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Permit CITY OF TIGARD y �, DEVELOPMENT SERVICES ELECTRICAL PERMIT !+�- \1 4 IW 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT S : D 16 / 9 DATE I5SUED: 0 4 / 04/16/97 PARCEL: 2S112DA -01300 SITE ADDRESS...:O664O SW REDWOOD LN SUBDIVISION •MLP96 -0002 ZONING:I —P BLOCK • LOT • JURISDICTION: Project Description : Electrical service for shell and corridors only -08 #, a� - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0 LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 1 MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0 - - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- - 0 — 200 amp : 3 W /SERVICE OR FEEDER: 19 PER INSPECTION • 0 201 — 400 amp • 1 1st W/O SRVC OR FDR.: 0 PER HOUR : 0 401 — 600 amp : 0 EA ADD'L BRNCH CIRC: 0 IN PLANT : 0 601 — 1000 amp • 1 PLAN REVIEW SECTION 1000+ amp /volt • 0 > =4 RES UNITS > 600 VOLT NOMINAL..: Reconnect only 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.: Owner: FEES PACTRUST REALTY type amount by date recpt 15350 SW SEQUOIA PKWY PRMT $ 575.00 DRA 04/16/97 97- 293377 TIGARD OR 97224 PLCK $ 143.75 DRA 04/16/97 97- 293377 SPCT $ 28.75 DRA 04/16/97 97- 293377 Phone #: Contractor: OREGON ELECTRIC CONSTRCTN INC $ 747.50 TOTAL 1010 SE 11TH REQUIRED INSPECTIONS PORTLAND OR 97214 Ceiling Cover Underground Cove Phone #: 234 -9900 Wall Cover Elect'l Service Reg #..: 000002 This pereit is issued subject to the regulations contained in the p vI* _ Tigard Municipal Code, State of Ore. Specialty Codes and all other P eOl i►'t e e i ! at ur --"— applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issuance, or if work is suspended for gore _ _ . �� !- �/ • -� i�_ than 180 days. Issued By OWNER INSTALLA IN ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: _ CONTRACTOR INS ONLY SIGNATURE OF SUPR. ELEC' N : J�O1 Y �„^ DATE: LICENSE NO: Call for inspection — 639 -4175 --_, -=/ fr CePI/L4 i / A Community Development EL PERMIT APPLICATION / 13125 SW Hall Blvd. C j am[` y I Sp y > /- Tigard, OR 97223 'A Planck/ e # oL Jl.o 7 x y w . 'f Permit # LL i''� l i Phone (503) 639 -417 v i Date Issued s r FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Issued by Inspection 503) 639-4175 1 1. Job Address: JOB NO. 12392 4. Complete Fee Schedule Below: Name of Developmen - Number of Inspections per permit allowed Address 6640 SW Redwood Ln. Service included: Items Cost(ea) Sum City/State/Zip Tigard, OR 97224 4a. Residential - per unit 4 1000 sq. ft. or less $110.00 Name (or name of business) Providence Ptld Clinic Each additional 500 sq. ft. or portion thereof $25.00 1 Commercial El Residential ❑ Limited Energy $25.00 Each Manufd Home or Modular 2 Dwelling Service or Feeder $68.00 2a. Contractor installation only: 4b. Services or Feeders Electrical Contractor OREGON ELECTRIC GROUP Installation, 200 amps or ess n, or relocation 2 3 $60.00 180.00 2 Address 1010 S.E. 11th 201 amps to coo amps T $80.00 80.00 2 401 amps to 600 amps $120.00 2 City Port land State OR Zip 97 214 601 amps to 1000 amps T $180.00 NEMO 0 2 Phone No. (503) 2 34 -! ±. Over 1000 amps or volts $340.00 2 Contractor's License No. 2: -95C //7r Reconnect only $50.00 - Contractor's Board Reg. N . 20 IBM 4c. Temporary Services or Feeders � - Installation, alteration, or relocation 2 . Signature of Supr. Elec'n `, / " ` 200 amps or less $50.00 2 - License No. 2345S Phone No. c 4 -9900 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 . 4 ► R� U /t 0 Over 600 amps 'b to 1000 volts 2b. For owner install grif / l l see ' above. � `L 7 4d. Branch Circuits Print Owner's Name iS �fiW " -- New, alteration or extension per panel Address a) The lee for branch circuits with City State Zip purchase of circuit or feeder X 1 2 19 $5.00 95.00 Phone No. b) The lee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 not intended for sale, lease or rent. First branch circuit $35.00 2 Each additional branch circuit $5.00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or irrigation circle $40.00 2 - Each sign or outline lighting $40.00 Signal circuit(s) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension 1 $40.00 40.00 4 or more residential units in one structure Minor Labels (10) $100.00 X Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over X Classified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 Per inspection $35.00 Per hour $55.00 In Plant $55.00 Submit 2 sets of plans with application where any of the above e apply. Not required for temporary construction services. 5. Fees: 'j / j .C° NOTICE 5a. Enter total of above fees $ 475.00 5% Surcharge (.05 X total fees) $ •.2-371-5 2 i S- PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 8 . 7 AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. Enter 25% of line A for Plan Review if required (Sec.3) $ 418.77r jL j j ; 7 CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ FrH -'`t) A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. a ❑ Trust Account # $ Balance Due $ • G 1 l . ¢0 r7117 s0 .cabana. ; .. �� V/ `�1 �� � Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0109 • PACTRUST REALTY 06640 SW REDWOOD LN 05/13/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ELCC001 Application received / / / / 02/24/97 RECD JMH 02/25/97 DRA ELCC003 Permit created / / / / 02/25/97 PASS DRA 02/25/97 DRA ELCC115 Routed to Plans Examiner 02/25/97 / / 02/25/97 Permit is for shell & corridors only. PASS DRA 02/25/97 DRA Plans indicate future work, but indicate work not for this permit. ELCC115 Routed to Plans - Examiner / / / / 02/27/97 New plans received on this date w /out PASS DRA 02/27/97 DRA redlines. ELCC120 Plans Approved /Routed to DSTs 02/25/97 / / 04/07/97 see letter PASS MJR 04/07/97 MJR ELCC400 (F)Ready to issue / / / / 04/15/97 PASS B 04/15/97 BON ELCC499 Return to pending / / / / 02/27/97 New plans submitted without redlines. PASS DRA 02/27/97 DRA ELCC500 (F)Issue permit / / / / 04/16/97 PASS DRA 04/16/97 DRA ELCC700 Ceiling Cover 02/25/97 / / 07/22/97 Hallway & bathrooms approved for wall PASS MJR 07/30/97 J*H cover. Entryway soffit cover approved ELCC700 Ceiling Cover / / / / 08/12/97 lobbies PASS MJR 08/12/97 MJR . ELCC720 Wall Cover 02/25/97 / / 08/26/97 ceiling approved PASS MJR 08/27/97 MJR ELCC725 Underground Cover 02/25/97 / / 02/26/97 cover without inspection but visual PASS MJR 02/26/97 MJR right after pour was OK ELCC730 Elect'l Service 02/25/97 / / 06/25/97 electrical service approved PASS MJR 06/27/97 JDA ELCC799 Elect'l Final 02/25/97 / / 01/26/98 Appears to be complete. All systems are PASS BRP 01/26/98 J*H functioning okay. ELCC800 Case Finaled / / / / 01/26/98 PASS BRP 01/26/98 J*H •