Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00557
'DEVELOPMENT SERVICES DATE ISSUED: 10/21/02
(I
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S101 DC -04601
SITE ADDRESS: 07477 SW TECH CENTER DR
ZONING: I -P
SUBDIVISION:
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Install of 1 200amp panel /feeder and 10 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: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 10 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
WATUMULL PROPERTIES CORP MID VALLEY ELECTRIC INC.
307 LEWERS ST #6FLR PO BOX 655
HONOLULU, HI 96815 WILSONVILLE, OR 97070
Phone: Phone: 503 - 682 -2955
Reg #: ELE 3 -542C
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/21/02 $146.80
[TAX] 8% State Tax 10/21/02 $11.74 Elect'l Service
•
Rough -in
Total $158.54 Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 -8044.
Issued By: 411410 �4/) a , r / 4 � Permit Signature: n 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: 1 OLIC' 1 "'
Call 639 -4175 by 7:00pm for an inspection the next business day
Oct 16 02 08:37a Mid Valley Electric Inc. 503 - 682 -7904 P.2
r
Electrical Permit Application
Datereceived: /0 _2/ -o 3-- Permit no.: Ewa o vS 7
:t. . r t • • •
...... y y�l City of Tigard , Projecdappl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd; Ti g C '9r/�23 Date issued: By" I Receipt no.:
Phone: (503) 639 -4171
j
Fax: (503) 598 -1960 OCT 1 6 2002 Case file no.: Payment type:
\�
Land use approval: .
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory j Commercial/industrial 0 Multi - family ❑ Tenant improvement
0 New constructi • . it ' Addition/alteration/replacement 0 Other: 0 Partial
4
• JOB SITE INFORMATION
Job address: — i.goatiek Sw C e, c , 0 ,r Bldg. no.: . Suite no... _ ax map /tax lot/account no.:
Loc I Block: $Subdivision: "T�c.,- a. 1 Le-1'l Cc"
Project name: N ; : ,.,.. „„_ I Description and location of work on premises: ,. . c k v,.
Estimated date of completion/inspection: Se 4e4r1 o,,re crre rte. orN1
CONTRACTOR APPLICATION . . FEE SCHEDULE
Job no: t'c t act l..1 Fee Max
Business name: t a, V ELL -,.; ` Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address: VO G dwe lingmit-Includes attached garage. •
City: l� t , State:' R I ZIP: on 0--11/4 Seniceinduded:
Phone: b e, a _ 5 I Fax: - 7eto'4 E -mail: 1000 sq. ft, or less 4
Each additional 500 sq. ft. or portion thereof •
CCB no.: •151bl: I Elec. bus. lic. no: '?y -59 c_. Limited energy, residential 2
City /metro lie.: -: ,y� . • • . •• _ Limited energy, non - residential 2
k .. 5•,, :":7 ,,, it _,,;,•„•;. I v_ 16_ <1.. Each manufactured home or modular dwelling
Signature of supervising a ectrici •i quire
Service and/or feeder 2
Sup. elect. name (print): V V3;,.4.e, License no: :14,835 Services orfeeders — installation,
PROPERTY OWNER alteration or relocation:
less
200 amps or less ' ,3t:• $0 • at; 2
Name (print): \: -.N-u S 201 amps to 400 amps 2
Mailing address: 5 aC� a �. 400 401 amps to 1 00 amps 2
601 amps to 1000 amps 2
City: c- time I State: e p, I ZIP: s--0,0 _ Over 1000 amps or volts 2
Phone:aa5 - tiy3L1 I Fax: 1E-mail: Reconnect only 1 •
Owner installation: The installation is being made on property I own Temporary services or feeders - .
which is not intended for sale, lease, rent, or exchange according to installation; alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 turps to 400 amps • 2
Owner's signature: Date: - 401 to 600 amps 2 '
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit `Q 6.1 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
Each additional branch circuit: .
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps- commercial ' 0 Health- carefacility Each pump or irrigation circle 2
O Service over 320 amps- rating of l&2 0 Hazardous location Each sign or outline lighting • 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories O Feeders, 400 amps or more *Description:
Cl Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection l I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other p
N all jurisdictions accept edit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ ‘ 6- VV
, ‘Visa a se O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. E`li i?-,cc. 0.01c, 4 dIlo a / /05'
within 180 days after it has been State surcharge (8 %) .... $ I ■ .. 1
ri., au : c- a Expires accepted as complete. TOTAL $ 15R - SLt
o to • . 0 • own on = `t car • `5
Cardb • der si _•. I . O Amounto c 440-4615 (6I00/COM)
, -A--°- ) 71 7 7
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION QIVISION Business Line: (503) 639 -4171 MST
// BUP
Received Date Requested 4� AM '° PM BUP
Location 77 "7 7 Suite MEC
Contact Person /� P -� Ph ( ) _ c 75 PLM
J) /
Contractor 2/c J 1 // , Fjfc-&x Ph ( ) X / SWR
BUILDING Tenant/Owner `e' Z./ 3 S ELC 62 —0 0,53
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ' v
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall L '
Fire Sprinkler � 1 / 7 11/A/2
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer Q
Rain Drains O '
Catch Basin / Manhole
Storm Drain rr
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
:ou•h -
UG/Slab
Low Voltage
Fire Alarm
L ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
ri Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line /�
ADA 00t 6 Inspector �L/� / r� Ext
Approach /Sidewalk Date p v
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL