Permit r. CITY T Y O 1 TI CARD ELECTRICAL PERMIT
;,,F, �i PERMIT #: ELC2004 -00113
�
DEVELOP SWOP M ERo ICES (503) 639 -4171 DATE ISSUED: 3/10/04
/Z oZ s PARCEL: 2S101 BB -01500 friall
SITE ADDRESS: .W GA DEN PL BLD.1 ZONING: C-G
SUBDIVISION: CROW PARK 217
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: Panel relocate with 15 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: 15 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 OOCC:
Owner: Contractor: Tja- -n rr{u
SPIEKER PROPERTIES LP MILESTONE ELECTRIC
4380 SW MACADAM AVE STE 100 2056 NW ALOCLEK #35
PORTLAND, OR 97201 HILLSBORO, OR 97124 ,
Phone: Phone: 503 - 645 -5323
Reg #: ELE 34 -618C
LIC 153480
FEES SUP 2113S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/10/04 $180.05
[TAX] 8% State Surcharge 3/10/04 $14.40 Rough -
Elect'I Service
Total $194.45 Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Speaalty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 32-234
Issued By: a Permit Signature: /� I'' / . � � �
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: (9-1
< 5
Call 639 -4175 by 7:00pm for an inspection the next business day
Elec rical Perm't A a 1i _Con ' Received Electrical
Oatr/By: .- 1/1 - .. 4 // 0 Q ` f Permit No.: 07 d a // 5
City of i and Planning Approval Sign
g Date/By: Permit No.:
13125 SW Hall Blvd. MAR 1 0 2004 Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax:C (�g0- i! RD Post - Review Land Use
Internet: www.ci.tigard.or.1BWLDING DIVISI e , � I j` Contact Case No.:
:'I � Contact Juris.: i.� Scc Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: rti Gj Supplemental information.
- .:,; •,• �: .. ,,r1 fl. �: " :•. �; :'T�EkOP'i -W.O ' ��,: • ; i'
m •�,..: 7N, i, r.•
' . RK; „a a, i,,, :,t,. 2:i...cJ:l;;,::,v . iii.. I'LAI� REVIEW: (Plea' cEilil4,th$t°AppY3') ; ,, ,s..t,. ,4 -.,;:-.'•
• 1 Ne w construction r] Demolition 0 Service over 225 amps- D Health -care t cility
,- commercial ❑ Hazardous location
ddition %alteration /re laceftlent ❑ Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
0 5 " iiir∎a j ;Ng 111fi ORRy OF'. • ONSTRUCTION' .O!iti ,I.1 :; , :S; 1 & 2 family dwellings four or more residential units in
El 1 & 2- Family dwelling ommercial/industrial 0 System over 600 volts nominal one structure
Accessory Building Multi-Family ❑ Building over three stories 0 Feeders, 400 amps or more
_ 0 Occupant load over 99 persons ❑ Manufactured structures or RV park
. Master Builder j Other: ❑ Egress/lightting plan Q Other:
N „ :Li 4!1 .. il�G 001i$ --EO T10NG; n''d LOCATION;I,I '.;- , Submit sets of plans with any of the above.
Job site address: .222.....S-41 S, W / The above g ate not s ara
p
cable to lem ry construction service.
/L.a / '4:;iq . A4 Ylteit:.fg'yh0 �i it eVt t ,, 4' P3w"' i'l:' . 1'f tin
Ii Suite #: Bldg. /A t. #: Number of inspections per permit allowed
Project Name: O- c.. re/ tc�� Description Qty Pee (ea.) Total
New residential - single or nwlti- family per
Cross street/Directions to job site: dwelling unit Includes attached garage.
Service included:
� � 1000 ft. or less 133.10 4
�( additional addinonal SW scLft. orportion thereof
33.40 1
Limited energy, residential 75.00 ' 2
Subdivision; ___I Lot #: Limited energy, nonresidential 75.00 1 2
�� n f� � .S �,! Tax ma • / ► arcel #: ;y Each manufactured home or modular dwelling
Wi l I C , ill. p %,Yl no „ service and/or feeder 90.90 2
;� , � On ,• '' "�i'iyi :.- !': m'�. s'sa'W &d
Services or feeders - lista/lade ,
e (o C.P./ P- ►i.! -1 4- c i lam;..- alteration or relocation:
01\11)
200 amps or less I 80.30 d v 2
201 amps to 400 amps 106.85 2 •
�! 401 amps to 600 amps 160.60 2
Kr127 'W�'y rt,:.(it 11Ni��? i�! Z ills
1 ;1- I i vl 9'Y N p P. _' " " ',.J " J 601 amps to 1000 amps _ 240.60 2
Over 1000 amps or volts 454.65 2
" . i -
��' u
1 1 a R econnect only 66.85 2
Address: 77-c 4r, 7�-,_ Sf t flo ‘20 Temporary services or feeders - installation,
alteration, or relocation:
City/Statc/Zip: pip-14
6.- 2! -2J— 200 amps or less _ 66.85 1
Phone' i -S333 Fax: 201 amps to 400 amps 100.30 2
y ,,,, ,,. 401 to 600 amps 133,75 2
1 li i. PI ,�?!�.. ''�'it it^ a ny `rk 0 R ?S! Elhl "i r ' NI Branch circuits - new, alteration, teratlon, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit
purchase /S 6.65 9 r ?
City /State /Zip:
B, Fee for branch circuits without tuchase of
service or feeder fee, first branch circuit 46.85 2
Phone: I Fax: Each additional branch circuit 6.65 2
E-mail: Mitc (Scrvicc or fonder not included):
} ^ ill ,t 1 a a, It M , Each pump or irrigation circle 53.40 2
IN ..� ,�`� Ya.�,°d. ,� J�f!i�!� �i'�'• . 9 .3. A '.r. 1 ,: L rk< J'4•,- :•�'. ,.
Job No: Each s or outline lighting 53.40 2
Job iV o: Cs Signal circuit(s) or a limited energy panel,
Business Nanle: ` ` alteration, or extension Pge 2 2
/"'! /fir tl' Descnption:
Address: 2,074' , /1 /nclek Lr. ,,S y- s 4
City /State/ZIP: / �/ � Q � , / Each additional inspection over the Allowable in any of the above:
y /��` � �� fJ n rr (1�Z�t Per inspection per hour (min, 1 hour) 62.50 •
Phone: 74, , - it Fax: 57,3 - , • / —i Investigation fec:
-
B Lic. #: ` / Other,
- • ';� in,� ^ ,�,u d it i il� pH�t � � '. r
„'' , i ., 1•i!t � >2«a,l,-•• : •os �.g 0 j . 1CCt E ",, G.'. ,. ,-- :,,i., �r I j ' y. :.....∎ :l71.i'���:6,..,;'t{
Supervising electrician
/� I�� J25% of Permit Fee) $
j ''�
Plan Review Subtotal $ At .
signature required:
Print Name: . j „ � Ltc. #: State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $ / £,r
Authorized ,1/y _
G ad - Notice: This permit application expires if a permit is not obtained within
Signature: /� i Date: 3 /O — 0� 180 days after it has been accepted as complete.
• *Fee methodology set by Tri- County Building Industry Service Board.
. / i "_
1 rriglJ
(Please int na
I:\Dsts \Permit Fumrs \L•1cPenrutApp,duc 01/03
£ d 917OZ£Zlll9'ON /9 '1S /9 t00Z Ol £ (03M) NOd
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
p , �� / BUP
�
Received a Date Requested � ` , �� AM PM BUP
Location / Z Z" S SZ �YCJ(14 CL - ,--e Suite / MEC
Contact Person Ph ( 97/) 4 J7'1 PLM
Contractor Ph ( $D
BUILDING Tenant/Owner C 44z 1 /
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam a-te- �
Shear Anchors (� 734.6,(7f,
— -Ext Sheath/Shear -
Int Sheath/Shear
Framing t�✓�'i� ✓/`��% A fir%' iLc� riG /�
Insulation
Drywall Nailing C�� G��G�' G dr✓ /',� d �/
Firewall
Fire Sprinkler �'�' `��' —� �,r., L �/' ��=��1' l}
Fire Alarm
R Ceiling
Roof
Other:
Final '/— !t� ' C) .'
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In h
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 r
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
I. arm
r PART FAIL E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA /
Approach /Sidewalk
Other: Date l / iC G V� Inspector pj Ext
`
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL