, : ) 80.30 U° in 2 /..a f; :7, .`Sj "yPc iw t1i f�• '"� w it" ;z;tf > i tt L '7 } � :; m:r : - 201 amps to 4 6 Name: , ,s r, :tt- C ti ,%: s. IP..,-1'i ?:'3s Ii: 3 ' !? .i:f»re1! ra. '4-.2.r...4,1 401 amps to 600 amps _ 106.85 2 • 160.60 2 address: 601 amps to 1,000 as 240.60 2 Over 1 ;000 amps or volts _ 454. 2 City /State/Z1p: Reconnect only 66.85 2 Temporary services or feeders installation, alteration, and /or Phone: ( ) Fax: ( • relocation Owner installation: This installation i8 being ade on property 200 amps or less 66.85 1 8 p perty that I own which is not 201 amps to 400 amps 100.3p intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 2 Owner signature: 401 amps to 600 amps 133.75 Date: Branch circuits 2 . :�i ^ 'ii f � ; ��'Y 3'• ,; '� , �_ r �u �, � ;•:. " 1; ; : w :, - ., .. --= m ,.,,. ircuits - new alteration, F - ;I `s 4 r^ �1� . h r ti.G: ;j�l- .': ,tr .. ::,�viY ,, :' .max„ :f55 ;� , n, or extension, per panel Wg4,.t..,:t :.a :: ,. •.;,t ±, >,t . r r ! +'i x$ ::,: F .:: z P oe �....s„ a• ✓. ' fi 3I - . E.:M �!,..d� +..,.�t �::. � �t lrt 1 5-�`!� � i��t���t '�� :� '� r SS:� A. Fee for branch circuits with p -- Business name: service or feeder fee, each branch circuit 6 6.65 3 90 2 Contact name: B. Fee for branch circuits withoul service or feeder fee, Address; each branch circuit 46.85 2 City /State/ZIP: Each add'l branch circuit I 6,65 2 • Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 13-mail: Sign or outline lighting 53.40 2 ?�' G `,, u r; M o y sg ? z n r Signal circuit(s) or limited - . i''i,1y,;t,f s..� il Z_ ..r1,rlL? ,M1.e?:,,. Cr+ 3;> G'S '� t " :3. ���., t.. f ,��C) -Ce it 'aci ��� , .� Ta : aP alters �,.., 1 .:. , a'L,,. - .x „fZ_...,..�.'� :� ` _,:st �r�.3� -pia _,��x_�P;�� energy P t10t1, or B.usinessnante: BOOries Ferry Electric extrnsion_bescnbe: Page 2 Address: P O SOX 628 2 8 Each additional inspection over allowable in any of the above City/State/ZIP: Wilsoniile 0R 97070 Per inspection 62.50 Investigation per hour (1 hr min) 62.50 Phone: (5.`03) 682 -4936 I ]Fax; (5 0 3) 682-7946 Industrial plant per hour MI 73.75 CCB Lic.: $8482 I Electric:t ic.:g R SS t `<lft�w�c?('a!i',tl,is 3J r, -'� 2 2 3 Su prv. Lie -: 1 S t w , .f . N 0 Subtotal j Z . _ ,' 1 Suprv. Electrician signature, re.0 Plan review (25% of permit A State surcharge . Print name: c a 8% of _ -U `i"1 I etZon Date: 9` 7- d arg ( permit Authorized Signature: TOTAL PERMIT PEE This permit a pplica tion expires if a permit is not obtained fined within 180 / Print name' days after it has been accepted as complete 7' Date: • Fee methodolo gyset by Tri- County Building Industry Service Bo i # $uildu:g 1 pM „ ;ss�C PertnifADA,de 12/05 - "" Number of inspections per permit allowed. 44046 I Sr(10 /02/Cptvr/WSS CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00350 c�l� DEVELOPMENT SERVICES DATE ISSUED: 7/13/2004 � 13125 SW Hall Blvd.. Tivard. OR 97223 (503) 639 -4171 PARCEL: 2S 110DC -02400 SITE ADDRESS: 11565 SW DURHAM RD 100 SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING. C - BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical TI for medical clinic. 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: 41 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: DOUGLAS FRY BOONES FERRY ELECTRIC INC 2423 REMINGTON CT PO BOX 628 WEST LINN, OR 97068 WILSONVILLE, OR 97070 Phone: 503 - 348 -2237 Phone: 682 -4936 Reg #: SUP 3170S LIC 88482 FEES ELE 3 -223C Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/14/2004 $319.50 [ELPLCK] ELC Pln Rev 6/14/2004 $79.87 Ceiling Cover [TAX] 8% State Surcharge 6/14/2004 $25.56 Wall Cover Rough -in Total $424.93 Elect'I Final This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspende. : = an 180 days. • TENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules - - set forth in 0A •52- 001 -I I i th e h OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 , .699 or 1-800-332-23 Is . ued By: ' 01L,,/,&j_j_i Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: c �� DATE: LICENSE NO: 37' 70 Call 639 -4175 by 7:00pm for an inspection the next business day Electrical P . lii ,�, . : .‘,f ! :. : 1•, Vf ` 4�'�t x � e r {rlyd "srr+ii+[+i�ni$iG ii�`*t`. t � i 4,1.4!: erit Applies ®Ili , {r `' ` ' 1 FOR OFFICE L•S O \Ll' � �NI lo'- -:::::.5:':.' Received Date/By: , ` �' E N � (.(�/O0 -�� DateJBy: (t/ Q ., Ptsrrrtit No :: O`�/ City of Tigard` • . Planning A( val , ' Si 13125 SW Hall Blvd. 10 _ Date/By: t6 Permit No.: Plan ,� Date/By: otter Tigard, Oregon 97223 r 1 r, N y Permit No.: Phone: 503- 639 -4171 Fax: 5 03=598 1960J Post - Review La g /`11 ,� i." t Land Use Internet: www.ci.ti ard.o n \� D 't! II - I Date/By: case No.: 24 -hour Inspection Request:� -639 4175 t�' - Contact i See Page 2 for Name/Method: / ( Supplemental Information. ,_ , Q New construction ` - `, .',,,•-•:. �!'(Ple2"�ec�ieck'all;�tiaf aPPIY� =` -:� :' • ❑ Demolition ( ' Service over 225 amps- ealth -care facility Addition /alteration/replacement l 0 Other: commercial azardous location �_ ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet, ::: '; : ;CATEORX `.OF<,CONSTRUGfON : • ; ,,; ; •` :: ; I & 2 family dwellings dwelling .. ZC y four or more residential units in ❑ 1 & 2-Family ommercialandustrial ❑ System over 600 volts nominal one structure ❑ B ❑ Accessory Building Building over three stories g 0 Multi- Family ❑ Manufactured Lure amps or more ❑ Occupant load over n 99 persons ❑ Manufactured structures or RV park Master Builder _ , ❑Other: ❑ Egress lighting plan ❑ Other. '_:'.. ..i:; ,.;4OB:STTE 3NF0' Submit sets of plans with any of the above. Job site address: f I s 6 s sly r-7 R d The above are not applicable to temporary construction service. Suite #: 0 , . .. �r f e ` .•' G D i ,.y._ / 0 I Bld /A #: �7I 4t i{ "� Number of inspections per permit allowc, Project Name: /7 S h W i •\ V .l` Description Qty Fee (ea.) Total Cross street/Directions to job site: New residential single or mn1U family per dwelling unit. Includes attached garage. Service included: 1000 sq. ft. or less 145.15 Each additional 500 sq. ft. or portion thereof 33.40 Subdivision: 1 Lot #: Limited energy, residential 75 00 Tax map /parcel #: Limited energy, non residential 75.00 4 . ., :u , . _. __ '.:'-;;.i,_. . �._._, . .� Each manufactured home or modular dwelling .; ..:.::: .:: :.!'-.'' :. � ; S)OR service and/or feeder 90.90 '.CIE T. I {. - PQ--n T d i Services orfeeders - installation alteration or relocation: 200 amps or less 80.30 201 amps to 400 amps 106.85 ? RAPER m 401 amps to 600 amps ¢ P 74 c " `j 'F� 601 am s 000 am 160.60 cuit _.1.��=- ���,- ':'�y,r P to 1 ps 240.60 ' Name: �t b� _ Over 1000 amps or volts 454.65 Reconnect only _ 66.85 Address: Act 1 0^(71 Ox Temporary services or feeders - installation, City /State/Zip:( y 5 1-- 1 ,J1.1 oil 7 alteration, or relocation: �� 200 amps or less 66.85 • Phone: ' €—� a2.- Fax: 201 amps to 400 amps 100.30 APP IC° c3i r 401 t0 = I, .: .f : f �s i O' N tT4 ' � V' R :41 -1 � 600 amps 133.75 Branch circuits - new, alteration, or Name: extension per panel: Address: A. Fee for branch circuits with purchase of service or feeder fee, each branch circuit 6.65 City /S tate /Zip: B. Fee for branch c without purchase of Phone: Fax: service or feeder fee, first branch circuit • / 46.85 L 6. 9 S _ Each additional branch circuit tl I 6.65 47.2 , 6 r, E -mail: . ;;� t4 v C' Misc.(Service or feeder not included): laded s» : ,..ni" . A ;.: i jug.i,f ` .+ Each pump or irrigation circle 53.40 `r:: Each sign or outline lighting Job No: - x g 53.4 Signal circuit(s) or a limited energy panel, Business Name: Boones Ferry alteration, or extension Paget E l e c t r i r Description: Address: P.O. Box 628 City /State /Zip: Wilsonville OR 97070 Each additional inspection over the allowable in any of the above: Phone: f18 = 4 9 3 6 682-7946 Per inspection per hour (min. I hour) 62.50 Fax: Investigation fee: CCB Lie. #:88482 I Li #: 3 -223C Other: Supervising electricia " ' I � '�" +1 t.:� P g . hr ca e' mlf 'ees„, sarij: , e :, F ?: -Y signature required: Subtotal $ 3/9 • s 0 f 7 Plan Review (25% of Permit Fee) $ 7 9. 8 7 Print Name: He r r or>} L . #: S J `,� r) State Surcharge (8% of Permit Fee) $ L S . S( t Authorized TOTAL PERMIT FEE $ y'L 4'. ' 3 Signature: Notice: This permit application expires if a permit is not obtained within Date: 180 days after it has been accepted as complete. `Fee methodology set by Tri- County Building Industry Service Board. (Please print name) is \Dsts\Pemut Forms \ ElcPermitApp.doc 01/03 S d 0 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested ` — V AM 7 2(- PM BUP Location J • .2 Suite /00 MEC Contact Person / Ph ( ) 682- t V'73 PLM Contractor /&>V Ph ( ) SWR BUILDING : Tenant/Owner D � ELC 2a* — Z Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: / SIT Post & Beam / / W� 3U /LJtN Z 1 Shear Anchors r7 Ff� L. -dGt. :Exf Sheath /Shear Int Sheath/Shear • - �) Framing Insulation Drywall Nailing 1` 1 J F// V4t— Fire Fi rewall Fire Sprinkler Alarm Susp'd Ceiling � t Roof Other: Final PASS - PART FAIL PLUMBING Post & Beam Under Slab - Rough -In Water Service • Sanitary Sewer Rain Drains Catch Basin 1 Manhole Storm Drain Shower Pan Other: _ Final - PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRIC AL i Service Rough-1n UG /Slab - Low Voltage ri re :larm Fir - Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ' PART FAIL SI Please call for reinspection RE: n Unable to inspect - no access Fire Supply Line � ADA l t� (- ^� L636 V Approach /Sidewalk Date ` Inspector EXt Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL • Worksheet 5a Project Name: Dr. Schwitidt Page: • LI GHTING SCHEDULE it) lame � � r F � , � • It) Is identification � � ,F ? (c) , (e ) number or inner `.ID '' Type o Lamp'l ballast Description Power (W) used in your plans Or spsclfication: A Oft Rapid Start T8 V 3 - F32T8 1 - ELECT --- 93 * Enter the . C tbmpact Fluorescent Twin 2- CF13W /G23 1 -MAG STD number and type of . G Incandescent 200 watts lamps in the 200 IUmineire, See M 12 Volt Tungsten Halogen MR16 'V 1- Q35MR36(12y) 1 -ELECT Table Sb for typical lamp codes UC M Rapid Start T8 V 1-F3218 1-ELECT ' 3 " Enter the NONE 'V - number and type of - NONE ballasts in the NONE iuminaire, For 'V - fluorescent and high intensity v discharge lamps. — v Wattage typical • Wattage ■ abbreviations are v Wattage MAG . for , s Magnetic Standard ■ Wattage . , v MAG EE for — V Wattage Energy Efficient �rtg • Magnetic r ■ ■ Wattage ELeer for ' Electronic v Wattage ∎ Wattage w See Table 5b for = Wattage other ballast V abbreviations v Wafts � i v Wattage v -- Wattage Wattage v • Wattage Wattage v L • Wattage ■ " IWattaq User Defined Factures but S mu st be included to verify wattage of complete luminaire © . P. Fi a C}est iption z p Worksheet 5a . .0,5,..,,,,, Dr Homo I ng 2001 6/11/2004