Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00832
COMMUNITY DEVELOPMENT DATE ISSUED: 12/12/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 ZONING: C -G
SUBDIVISION: ONE EMBASSY CENTER LOT : JURISDICTION: TIG
PROJECT: ARTIELLE
Project Description: (3) branch circuits for recpt. and switch.
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: 2 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:
PORTLAND OFFICE ASSOCIATES R C COSTELLO ELECTRICAL CONTRACTING
BY TC PORTLAND, INC PO BOX 336
8930 SW GEMINI DR AURORA, OR 97202
BEAVERTON, OR 97008
Phone: Contact #: PRI 503- 982 -7400
FAX 503 - 982 -7401
FEES
Description Date Amount Reg #: ELE 3 -344C
IELPRMTI ELC Permit 12/12/200' $60.15 LIC 87402
TAX] 8% State Surcharge 12/12/200' $4.81 SUP 3934S
Total $64.96 REQUIRED ITEMS AND REPORTS
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: Permittee Signature:�('� ,J - --
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
'b
Electrical Permit ApplicRECEIVED FOR OFFICE USE ONLY
. Received
- City of Tigard Permit n Q Z
IN
v 0145'2E3 I Date/By °'� I Z/0 T7� _C C / �o 3
13125 S W Hall Blvd , Tigard, 1 2 /III / Plan Review /
l7 Phone 503 639.4171 Fax 503 . 9bQ Date/By. Other Permit
I nspection Line. 503 639 417;..: Y U r- ! l tAND Date Ready /By. lures ® See Page 2 for
TicAlin g g UI LDINGDIVISIO�
Internet. www ti aril -or gov I Notified/Method Supplemental Information
TYPE 'OF WORK PLAN REVIEW -
❑ New construction E Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards
' -- CATEGOI;Y OF •CONSTRUCTI . exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
,
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi - family [Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB' SITE INFORMATION,.AND LOCATION - • . - ' ❑ Addition system larger separately denved system
❑ Adddition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: (7U 2U S (& J �qS h'� /I7 - ion S Q,/ I x or or more occupancy
Z ❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: � t U 2 ❑ Health -care facilities 0 Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
ui a Idg. /apt. no.: 1 S O Project name: 4r �e / /e_ ❑ Service or feeder 600 amps or more
FEE SCHEDULE ' .
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Eryba O� - Li I cl ;If Lot no.: 1,000 sq ft or less 145.15 4
Ea add'l 500 sq. ft. or portion 33 40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq ft.) 75 00 2
Limited energy, multi - family 75 00 2
3raviC 1, (? 1 rev �f -['� r reap tU c les residential (with above sq R )
//+ Services or feeders installation, alteration, and/or relocation
( S W i (.1-, I i i k f 7 t xiire S 200 amps or less 80 30 2
❑ • PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240 60 2
Address: Over 1,000 amps or volts • 454 65 2
City/State /ZIP: 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 I00 30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT • I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
Business name: each branch circuit
B Fee for branch circuits
without service or feeder fee, / 46 85 6 5 2
Contact name: first branch circuit
Address: Each add'I branch circuit Z 6 65 /3 • 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90 90 2
Phone: ( ) Fax: : ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53 40 2
• CONTRACTOR Sign or outline lighting 53 40 2
Business name: C r ite Jr, Elec Iri(q 1 ,�, Signal p a n e l ,(a) e rIt on , or
(.b �., c, energy panel, alteration, or
extension Describe Page 2 2
Address: -- Po , -30h 33 6
City/State /ZIP: ( 0 K cr 3 L Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: (50 J ) qqZ- --) L(p V Fax: (50 3 ) 9 b L- 'No / Investigation per hour (I hr min) 62 50 _
CCB Lic.: '3 - )L/O Z Electrical Lic.: 7 -3Z-ley C Suprv. Lic.: 3q y_ f lndustnal plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: �� Subtotal Cep - /3
// Date: // Plan review (25% of permit fee)
Print name:
y Lo S / �" /L / /Z ! - ' State surcharge (8% of permit fee) #
Authorized signature: TOTAL PERMIT FEE ( o r� -,C1L, '
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Building\Permits\ELC- PermitApp doe 05/23/06 440-46 t 5T(i t /05 /COM/WEB
_.
Electrical Permit Application - City of Tigard [_� `,��'� � f ° 3
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
R ESIDENTIALWORK ONLY: -
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL.WORK ONLY:' 4_
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
I \Budding\Permus\ELC- PermuApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION ..,,. PERMIT #: ELC2007.00832
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17/12/2007
Phone: (503) 639 -4171 4 "" 9
Inspection Requests (24 Hrs.): (503) 639 -4175 �. '!
INSPECTION WORKSHEET FOR DATE: 12/13/2007 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: ARTIELLE
DESCRIPTION: (3) branch circuits for recpt. and twitch.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 503 -982 -7400
Inspection Request Scheduled For: Date: 12/13/2007 Pour Time:
Code # Inspection Description \ Confirm # 'Contact # Message
'125 Wall cover 061425 -01 03-604 -6757 N
Corrections /Comments /Instructions:
Y PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ----, NAS,€ LE Date: 11243' O') Phone #: (503) 718- 24410
CITY OF TIGARD
BUILDING DIVISION _ PERMIT #: ELC2007 -00832
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
Phone: (503) 639 -4171 /asrwd I
Inspection Requests (24 Hrs.): (503) 639 -4175 all °TI L
INSPECTION WORKSHEET FOR DATE: 12/27/2007 TIME: 7 PAGE: 2
l
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE: 1
PROJECT NAME: ARTIF_LLE
DESCRIPTION: (3) branch circuits for recpf. and switch.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: R C CO ,TFLLO ELECTRICAL CONTRACTING k PHONE #: 593-982 -7400
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 062217 -01 503-706-3211 {{ Y
Corrections /Comments /Instructions: - �� vu
— ;Si_F — #► AM
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CI".', W W LC' Date: wIli 01 Phone #: (503) 718 -1A
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007•00832
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12113/3.007
Phone: (503) 639 -4171 ' 1
Inspection Requests (24 Hrs.): (503) 639 -4175 4 'I �..
•
INSPECTION WORKSHEET FOR DATE: 118 / 006 TIME: 7 :01AM PAGE: 23
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 4160 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: AR li i _LLF
DESCRIPTION: (3) branch circuits for rocpt. and smitch.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 603 982 - 7400
Inspection Request Scheduled For: Date: 102009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 062757 -02 503.504.6758 N
Corrections /Comments /Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
(l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • N W (-Lt Date: 1-'1' t Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00832
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17J1212007
Phone: (503) 639 - 4171 ° i A, Inspection Requests (24 Hrs.): (503) 639 -4175 "'II
INSPECTION WORKSHEET FOR DATE: 11B/2008 TIME: 7:01AM PAGE: 24
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 CLASS OF WORK:
SUBDIVISION: ONE EMBASSY CENTER LOT #: TYPE OF USE:
PROJECT NAME: ART' FILE
DESCRIPTION: (3) branch circuits for recpf. and switch.
OWNER: PORTLAND OFFICE ASSOCIATES, PHONE #:
CONTRACTOR: R C COSTELLO ELECTRICAL CONTRACTING PHONE #: 503-982-7400
Inspection Request Scheduled For: Date: 1/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
' 30 Ceiling cove 062757-01 503.504 -6758 N
r 9 q VI N AL,
Cor = tions /Comments /Instru• ions: ' (iii\U (. III Ct
•
�` ❑PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 06 d
Date: I " ' 1 Phone #: (503) 718- 2-1.11A