Permit . ) 4'
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00866
DEVELOPMENT SERVICES DATE ISSUED: 11/312005
I I- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112AB-02300
SITE ADDRESS: 14150 SW MILTON CT ZONING: I -L
SUBDIVISION: BONITA INDUSTRIAL PARK LOT : 005 JURISDICTION: TIG
Project Description: (2) 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: SIGNAUPANEL:
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: 1 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:
SHEININ - MENDENHALL LLC I LIGHTWORKS ELECTRIC CO
BY PARROTT PARTNERHIP 19290 SW CONZELMANN RD
12725 SW 66TH AVE #202 SHERWOOD, OR 97140 •
PORTLAND, OR 97223
Phone: Phone: 503 - 625 - 1953
FEES Reg #: LIC 158595
Description Date Amount
[ELPRMT] ELC Permit 11/3/2005 $53.50
[TAX] 8% State Surcharge 11/3/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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 -2344.
Issued By: ":277,6), Permittee Signature: 5p .. . O
• OWNER INSTALLATION ONLY i
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 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.
11/012005 17 :15 5036252890 LIGHTWORKS ELECTRIC PAGE 02/02
a. I C�)r�Ca� Permit Application FOR OFFICE USE ONLY
City OiFTigard E CEIV D Received — _ �,�/_ .
13125 SW Hall Blvd., Tigard, OR \•/ D' L , . 11
,c ..: . r Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1 • , ' I r l � Da to/ n : Other Permit:
Inspection I,S 503.639.4175 N11 " 7 2005 ■ • t'TI I Date •
ReadyBy: la Sec Pogo 2 for
Internet: www,ci.tigard,or.us No a Notified/Method: Supplemental Inrormat;on
i4,'�bt'r4,'r1o1i11A, f+Il „�� 111J. { ; vst i rtnt� ;r jm�ar �iltV �tilj'�i'7^'. a'�i -a
,{ t�l 1 . 6, t1 :1 , I :4 i+. ��.� .1 1.1 _ES 1 1i ii �r1 0 . �t...0 1 u.:'l:Pd�l i.. ��ri lid. j n:�41',k Iu�'l
. ,,.: I :t, , • �. y .x r g 1 ..
❑ New construction
�.tL x4i..V.11��1.t rj _:[:r r. S �J,,.. �. tl,:• .� •t,J.�.ft1Li>j, ?.Jrl���._.�; t�1k. ��'. ti ^r il`�;C..�9.c��,1.�+!1:.�4l:tl irnl+(��, Iri l� �f��� l+ . , a< �i l�� r , �/� 611' al �t- aol• . ,o a ,.. '. .
1 ,�.+� ��i91L J. � _i �� { .,,. n�.{:i� ?+: or''�ur`dl !�vkui� ha, .l'vr :Y, -.. � } .
�1� t • t i n - :cent Please check all that
��raBr� apply:
❑Service over 225 amps, comrn i ❑ Hazardous location
1:1 Demolition C] ether;
4�; 5!�a } 6�'' it :•�ril�f•411'lT.t(�'',[ilR[{.'�.,, r l + r, yf 0p, t ;} "r�i �T .Y�' 'r` ( /�i
`,• �rJ I � .,l ,i- ,, r !(,.�,�'*, �e•.I�i ❑Service over 320 amps - rating ❑Bulldog over 10.000 sq. ft.,
r.J7Sl'¢ ,.I dot °_��ll!.:urd. -.. "! 4,1n 3�ti..I. .„ ,!µ`.r3` n� ;:,t{;p4jf . ,4 ,,:,,„'� (hll. � E "ail. ,,, :, `•f,,Jj in "II ,.,AiAt, of 1 -and 2-family dwellings 4 Or more new residential
0 1 - and 2- family dwelling jaComnictcial/industrial LI Accessory building ['System over 600 volts nominal unit in one structure
Multi family ❑Master builder 0 Other; ❑Euildmg over three stories ['Feeders, 400 amps or more
v° � riyr,t •;? .i - ,ic;;r !r . c;1rl, -rr m,- , rrt;sr rrr,e:: ;::,lr l : •� ,r ,n: �r. , . x ., ['Occupant load over 99 persons ❑Manufactured structures or
r.'1 } . 1 L4r1,1ii;� l 5+W . ' 1 �.� 1 1 : v . .� � f '� 3f t JI LI i I. G�i t n llt � r'i r ai � t �� 1 v �1 71 , RV. park
iii ."53.i1,'L I.. :,: i'F1:b, G c 7t.{ . J u. I Nteh. s,. v,r.. ,. }� jfi,1 I .i .at 'l ❑Egres. plan
Job p
o .it:�C.1�
no.: Job site address: � � ` S V 1 ` � 01-care facility ['Other:
Submit, sots of plans with any of the above.
City /State/ZIP: Tr od c 0 ( • ! The above arc not applicable to temporary construction service,
5uite/bldg, /aptno.: Project name: ' • I �/A 1 /i✓� ij. Pligl il l` J ? °� ° ; !•4�' r , : ..):
0 t u l ; -t i_i�ir 91L. I u"�ti1Sl 3Il}tn%7:� r °i4-�u L .•ll r.' ,N ti r;••:'
Lk Dercrtpdnn Qty. Pee, Tolnl -•��
Cross street/directions to job site: 1 U 4—u, .1 New residential single- or multi family dwelling unit.
Includes attached garage.
1,000 sq. ft or less 145.15 4
Subdivision: n W , r Q(/i~ Q(4_,fryl Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 • 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
+Wl'. t,� ri , n r li '+/ r��, . p•� ,r. .rc rr -ti +s : [ ter t• Limited energy, non - residential 75.00 2
1 ` ; } rJ r1 '' 7 �}i rllf;. PFI ' I rt(*t EEf rrit �s 1m1�..cin 'Si'� ��5;:4u� - «.w IS, L rg,r lrltUil,� r
f.uk.e:? ,9 ,., :. �.: � �,�.; a��.f.�. , �., -•. + 1V � r Each manufactured or modular
,. , � n _ ? p ,,, ,Q U dwelling, service and/or feeder 90.90 2
. I I Y t•() (J(, Services or feeders installation, alteration, and /or relocation
I II i h. .L'V ■ ,, 5:0 UVCde 200 amps or less 80.30 2
�h�i {! ;4jyi�rr;�sq :gr. ?, ;JT'd J,1 •';'-;r"1• -+, Fit's �i hie li s7rF"i,w 1 .!'[r r nr, +
lit'` tlr 'ctlE!tia.;,.,•''line"� a �iif,Emil."1.44 �/��!�t�� 1.il 111.,l' �i 1 1. !n �•,`n ,r r„l 1u141 201 amps to 60 0 amps 106,85 2 •
u3^Wf, is .." Yt�.r . iv 1 ��+u.a3�lSaNl ht -. fu n 7 ' J I �i l .�n_.f. P,;.1� 401 amps to C00 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 1 _ 454.65 2
Reconnect only ' • 66.85 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
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 600 amps 133.75 2
Owner signature: e , te:
1 � ,} " ,r , , n r• T Branch circuits- new, alteration, or extension, per panel
f t;' r11 }Sb1, ! + 'l'OP4S11} :l. fi ` fs c y(�� tt4K'f lei Y,.,,r1,W. •l;.tl' I7�f.- .. �,m.+'�j7i'y �r
,U1 /6 Q `('1 I
!.tt,1 '.,.''! r ,rC r - /� -1• ,i 7-i�tli , 1 .. ,,Liu,, y+,M.1.�,?1�i'��::L1u� c,�Pe�40_��11��?o, °DJ�i Plfd +� 1{} VjtR•�t�. /�, Fccfor branch circuiu with
`" �”' "" i '' ' ' "' service or feeder fee, each • 6.65 7.
Business name: li‘T.A branch circuit
Contact name: B. Fee for branch circuits
Awe* ti r
B. without service or feeder fee, 1 46.85 yi,, 85" 2
Address: each branch circuit
Each add'l branch circuit ` 6.65 (p 5 2
City / State/ZIP: Miscellaneous (service or feeder not included
Phone ( ) Fax; : ( ) Pump or irrigation circle 53.40 2
E - mail:
Sign or outline lighting t 53.40 2
Signal circuit(s)
r'i..; is ;= � "" ;yiq�t:: ^,1���!"!"� �,y ^; n.�..�•s ���+ ,, r.,-, (3� I ITCUIt(5) or limited-
II :� }�:! , }'I' a. trq t � c( �i l jrumA1 •lr�UR t1�� }4Ii' IifC( li tI�G�K , l4E , E ~ j±a {
1 "rS;1'`�r.4 energy al
ion- +�'L:.a�ut:,�Cl.i1' /j,. ..,',j.'$tSi�1911�ir ikl, 41� �.i: ro. r�ciMF .�n•.irliLi.C.t�l...lJ,�'i EYa.I''L� {a:11 h�k�lluullYlS��4�1. 1: 17.', I��iNi +,.1Y�,11.1i��rJ1�11rl:.rrll g Yp an , tCratlon, or Paget 2
Business xxamc: (' ha, OA S extension, Describe:
y.! _em ��J
Addresq: • • ' a , 1 „' A � Each additional inspection over allowable In any of the above
!/J 0
City /State /ZIP: Jay i ,� D Per inspection ti . ati 62.50
7 � � Investi • ation per hour (1 hr min) 62.50
Phone: 62 . 4 K - 563 ) '/ 'g xn' r Fax; ( Q Industrial plant per hour 73.75
��.. -.,.�yq.�•1:.T}',, ,. r, ".q:K,..., ..,,
r.n "rrq Ii'r, G1LtIn,�C�er— e1! 1� �k' �. 1 Wf!R -Er7 'yy1 i . .
EMISMZIMIEZEICEMIll SupTV. Lie.: 3 I �Fr 1n,::,'_ �r' 4 P`.... ,..L�;
c - Al, Subtotal 5-6
Suprv. Electrician signature, required: 1 / p I Cs't. Plan review (25% of permit fcc) --
Print name: R a _ 4 9 _ Date: fir_ 05.- Statc surcharge (8% of permit fcc) y,
Authorized si ature: "O r / _ TOTAL P1tYtMIT FEE 5
_ ,. , .,,/ .. ' !�.�./',,,g (ytfw() This permit nppiteatlnu expires If n permit it not obtaine within t So
Print name: / days after it has been accepted as complete
14 1 .. 1 0C . lis•I r Date: 1 a �Q - .Fcc methodology set by Tri- County Buildin Industry service Board
'• Number of inspections per permit allowed.
IM olding •PermltApp,tlee IZ/O, 440.4615T(10/02/COM/wEt1
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC200E- 00666
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/31200b
Phone: (503) 639 -4171 aa
Inspection Requests (24 Hrs.): (503) 639 -4175 ,' " I I..
INSPECTION WORKSHEET FOR DATE: 12/27/2005 TIME: 7 :03AM PAGE: 44
SITE ADDRESS: 14150 SW MILTON CT CLASS OF WORK:
SUBDIVISION: BONITA INDUSTRIA, PARK LOT #: 005 TYPE OF USE:
PROJECT NAME: NW MEDICAL TEAM
DESCRIPTION: (2) branch circuits.
OWNER: SHEININ - MENDENHALL _LC I, PHONE #:
CONTRACTOR: LIGHTWORKS ELECTRI . CO PHONE #: 503 625 - 1963
Inspection Request Scheduled For: Date: 12/27/2005 Pour Time:
Code # Inspection Description ■ onfirm # Contact # Message
199 Electrical final W4007 -01 603 625 - 1953 Y
Corrections /Comments /Instructions:
('■% 01-.
"IAPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � ' ` � Date: %
��,�(,�,,�
p Phone #: (503) 718- " A ' V