Permit CITY OF TI ELECTRICAL PERMIT
PERMIT #: ELC2004 -00439
`�i� DEVELOPMENT SERVICES DATE ISSUED: 7/19/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 150
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Tenant improvement, (16) branch circuits.
Job # 666.
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: 15 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 WILLAMETTE ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 230547
PORTLAND, OR 97224 TIGARD, OR 97281
Phone: Phone: 503 - 624 - 3631
Reg #: LIC 75059
SUP 1965S
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/19/2004 $146.60
[TAX] 8% State Surcharge 7/19/2004 $11.73
Total $158.33
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 a7- b Permit Signature:
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
JUL .15 2004 11: OSAM HP LASERJET 3200 p . 2
,. • •
Electrical t'ermit Application
YOR OFFICE USE. ONLY
City of Tigard • CEIVED Received ,
/ -,..- ..•
ei Permit No.:Li LC. OdYP 5 t
13125 SW Hall Blvd., Ti _
gard, ORT A. Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 L b:/;,,,, Date/Dv: Other Permit
Inspection Line: 503.639.4175 10 !_!.4- : 1 Date Reaclyil3y: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: I Supplemental Information
_ _ r 1 2 ■ : _
iTZ J. :6'7;W . 3:R.R'F,'4'..kl i 1,'.i')-,i.:'.1',I'Fri-•:-A-'45,7-17-tIV''''J'A.I4FTWIFIP1];*:1:-*gli ,...1 '!•-).:-. ; , . • •
Litgftr:Ail. - ... 1 1220.].. 1 .'" eA.'::.'211,i.1 .2'Lq_ VI.:-■-tisP=1.!-ZH :€ , ._.- II - • a ' -... ' 2-77, .'' '7 ' . •' . •
0 New construction Iv_il. oil i.litf: . ation/replacement Please check all that apply
['Service over 225 amps, comm'l ['Hazardous location
E3 Demolition EI Other: - ,,,,, ,,. ['Service over 320 amps - rating OBuildng over 10.000 sq. ft.,
V.,i,n; ruT6
tz,Lb:il :i:til:fi': :::. ". st .: IN -.:,i '-'-l - ,, -- iAk=1 -1 .>:.; • i:..-A2,1;ihd ,, I- and 2-flunil dwellings 4 or more new residential
El 1- and 2-family dwelling IX Commercial/industrial 0 Accessory building Ll System over 600 volts nominal units in one structure
['Building over three stories OFeeders, 400 amps or more
P: ! E1 [Vaster builder El Other: ['Occupant load over 99 perscrns ['Manufactured structures or
'.01;Vr-,:i',Pli'iN-,-.P.---ci-'.5'.:114P:1',",:iikl-n11-7-r.,.-42i;r(1,i'lll'A;',,Iir4fif-7.1.1:',3:;, VT in RV park
N...1'.42,-V[1:-.1.-iii..n22i4i.. F
r!kisi r2f1. :,2,]:'::ifimilldid i-iBigcseigh Pima
Job no.: 64, 4 Job site address: 0Health-care facility POOter:
I g q r SLu Ce • . few_ 4- Submit 1. sets of plans with any of the above.
City/State/ZIP: i .., , 0,„ ci /- z.. t. SI/ I 5---C) The above are not applicable to temporary construction service.
Prr'f/l T
Suite/bldg./apt.no.: It Project name: . . - •
, le ,_..c.....!.Q.E.22. :.d 4 . 6 . ' , L, : -r'4::_ r. , ..."'•-, A,. L.r• • e-:'.••: ' . • _
Damon. Qtr. Fea• Total ••
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
Subdivision: Lot no.: Es. addl 500 sq. ft. or portion _ 33.40 1
Limited energy, residential 75.00 2
Tax map/ parcel no • .. _.., . _. Limited energy, non-residential 75.00 2
r 1 :
:,i..■1; r vli zIAP.,: 0
pu sT77,....tqii.y,......„,.;fli,
W. g,Y.P. ... ..iI,:?..-.141ZP:-..t,!.!.41,4hL',:.■i!0,,qh-.',....:i17-:`,:;;:14.%1;1T-4.k.:0.111,:: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
...... „ _ , _4 ' di a■f-ad. . dd. Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
1K4F:',T,":11)_Irr'FtVrLi..74.771:'-g14Y11-3g'gtViNN.lig'F':;r1PP:iii,17:2;`,;;F:il.,,:.'`fiiir,'W,;'.--,r`jr,',1 201 amps 03 400 turps 106.85 2
'-ai,-,:.:: Lth.T.' zl bi 11 4 ' .(,,c1,01.1'.1:1;ti.,;!'.riLIL:i.!:6,:;;Iii.:ii.::,;101z.tir_641:1,t 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: i s 1 --' -
,.,.., _ ,, I
__. 1 _./.4/ CI Over 1,000 amps or volts 454.65 2
-• - Reconnect only 66.85 2
City/State/ZIP: 7- ,: a
A_ ?. 2. Temporary services or feeders installation, alteration, and/or •
relocation
Phone: ( ) 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
Owner signature: • Date: Branch circuits- new, alteration, or extension, per panel
ille.g.td,ifilliiiii:--1:r.i.II,U'in't:1::..761.0-.4itill'717-YN',IXelle'.-2:f-LII71...f1112:.Iii-J. 14'!11`.°'Vt$7.-1 A. F ser ee , f f c cr e ar branc r ee d h L ircui f eei ts ea Wi c h th
6.65 2
Business name: branch circuit -
B. Fee for branch circuits
Contact name: withour service or feeder fee, i e
• 46.85 yer 2
each branch circuit ---
Address: Each add') branch circuit 'sr 6.65 rif PX-- 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( Sign Sign or outline lighting 53.40 2
_
E Signal circuit(s) or limited-
r, 4;' j.7,171,; iii;i'.:6111 '.fil - 11 r .' 1 , 11 F - : . ; lOkt'l 7z .ii-4ii 1 f. i.L.! enelEY Panel. alteration. °I'
1 !t:' trZd T:11,:: '.. ;. , .1,:o'.i v&.-7...•13,...i-2.,sr '...:22 i L.- p.P.'.. i .irr. A ..aLITILIjIlf i I-- .11.a.,•,A,1i11.1 . onDsc . be
extensi. en: Page 2 2
Business name: la V , e _ -- A. 'C.-
Each additional inspection over allowable In any or the above
Address: • I Al a # Per inspection 62.50
City/State/21P: i . , . 0 • 4„ z i.... ( , Investigation per hour (1 hr min) 62.50
Industrial phmt per hour 73.75
Phone: ( _En ) t 2 4 _ 3. s t Fax: ( 511IS ) 6 Vai ^ Lc/ if f1 ZI;Tr,Natf.-::',
113:EIMMI Electrical Lic.: 714 e Suprv. Lic.: • 6 . s- _ Subtotal i V
_
Suprv. Electrician signature, required: A riMierAlli.1111111111 Plan review (25% of permit fee)
State surcharge (8% of permit fee) //, 7.7
Print name: ,, C , Date: . - 3---c-te .
I IN, TOTAL PERMIT FEE (5Si 53
Authorized signature: This permit application expires If a permit is not obtained within 180
days after is has been accepted as complete
Print name: Date: • Foe methodology set by Tai-County Building Industry Service Board
es Number of inspections per permit allowed.
t \BuildinecrminaLC-PertaitAopdoe 12/03 440
CITY OF TIGARD 24 -Hour
BUILDING Inspection line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / AM PM BUP
Location / 5 4 9 S" Suite lsD MEC
Contact Person Ph ( 9 7 ( ) 0- , - O ( 7 1 / PLM
Contractor 911M Ph ( ) - ,3(a 3/ SWR
BUILDING Tenant/Owner V G72 2074/ ELC aOU`f /[
—D Y3?
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT f•-•
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear \`
Framing
Insulation ! I r f,ey) -D1L t 6 N /
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
t
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
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
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
F : Alarm
,,
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
c PART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line C �
ADA Date 1 ✓ 2v 0 Inspector M - - " Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL