Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00021
TA DEVELOPMENT SERVICES DATE ISSUED: 1/22/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 =4171 PARCEL: 2S113AB -00600
SITE ADDRESS: 16160 SW UPPER BOONES FERRYRD
SUBDIVISION: BAD(° CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Job No.9773
Tenant Improvement
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: 12 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:
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 44569
SUP 2808S
ELE 26-451C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 1/22/02 $160.10 2720020000( Elect'I Service
Elect'I Final
5PCT CTR 1/22/02 $12.81 2720020000(
Total $172.91
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
Permit Signature: j ni cto Issued By: t_a
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
4 Elect rical PermitApplication '
Datereoeived: - _O "L Permitno.:fei 00 Oob ' I
' of T' an d Project/appL no.: Expire date:
Cy air-Ward Address: 13125 SW Hall Blvd, a . ; l ( ' r -' ' E ', Date issued: By: Receipt no.:
• , Phone: (503) 639 -4171
. - Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: JAN 17 2002
milimiliiiimm
01 & 2 family dwelling or accessory O Commercialrmdustzial O Multi - family O Tenant improvement
O New construction O Addition/alterationheplacement 0 Other: _ 0 Partial
.1011S11 1: 1\1 OIt \l \ll()\
Job address: • . t -1. •.•.• ■ i • R RO4D Bldg. no.: 1 Suite no.: Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project name: FXpr.TXTS I Description and location of work on premises: TENANT IMPROVEMENT
Estimated date of completion/inspection:
•
( ()\ I It . \( I OR .t1)111 It k " lON. 1 1 1: LI.:_; __ -
Fee Max
Job no 9773 Qty. (t Total 1e.. low name: Bachofner Electric, Inc. New redde odd-Waft per
Address: 55 SE Main St. dwelliags&Inciniesdtacisedppuage.
City: Portland . I State: OR I ZIP: 97214 Sevvicelocideek
Phone: 503 - 233 - 2006 I Fax: 233 -2963 I E-mail: 1000 sq. R or less 4
additional son sy ft. or portion thereof
CCB no.: - 44569 I Elec. bus. tic. no: 26 I C
Limited Limited energy, residential 2
V
City/metro lic. no.: 6 Limited energy. non-residential 2
‘t&e*4--..- 01 —1 5 Each manufactured home or modular dwelling
D ate Service and/or feeder 2
Signature of supervising electrician ( Services er feeders — IssWla i s,
Sep.dat same(prmtk W. Bachofner Licrosem: 2808S
alteration orreload=
PROPER \ 0%1\[It 200 amps orlcss f Oar' $03D 2
201 amps to 400 amps _ 2
Name (print): 401 amps to 600 amps 2
Mailing address 601 amps to loon amps 2
City: I State: I 23P: Over 1000 amps or volts 2
Phone: I Fax: 1 E-mail: Reconnect only I
Owner installation: The hutallation is being made on property I own Temporary servic s arfee ien -
Installmnom
which is not intended for sale, lease, rent, or exchange according ationodterationorrelo 2
zoo amps or less ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's , •.,..., . : _ ___ ___ _ -- -- -- — Dale: 401 to 600 , 2
I.\ (;1 \ L I: R Breate:1min - new, alteration,
'.- or extension per panes
Name: A. Fee for branch civets with purchase of i ooch .� • r , � 2
Address: service or feeder fee, each br circuit
City: I State: - I ZIP: B. Fee for branch circuits without purchase
of service or feeder foe, first branch circuit 2
Phone: Fax: 1 -mail: E additional breath circuit:
1'1.: \ \:IIL\ 11:11 (I'Ica.e check all Iliac applI) Misc. (Serviceorkedersatinc des*
O Savieeovet225mnpseommerei
2
d 0 Haab- mean:lity Each pump or irrigation circle 2
O Savioe ova320 amps -sating of 1&2 Cl Hazardous location Each sign mouth= lighting
Emily dwiding* O Balthos over 10,000 square feet fav Signal circuit(s) or a limited energy panel.
O System over 600 volts at >rniaal more residential wens in one structure
alteration, or extension 2
O Buittfmg ova three stories 0 Feeders. 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable in any of the abover
O EgfesanightialiPlaa 0 Otheo. - Per inspection t 1 1 1
Submit _ sets of plans with any of the above. Invatigatim fee
The above are not applicable to temporary coostructloa service. Other
Permit fee S 160 • I
No a yutsaca°. soap eater cues, pi. ca jurisdiction for mate Moran non Notice: This permit application review (at %) S
O Visa O Plan r
MasterCard expires if a permit is not obtained State evie acgc ( .... $
ctwatm era �� / / within 180 days after it has been TOTAL $ l 7 7, • GI /
� accepte as comp
Name of cardbolder sr shown on at cad .
$
rsrdbalder tie Ammon 440461 5 (600000M)
•
Electrical Permit Fees: Limited Energy Fees: i . N,
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee___. _...._ _ $75.00
Wilber of hspections per permit allowed (FOR ALL SYSTEMS) ..,
Service Included: Items Cost Tote! 4. Check Type of Work Involved:
Residential - per watt • 1000 sq. R or less $145.15 4 ❑ Audio and Stereo Systems
Each adelo al 500 sq. It or
portion thereof $33.40 1 ❑ Burglar Alarm
United Energy $75.00
Each Maraca Hare or Modular ❑ poor Opener*
Dimling Service or Feeder 59090 2 , _ .
Services or Feeders ❑ Heating. Ventilation and Air Conditioning System*
installation. ekeration, or relocation
200 amps or less / $80.30 SO. 30 2 El Vacuum Systems
201 apps b 400 amps $106.85 2
401 amps b 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts • $454.65 2
Reconnect only $66.85 2 •
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
upon. atierallon. or retooaion Fee for each system_- _.._.....__ _.. $75.00
200 amps or lass $66.85 2 (SEE OAR 918-260 -260)
201 apps b 400 amps $100.30 2 Check Type of Work involved:
401 amps b 600 amps $133.75 2
Over 600 amps is 1000 volts,
see 'If above. El Afq and Stereo Systems
Branch Circuits ❑ . Boiler Controls New. alteration erd
on ension per panel •
a) The fee for branch climb El Clock Systems
with pwchess of serve or .
feeder fee.
Each branch sinus /= $6.65 / 2 ❑ Data Telecommw nication Installation
b) The fee for branch drub
without owe: eseofservice ❑ Fire Alarm Installation
or feeder ha
First branch circuit $46.85 ❑ HVAC
Each addilonel branch dray $6.65
Miscellaneous ❑ Instrumentation
(Serves orfeeder not induded)
Each sign or outline Yghti lighting $53.40 ❑ Intercom and Paging Systems . -
t9gnd ckcdt(s) or a limited energy ❑ I1fiQafbn Control'
panel. denim ar a:d rision $75.00
Idnor labels (10) $125.00 ❑
Each additional ktspedion over Medical
the allowable In any of the above ❑ Nurse Cats
Per knspedlon $62.50
Per how $62.50
in • ❑ Outdoor Landscape Lighting*
mss: , C ❑ Protedive Mending •
Enter total of above fees $ / f0 0 ❑ Other
6% State Surcharge $ 12, P I Number of Systems
25% Plan Review Fee • No Scones are reghihed. Licenses are required for al other Installations
Plan RevleYrr sector on $
front of application.
/ � i Fees:
$ Total Balance Due Ili Enter total of above fees • $
❑ Test Account i 8% State Surcharge $
Total Balance Due $
•
i:',d formAelc- fecs.doc 10109/00
CITY OF TIGARD • - 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received / Date Requested 3 + 7 AM PM BUP
Location ! (o / Suite MEC
Contact Person Q- Ph ( ) qep 7g'
PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 0 °).-
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain -
Slab Inspection Notes: • SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation 1 IN a , 0 _� �
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof I Y L h
Other: , /
Final N 4 4s )/119 6Th
PASS PART FAIL
PLUMBING h 4 04\c�
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 _ � ;,
1CAL y• – V
4
UG /Slab
Low Voltage
Fire Alarm
PASS FAIL 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
Approach/Sidewalk Dat — � Inspe /sir ";/// Ext
Other:
Final DO NOT REMOVE this inspection recor from t ob site.
PASS PART FAIL
CITY,.F TIGARD 24 -Hour
. " • BUILDING �l -a -) Inspection Line: (503) 639 -4175 - e
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
ll BUP
Received Date Requested / - AM PM BUP
Location / ((O D (1 • /3 I1-ao Suite r MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 66 ,x ' 006 '
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing t \ l
Firewall t) N((�. V.4 6D OK C-6 ?P 4-S
Fire Sprinkler `°�
Fire Alarm
Susp'd Ceiling � ` y� I }� 1� j
Roof `` V1� �lt�1 g \ 1111 14 V E P � �
Other:
Final
P ASS PART FAIL J am- X 1 1
PLUMBING S( N zD \ N-1) . , 0 IN � D I► h v� r 0
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
• ug -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
Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA
Approach /Sidewalk Dat - o°� Inspe /�i .�,_� ,sueI Ext
Other:
Final DO NOT REMOVE this inspection recor from the ob 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 Re • uested AM PM BUP
Location / (o I &; e - �i t1-0 Suite ('�/L` MEC
Contact Person Ph �`2 - 2 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 66)C U
Footing
Foundation ELC
Access:
Ftg Drain . ELR kit
Crawl Drain e�
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors V
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall �(( . N L
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 el Ocs - vO 2 o 7
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA `/ ' `,�
Approach /Sidewalk Date Z '� e' 2--- Inspector ' —( Ext
Other:
Final DO NOT REMOVE this inspection record from a Job site.
PASS PART FAIL
•