Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00781
, DEVELOPMENT SERVICES DATE ISSUED: 12/9/2004
,�. II 13125 SW Hall Blvd.. Tidard, OR 97223 (503) 639 -4171
PARCEL: 1 S135BB -00501
SITE ADDRESS: 10575 SW CASCADE AVE 130
ZONING: I -
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: (1) feeder, (8) 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: 8 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:
AMB PROPERTY L P BOONES FERRY ELECTRIC INC
BY TRAMELL CROW NW INC PO BOX 628
8930 SW GEMINI DR WILSONVILLE, OR 97070
BEAVERTON, OR 97008
Phone: Phone: 503 - 682 -4936
Reg #: SUP 4918S
LIC 88482
FEES ELE 3 -223C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/9/2004 $133.50
[TAX] 8% State Surcharge 12/9/2004 $10.68 Rough -
Elect'l Final
Total $144.18
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 1-800-332-23
Issued By: - _ J % Permit Signature: j 9
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
• ElDec. 8. 2004112:24PM)fi '4jES FERRY ELECTRIC' No. 3059 P. 1
FOR OFFIC at Ly
City of Tigard
•
13125 SW Mil Blvd., Tigard, OR 9722 �� DataBr i ' , { �
Pima. 5'03.639.4171 Pax: 503.598 -" D /B : w e /
Q • ° Fr � ; Date/B : other Permit:
Inspection Line: 503 639.4175 �j Q^ . J {
%tamer www ci trgard or us ��� \ Date Beady/By. 0 See Pege nta Z for
Nonoacvmethod.
\ ". , ;:' 727 5-:.;7'.7,T7 - - . .,':?--_,-....,-,-, ` 2 1 r \ Supplemental lnterrnat;on
. i. : _ ".. . -.. 1, i 1� 7� ','.',7,:-5'; 411 � "t', F F � , -,' a t
_.� :al ..�5 r. a:L 7ti ' -�_ ...V.; ,'� f ' i t f E � f a I 1 .a
0-New construction �Additio� , 'n/replacement Please check all "` �\� ` - ,,T... .._ - %: ; ; _ ;
` 11 that apply:
❑ Demolition 0 Other \ ❑Service over 225 amps, comm'1 0 Ha2ardous location 7 S tt. ,� I > ,� (t 1 1
J U i . l n < , A t ° - r ,r ,� ry i C -. +^ -�Tnx, 1 , a , ❑Service over 320 amps - rating ['Bulldog over
- ,.e,..,: - Lu . " :_,) t U. 11 { ;11 /'11,0,. ;ti .I y , � L1,y_ i g er10 sidential
�_ of 1- and 2•farnily dwellings 4 or more new residential
❑ 1 and 2 family dwelling - 4SLCammercial/industria1 0 Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family 0 Master builder ❑ Other []Building over three stories ❑Feeders, 400 amps or more
y _5� `' ' �� /u1 -i � �is?¢/ C
c1 �L:1 r ' - ♦ +T i _ - ['Occupant
t..t�. -.. :.. ,',4 j '. S 1 . 4�•� r x ! :,-P uP� persons MI Manufactured structures or
„_ . r. . ❑Egress/li RV park
Job no.: 7 9-Z Job site address: f 0575 s,,, Cascae4 19U ❑Health care fac ility ['Other:
City /State/ZIP: Submit �,, sets of plans with any of the above.
The above are not applicable to temporary construction service
Suite/bldg. /apt no.: / 3 0 l Project name: A ' .i
P� co lv) .1.n..: s 1 ° S ?''. ' 'I 'f a s -2 A tF Oi • i= tit':'..e l '.ur:a
Description Qty. Fee Total
Cross sh eeUd rections to job site: New residential single- or multi- family dwelling unit. -•
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: l Lot no.: _Ea. add'l 500 sq. ft. or portion 33.40
Tax map /parcel no 1
Limited energy, residential
I 75.00 2
I l,'f.,, a't t � 1 ' 1 I-, . ' ' rr (' j : 37 i'."F 4a" t i i r r . T Limited e nergy, non -residential 75.00
. �t -- -' -- '..►.�:.� ;, � _:...,�. �"`IS 'E ,i!�,r'a �r,..�,:�F ',�' Each manufactured or modular _ 2
ot. v•' 4 .; S C r- I=.4 S .(0 ? i dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
a T z ) 200 amps or less 1 80.30
�'. ru�`.: .I :1 1� - ,� `If {l f j S r >> ��� r� `� k� `•�> Y , ,,, 1. _ : i rr II , z, 201 amps to 400 2
l._: .w. �ln r, P : _� ra - ?>saht 9 n.'l i_t� I ^ice .�: amps 106.85 2
Name: ��� � 401 amps to 600 amps 160.60 2
Address: l' ` 601 amps to 1, amps 240.60 2
Over 1,000 snips or volts _ 454.65 2
City/State/ZIP; • Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) [Fax: ( ) relocation
Owner installation: This installation is bein made on _ 200 apps or less 66.85 1
being property that I own which is not 201 amps to 400 amps 100.30 .
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 2
Owner signature. - Date; 401 amps to 600 amps 133 75 2
r �, 1 v r A k, r , Date Branch circuits- new, alteration, or
_.._ L It r 1 a E � t ., , i. c extension, per panel
z c td / t _ �� _ 1 A. Pee fo r branch circuit r ''. ?�.r., y , c: ," ,,,.) �..,3, � � , I ; a .� , r � 3 ,, ts with
_
_,. _ ;i
ce or feeder fee, each
Business name; , service
branch circuit 6.65 53 ,L� 2
Contact name. B. Fee for branch circuits -
wtrhour service or feeder fee,
Address: each branch circuit 46.85 2
City /State/ZIP; Each add'1 branch circuit 6.65 2
Artseellaneous (service or feeder not included)
Phone: ( )
Fax; : ( ) Pump or irrigation circle 53.40 2
E Sign or outline lighting 53.40
i d` __ ;,; c T{ t T X 4 t �x x ,1Lk a Signal circuit(s) or limited- 2
s � � ti r j'a: '� '•',., :: t w 1 .Ir r ` ' : i ewer Panel, a
-.. ¢J ' „ , , i �.. 1, p t t rib e : i, or
ncssnatne: Boones Ferry- Electric extension. Describe: Paget 2
Busi
P.O. Acklmss 1 OX 6 2 8 Each additional inspection over allowable in any of the above
City/State/ZIP; WilsonViixe OR 97070 - Per inspection 62.50
Ir►vestigation per hour (t hr min) 62.50
Phone: (6.'O 3) 682-4936 Fax: (5 0 3) 682-7946 :7 Industrial plant per how _ 4 73.75
eCa Lk.: 884
[Electrical L'c.: : " tt : al;, `$t FI.,�7 17A PJ 'l� 1 r 1 j S.r � ' 1 2 ., r+
8 2 t 2 2 3 I Suprv. I- i c.: J/ S :. r�t.rr
Suprv. Electrician signature, required:
Subtotal j 33 . 5a
Plan review (25% of permit fee) - -----.....
•. Print name: $ .1ce n Date: State surcharge HBI�pri JL � e ^O �� arge(8 /eofpermrtfee) )13 . 6 8
Authorized signature: TOTAL PERMIT FEE , / 8
This permit applicadon expires if - a permit is net obtained within 180
Print name: days after it has been accepted as complatz
Date: * Pee methodology set by Tri- County Building industry Service Board
.0 8 trildipePerm3s�.C-Pcrmtwpp.doc 12/03 F ` Number of inspections per permit allowed.
440-4615111 0/02./COM/WED
CITY OF TIGARD 24 -Hour ,
BUILDING Inspectiontine:1 -41
503) 639-4175 •
MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received / Date Re nested AM PM BUP
Location / Q S 75 Suite x3 MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 6 X' - 4L53k SWR
BUILDING Tenant/Owner ELC °�� y 7 K(
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam Anchrs
Ext Sr Sh ea t h / ear . / i- miff
Ext eah/h �_' -_ _ 1 � gip ' _i� i _ � � - ii�� �"
Int Sheath/Shear
•
Framing. ► ice•! _i Jig _ _
Insulation / I / • /
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 7
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
V0 — PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall; 13125 SW Hall Blvd. • 0 Please call for reinspection RE: - 0 Unable to inspect – no access
Fire Supply Line p _ /� n
ADA '2 1 porei-f�-� Ext
Approach/Sidewalk Date v Inspector
Other:
Final DO NOT REMOVE this inspection record from the job site. •
PASS PART FAIL