Permit . • A. CIi rOF TIGARD =AL PERMIT
DEVELOPMENT SERVICES DATE S UED: 2 00 0 -00407
- ' -- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00700
SITE ADDRESS: 15353 SW SEQUOIA PKWY
SUBDIVISION: PACIFIC CORPORATE CENTER ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Replace existing 220 volt treadmill, replace with 120 volt recepticle.
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: 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 REALTY ASSOCIATES BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 55 SE MAIN
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 233 -2006
Reg #: LIC 00044569
SUP 2808S
ELE 26 -451C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Final
PRMT JMT 7/21/00 $37.50 0003873
5PCT JMT 7/21/00 $3.00 0003873 EXPIRED
Total $40.50
rrit
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987.
P 906
PERMITTEE'S SIGNATURE ISSUED BY
'141 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
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG- Structure set -up MEC - Mechanical Permit
Insulation 4 Inspection Description Date Passed By
Drywall nailing Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in •
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
-4 Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
J Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00407
4 j DEVE SERVICES ICES 639 -4171 DATE ISSUED: 07/21 /2000
PARCEL: 2S112DA-00700
SITE ADDRESS: 15353 SW SEQUOIA PKWY
SUBDIVISION: PACIFIC CORPORATE CENTER ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Replace existing 220 volt treadmill, replace with 120 volt recepticle.
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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 55 SE MAIN
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 233 -2006
Reg #: LIC 00044569
SUP 2808S
ELE 26-451C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT JMT 07/21/200C $37.50 0003873
5PCT JMT 07/21/200C $3.00 0003873
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE � ISSUED BY: i
c�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
pity of Tigard .
Electrical Permit Application Plan Check #
13125 SWHALL BLVD. Recd By
TIGARD OR 97223 RECEIVED n , Date Recd Date to DST
Phone (503) 639 -4171, x304 ,� %� Date to P.E.
Inspection (503) 639 -4175 1 2000 l
P rint of Permit #
Fax (503) 598 -1960 Incomplete or illegible 1 wi il ll iL$ ag Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) R 1 1 y La kg. Os wego C 1 . ervice included: Items Cost Sum 4
Address 15393 S W Sequoia Pkwy 4a Residential - per unit
1000 sq. ft. or less $ 117.75 4
City/StattJZip Tigard , OR 9 7 4 Each additional 500 sq. ft. or
Commercial ® Residential ❑
portion thereof $ 26.01 1
Limited Energy $ 60.00
Each Manufd Home or Modular
• 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit Issuance, applicants must provide contractor license 4b. Services or Feeders .
information for COT data base). Installation, alteration, or relocation
Electrical Contractor Bachofner Electric 200 amps or less $ 64.25 2
Address 55 SE Main St 201 amps to 400 amps 5 85.50 2
C City Portland St ate OR Zip 97214 401 amps to 600 amps S 128.50 2
�y p 601 amps to 1000 amps $ 192.50 2
Phone No. 503,233-2006 Over 1000 amps or volts 5 363.75 2
Job No. B 6 61 Reconnect only - a 53.50 2
Elec. Cont. Lice. No. 26 -451C Exp.Date 10 -2000 4c. Temporary Services or Feeders
OR State CCB Reg. No. 44569 Exp.Date 3 -2002 Installation, alteration, or relocation
COT Business Tax or Metro No. 04439 Exp.Date 12 - 2000 200 amps or less $ 53.50 . 2
201 amps to 400 amps $ 80.25 2
Signature of Su EIeC'n 401 amps to 600 amps $ 107.00 2
9 pr. Over 600 amps to 1000 volts.
see "b" above.
License No. 2808S Exp.Date 10 - -
4d. Branch Circuits
Phone No. 503 -213 -70(16 New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit 1 S 37.50 3 7 - 55 0
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. MIscellaneous .
intended for sale, lease or rent (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting S 42.75
Signal circuit(s) or a limited energy
panel. alteration or extension S 60.00
3. Plan Review section (if required):* Minor Labels (t0) $ 4Oe6
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Per inspection $ 50.00
Service and feeder 225 amps or more Per hour $ 50.00
System over 600 volts nominal In Plant S 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ _ 3 7 , 5 0
Submit 2 sets of plans with application where any of the above apply. 7� o Surcharge (47J X total lees) $ 3 0 0
Not required for temporary construction services. 7 Subtotal , off $ _
5b. Enter 25% of tine Sa for
NOTICE Plan Review if required (Sec 3) S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 4 . 5 O
IS NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account o
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 4 0 _ 5 0
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