Permit •
1. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00701
^ DEVELOPMENT SERVICES DATE ISSUED: 12/5/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DD-00500
SITE ADDRESS: 15860 SW UPPER BOONES FERRYRD B— I S
SUBDIVISION: i 1 GON BUSINESS PARK 1 ZONING. I -L
, BLOCK: LOT : JURISDICTION: TIG
Project Description: Install phone and data cabling and (6) 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: 1
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: 5 IN PLANT:
601 - 1000 amp: PLAN REVIEWSECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY - ENVIRONMENTAL CONTROL CORP.
15350 SW SEQUOIA PKWY #300 7606 SW BRIDGEPORT ROAD
PORTLAND, OR 97223 ' PORTLAND, OR 97224
Phone: 503 - 624 -6300 Phone: 620-4228
Reg #: LIC 64673
ELE 3 -434C
FEES SUP 4425S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 12/5/03 $154.65
[TAX] 8% State Surcharge 12/5/03 $12.37 Low Voltage Inspection
Rough -in
Total, $167.02 Elect'l Final
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 616,4 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
12/02/2003 12:29 FAX 5035981980 CITY OF TIGARD 2 002
Electrical Permit Application Received FOR OFFICE S () \L1'
Electrical
• Date/BY: l a S/o 3 Permit No. :LCat10 3 40 70
City of Tigard Planning Ap ro l Sign
EC o q ® Plan Permit No.;
13125 SW Hall Blvd. I'" v ta Review Other
Tigard, Oregon 97223 Date/BY: Permit No.: •
Phone; 503 - 6393171 503-55114960 Post - Review Land Usc
w ard.
Internet: ww.ci.ti r. 0 1 ".,, 1,,E 1 . 1 Date/By: Case No.:
g _ ■ � • Contact Juris.. El See Page 2 for
24-hour Inspection Request: 503 - 6394175 " Name/Method: Supplemental Information.
CITY OF TIGARD
BUILDING DIVISION -
s` : ;` :.. . ..... . : : ,., :! :1'YPE'_OZ ORICe; - • •.. ;,; _ .:. . ::F; _ , :: •` IPLANIIEVIEW IP.I, .. ii eheclleiNthats Ate•- :a :� ::sF, . `� := ,
❑ New construction Demolition ❑ Service over 225 amps- ❑ Health -care facility
-
commercial Srvirc a 320 ❑ Hazardous over er 1 0°n
❑ Addition /alteration/replacement ❑ Other:
❑ amps-rating of ❑ Building over 10,000 square feet,
s;i:`- -".:•1.-.4.;=• ; : ;: f- -f 9CATEGORYQF:CON UC'IITON: iM! :'ti : :: :.tN: :.:. •.,•L I I & 2 family dwellings four or room residential units in
❑ 1 & 2-Family dwelling Commercial/Industrial CI System over 600 volts nominal one snvcturc
Bu ❑ Multi-Family ' ❑ Building over three stories ❑ Feeders, 400 amps or more
Accessory ! ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other
°4. '.: ° •'• jOR- SITE:INFORIV AMO1V`•iiad)EO,CA.TION : :-.:F'' .: :: . '' ' Submit sets of plans with any of the above.
The above arc not applicable to temporary construction service.
Job site address: /5(,o car cupP«- 80.s. 4 s Cy_p_d , .. .: ' i ' '': , iEE SCEIEDtTLF7 ..trg - -:. c' i.
Suite #: I Bldg. /Apt. #: /5 Number of inspections per permit allowed
Project Name: ,x-1:.9°'" a, A- rye. p s I he • Description Qty Fee (ea.) Total
Cross str eet/Directions to job site: P .. - New r uni t. a Includes de attached multi-family per 1
co .,.......- dwellin anh.lneludes attached garage.
Service included:
1000 sq. tL or less 145.15 4
Each additional 500 sq. R. or portion thereof 33.40 I
Limited energy. residential 75.00 2
Subdivision: 45rc 3e, se ness P1< ,r I Lot #: Limited energy, non residential '75.00 2
Tax map/parcel #: /i Z Each manufactured home or modular dwelling •
:i : :...:?•: • DESCRIPTION OF 'WORK ',`',' .. ;: service and/or feeder 90.90 2
Services or feeders - Installation,
Pitef•se tit 1).-4-4, +
alteration or relocation:
(p - a 1 t C14.1 f - 200 amps or less • 80.30 _ 2
201 amps to 400 amps 106.85 2
- 401 amps to 600 amps 160.60 2
la.PROPERTIP OW ERI . ' ';.:["4 TENA - !.;=.=:;' =' ' :.`. - ' 601 amps to 1000 amps 240.60 2
' Over 1000 amps or volts 454.65 2
Name: Reconnect only - 66.85 2
Address: Temporary services or feeders - installation,
City/State/Zip: alteration. or relocation:
200 amps or leas 66.85 1
Phone: p Fax: 201 amps to 400 amps 1 0 0.30 2
•1J PPLI:CAYT.'. .1 . , .. -: Lt "CONTACT. :PERSODT :a • :T ' 401 to 600 amps 133.75 2
• Branch circuits - new, alteration, or
Name: extension per panel:
•
Address: A. Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without puchase of
service or feeder fee. first branch circuit i 46.85 44 •g 2
Phone: I Fax: Each additional branch circuit s' 6.65 ,32- , op 2
E-mail: Mise.(Service or feeder not included): "•
`t. t r. r , _ q..,..• r r .!.yeti..., - ', n• r. ti E ac h pump or imitation circle 53.40
•h. -fie .,. �i : COIQTRAC�QR.r+ r.•.. "'['`; t:> '?�.. .: 2
Each sign or outline lighting • 53.40 2
Job No: Si cimtit(s) or a limited energy panel,
Business Name: evvire:11, P m 74_1 e,-„ t / c,r aheruion• or =tension I Paget /S • e.0 2
_
/- . Description:
Address: .74 a G S•.► /3ri )._p ,a: d
City /State /Zip: p aro, 7 Each additional Inspection over the allowable in an of the above:
9 Per inspection per hour (min. 1 hour) 62.50
Phone: S4 7 - 91O 9 Fax: cos ft k - /ozq , investigation fee:
CCB Lic. #: 4 _ Lic. #: 3- vs V- C. Other:
Supervising elect 1ciar� / . / A C `x '; - ' -'': i;: +EUoCtFlita�`Pe t.Fet !!'u. :..'-'iti; , ti; r��, ::
signature required: �[ vv f I V I_' 3 • , o mit Fee $ /S 45
t'L- Plan Review (25% of Permit Feep S
Print Name:m..4. 4?e h%r4. _ Lic. #: yy z 55 State Surcharge (8% of Permit Feel S 1 L.31
TOTAL PERMIT FEE 5 I tal. 02.
Authorized /' Notice: This permit application expires if a permit is not obtained within
Signature: rra•-e ems. ee... p --i' / Date: /A -2-63 180 days after It has been accepted as complete.
/ L 'Fee methodology set by Tri- County Building Industry Service Board.
/C -e. ' e a 1.../ /7eLd...dh r4 C..
(Please print name)
•
iADSts\Perrntt Fomu\EIcPemtitApp.doo 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received // D ate Requested 2. / a -0 AM PM nZ C - BUP
Location 45 6(9 ( � . � Suite MEC
Contact Person / /..., . �`' Ph PLM
( ) 9 7
Contractor ei/U) , e y Ph ( ) 9 SWR
BUILDING Tenant/Owner a /����,� /�' Icr�'I�r`� ° ELC
Footing go 3 -00 20/
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall - o
Fire Sprinkler — �� ♦l
Fire Alarm ( / •
Susp'd Ceiiing �
Roof 4 el � Gx-J L/ ? 4 70)-ti—CP-"tql-74
'�
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam —?
Under Slab
Rough -In /
Water Service S �U ry e ›,dir
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final MINIMIP •
PASS PART FAIL _
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
5S PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA n
Approach/Sidewalk Date — 1 t'/ • 0 Inspector • _ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested � AM • PM BUP
8
Location /� Roo U I SoDYLf1.o Suite MEC
Contact Person Ph ( ) 59 7g/7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner = ELC 3 — 6 d 7o f
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall E
Fire Sprinkler
Fire Alarm
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
Fire Alarm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext _
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL