Permit CITY OF TIGARD ELECTRICAL PERMIT
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PERMIT #: ELC2007 -00324
COMMUNITY DEVELOPMENT DATE ISSUED: 5/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102CB -02300
SITE ADDRESS: 13240 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 008 JURISDICTION: TIG
PROJECT: WEST SIDE SURGERY CTR
Project Description: Refeed UPS (per specifications) adjacent to surgery suite.
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: 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:
PACIFIC PROPERTIES STONER ELECTRIC
BY MARTIN JOHNSON • 1904 SE OCHOCO STREET
13200 SW PACIFIC HWY MILWAUKIE, OR 97222
TIGARD, OR 97223
Phone: Contact #: FAX 503 - 659 -2824
PRI 503 - 462 -6500
FEES
Description Date Amount Reg #: ELE 26 -122C
[ELPRMT] ELC Permit 5/10/2007 $46.85 LIC 44823
[TAX] 8% State Surcharge 5/10/2007 $3.75 SUP 3496S
Total $50.60 REQUIRED ITEMS AND REPORTS
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: . /A/ / „ '// Permittee Signature: SU__ /1�oOh'CQ {7yt 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 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.
05/10/2007 15:05 FAX a001
•
• Electrical Permit Apuhca ioY przr‘r-11, U • FOR OFFICE USE ONLY
Da Permit No.: "� -- a •
City of Tigard MAY 10 20I oa6B : 5 ,
13125 SW Hall Blvd, Tigard, OR 97223 �� Plan Review Other Permit
Phone: 503.639.4171 Fax: 503.598. T+ l / ' r ill D° � : Si See Page 2 for
Inspection Line: 503.639.4175 11 j t,. _�'._ — Need Supplemental Information
Internet: www.ci.tigard.or.us Ff T
p PLAN.: REVIEW.. • TYPE OF ..: I. .:
n Please check all that apply:
❑ New construction Ile Addition /altetadon/replacement ['Service over 225 amps. comm'1 ['Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF 'CONSTRUCTION ...- of I and 2- family dwellings 4 or more new residential •
❑System over 600 volts nominal units in one structure
El 1 - and 2-family dwelling Commeroial/industrial ❑Accessory building ❑Building over three stories [Weeders. 400 amps or more
❑ Multi - family ❑ Master builder 0 Other. ['Occupant load over 99 persons ❑Manufactured structures or
❑E>� RV park
JOB SITE IIYFORMAT[ON :ANT)` :I:OCATION.. : : 1 8 1 itiOgplan
Job no.:5.425Ks I Job dde
❑Other:
site address: ? ['Health-care facility
132.40 $�J 9 +�)/ 9.9 Subunit 2 sets of IS with any of the above.
City/State/ZIPi Awci 8-y,_ The above are not applicable to temporary construction service.
/
/� • Suite/bldgJapt. no.: I Project name: J.J , z ,e y�P Description I Vty• 1 pee I Total 1 ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Subdivision: I Lot no.:
_ Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF. WORK: - Each manufactured or modular 2
dwelling, service and/or feeder 90.90
/g L' / / / 6 f t l�► (4'77esdt) Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
�, .)> ��'Q6 5 t 7 2 amps to 400 amps 106.85 2
❑ :
PROPERTY OWNER : :. TENAMI .'.:_. •: - 401 amps to 600 amps 160.60 2
. _ .•
Name: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 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 600 amps - 133.75 2
Date: Branch circuits — new, alteration, or extension, per panel
Owner signature: ..
A. Fee for branch circuits with
CONTACT PERSON:; ; : : : :. : :; :. : .. service or feeder fee, each 2
❑ APPLICANT 1 , . . � : � 6.65
branch circuit
Business name: ' B. Fee for branch circuits
Contact name: without service or feeder fee, I 46.85 1,g,15 2
first branch circuit
Address: Each add9 branch circuit - - 6.65 2
Miscellaneous (service or feeder not included)
- Pump or irrigation circle
City /StpteJZIP: 53.40 2 . Phone: ( ) Fax:: ( ) 53.40 2 Sign or outline lighting ,
E -mail: Signal circuit(s) or limited -
CONTRACTOR. energy panel, alteration, or
• extension. Describe: Page 2 2
Business name: STONER ELECTRIC -
Each additional inspection over allowable In any of the above
Address: 1904 SE OCHOCO - Per inspection 1 62.50
Investigation per hour (1 11r min) 62.50
City/State/ZIP: MILWAUIOE, OR 73.75
I F ax: (503) 659 -4968 industrial plant per hour
Phone: (503) 462 500 ( ) . • • ELECTRICAL PERMIT .FEES* .
CCB Lic.: 44823 1 Electrical Lic.: 26 -122C I Suprv. Lic.: 3496 Subtotal 4/ p 4J
Suprv. Electrician signature, required: tyL °
State surcharge (8% of permit fee) 3. 7c
Print name: MICHAEL FALCONER I Daie:5 010 7 ,
TOTAL PERMIT FEE t 50. to
Authorized signature: This permit app expires tie permit is not obtained wt hin tae
days after It has been accepted as complete
Print name:
I D • Pee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
i :\Buitdiug■Pemilts\ELC- PermitAea .due 12/03 4404615T(10/02/COM/WEB
05/10/2007 15:05 FAX el 003
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EXISTING 2200VA UPS
L EXISTING SUB
-PANEL
-PANEL
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•
•
•
•
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NOTES:
1. EXISTING 2200VA UPS CURRENT
FED WITH #12 Cu FROM 20A BREAKER.
° 2. UPS SPECIFICATIONS REQUIRE A
30A FEED.
3. CURRENT 20A BREAKER TO BE
REPLACED WITH 30A AND UPS TO BE
• REFED WITH #10 Cu. USING 1/2" EMT
& FLEX.
•
•
PLOT DATE:
5/10/2007
COPYRIGHT PROTECTED
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wuunwavm vx
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om
wn■wr DIE
PANELS �..
611tLTlr gym.
NONE
y 10/07
54 28a
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Sc... aecnac , DDW M.TALCONER
Ike sb SYSTEM UPS WIRING DIAGRAM 41ALCO"TER 7 �`
Seogeir Electric S uoNn�. E
1904 SE Ochoco °°"aE`"" WEST SURGERY CENTER STE. 200
Milwaukee, Oregon 97222 g roup Advmced Ent', Snh++n
(503)462 -630a (503)659 - 4999966
VOCE DATA
WWW.9t0nCrgrOUp.COm 13240 SW HWY 99 TIGARD, OR 1 1
Sr.,. e. cntic VAICOINER
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00324
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2007
Phone: (503) 639 -4171 puma c}�- ,I�I �
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' $ IJ..
INSPECTION WORKSHEET FOR DATE: 6/28/2007 TIME: 7:01AM PAGE: 20
SITE ADDRESS: 13240 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: FREWNGS ORCHARD TRACTS LOT #: 008 TYPE OF USE: -
PROJECT NAME: WEST SIDE SURGERY GTR
DESCRIPTION: Refeed UPS (per specifications) adjacent to surgery suite.
OWNER: PACIFIC PROPERTIES, PHONE #:
CONTRACTOR: STONER ELECTRIC ..F E 1 (3 \ -3.2,\ ` PHONE #: 503. 462-6500
Inspection Request Scheduled For: Date: 6/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051140 -01 971 - 678.5509 ' Y
Corrections /Comments /Instructions: , --
4! 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &-` ` N 0 leo l.,- Date: 6 -'' d1 Phone #: (503) 718- 1-44
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00324
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2007
Phone: (503) 639- 4171r,t� �1�I
Inspection Requests (24 Hrs.): (503) 639 -4175 `:
INSPECTION WORKSHEET FOR DATE: 5/16/2007 TIME: 7:00AM PAGE: 71
SITE ADDRESS: 13240 SW PACIFIC HWY 2.00 CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 008 TYPE OF USE:
PROJECT NAME: WEST SIDE SURGERY CTR
DESCRIPTION: Refeed UPS (per specifications) adjacent to surgery suite.
OWNER: PACIFIC PROPERTIES, PHONE it:
CONTRACTOR: STONER ELECTRIC PHONE #: 503 - 462 - 6500
Inspection Request Scheduled For: Date: 5/16!2007 Pour Time:
Code # Inspection Description /Confirm # , Contact # Message
199 Electrical final 048346 01 503 -347 -5238 Y
Corrections /Comments /Instructions: N \ 5 W I CO r\'\ I
(ups)
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fl6 6V A P lsiJ kiNiE W i j
o. ° ua-311• 0 O 30 , 118•34•0ogo
'''T 4 - NeVJA • pi3O RiaNiEw
nN sr /E
❑ PASS ❑ PARTIAL APPROVAL it,CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G O8 LC Date: 6114 01 Phone #: (503) 718- �b
1