Permit h CITY'OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00449
DEVELOPMENT SERVICES DATE ISSUED: 7/21/2004
II 13125 SW Hall Blvd., Ticard, OR 97223 (503) 639 -4171
PARCEL: 1S126BC-01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450
SUBDIVISION: ZONING: C -G
BLOCK: . LOT : JURISDICTION: TIG
Project Description: Wire office, TI, (5) branch curcuits.
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: 4 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 HILLSBORO ELECTRIC
BYTC PORTLAND, INC 21185 NW EVERGREEN PARKWAY
8930 SWGEMINI DR HILLSBORO, OR 97124
BEAVERTON, OR 97008
Phone: Phone: 503 - 439 -9666
Reg #: ELE 34 -4399C
LIC 134481
FEES SUP 4941S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/21/2004 $73.45
[TAX] 8% State Surcharge 7/21/2004 $5.88
Total $79.33
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty Codes and all other applicable laws
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION' Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1-800- 332 -2344.
Issued By: 7te � Permit Signature: 3..e,- t.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
'" i= rom:HILLSB0R0 ELECTRIC LLC. 5036013680 07/20/2004 10:18 #448 P.001 /002
Electrical Permit Applicati \ `� t<Ott OIFicE t IS IC ()No'
City of Tigard �� m e re L/ y ID Permit No.: , OOy oV
1312$ SW Hall Blvd., Tigard, OR 97223 ® Plan Review
e,
Phone: 503.639,4171 Fax: 503.598 1960 V �- �.'sw i (r� "u { i Date/B Other Pennit: .
Inspection Line: 503.639.4175 d �" —a L 1' Date needy/BY' @Sea Page 2 for
Internet: www. ci.tigurd.or.us ®� 1 ; � ,; Notitied/Method Supplemental Information
��,��� �
. TYPE OF ORI{ : PLAN REVIEW
),`-:-‘14-, „' apply:
❑ New construction 1:� Addltioi�lteration/replaeemert[ Please check all that pD Y:
Q Demolition Outer: ❑Service over 2.25 amps, comm'I ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION. . „ _ • . of 1- and 2- family dwellings 4 or more new residential
• ❑ 1- and 2- family dwelling tgl Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
Q Multi family [] Master builder 0 Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION 'AND ' , :; :: • RV
' �� ❑Eg ress /li p lan pa rk
Job no.: qv. Job site address: (� 5 w I ,. ' 4 D D ❑HCalth care facility ❑Other:
` w `�" rt S1 - Submit 2 sets of plans with any of the above.
City/State/ZiP: 7 j� i C e - , I of O. G 3 �a.3 The above are not applicable to temporary construction service.
bldg./apt no -: /5 ) Project name: �/ ` } t
_ ,'^.; :� -FEE". " - SCHEDULE ,'•':- .';'•; - ; . .
Sui
t'11r 1 1 tilt I ' m" M.tD ' MCA Pr /1 -V 66,1ption I Qty, I Fe, I TM .
aI • • I •t
Cross street/directions to job site: Of .}� C. / New residential single- or multi- family dwelling unit.
Includes attached garage.
. 1,000 sq. ft. or less 145.15 4
Subdivision: . i Lot 110,: >8 addi 500 sq. it or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
;, : • ., DESCRIPTION, 75.00 2
,'r• i. CRiPT , O.il' WO RK" . , ?•..;.i ,,,,;,.; biii;'..:,;
- �.ca. non-residential
o r modular'
Limited energy, no
• � �••� :: - _. � Each manufactured
' q . ^ dwelling, service and/or feeder 90.90 2
w • P (JT � t f: LS I / Services or feeders installation, alteration, and /or relocation
200 amps or less - J 80.30 f 2
' :. !. 2
' •, ❑•.PROPERTY OWNER � ;'�'�;';;,;'; ' ° ?''.'�;, "' ❑��TENAhI11' "' ^,;• , 20 1 amps 506.85
401 amps to 600 amps 160,60 2
Name: 601 amps to 1.000 amps 240.60 2
Address: Over 1,000 amps or volts 454,65 2
Reconnect only 66,85 2
City/State/ZIP: • Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less i 66.85 1
—
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
0 PPLICANT; : I "❑ CO PERSON - , - :.. ,
... •: •�„ { ; •.., ; :� : ; ' A Fee for branch circuits with
" , A ' : ' service or feeder fee, each 6.65 2
Business name; branch circuit
- - B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit i 46.85 1( 2
Address:
Each add'I branch circuit I Li 6.65 (p .(pOr 2
City /State/ZiP: Miscellaneous (service or feeder not included) _
` - — Pump or irrigation circle I 53.40 2
Phone: ( ) Fax: = ( ) _ - Sigm or outline lighting 53,40 2
E -mail: Signal circuits) or limited-
' ' ' - :. . : . CONTRACTOR' ' . • : .. ' , • energy panel, alteration,
extension. Describe: Page 2 2
Business name:
Hil lsboro Electric L.L.C. .._ _
Address: 21185 NW Evergreen PKWY Ste #110 Per Each
inspection inspection over allowable ie any of the above
Per ispection 63 SO
City/State/ZIP: Hillsboro , OR . 97124 Investigation per hour (1 hr min) 62.50
Phone: (5 0 3) 439-9666 I Fax: (503 )6 01- 3 6 8 0 Industrial plant per hour 73.75
•ELECTRICAL . :PERMIT FEES= :
CCB Lic.:1 3 4 4 81 I Electrical Lic.:3 4— 4 9 9 C Suprv, Lic.: 49 41 S Subtotal 7 3, 5/5
Suprv. Electrician signature, required: daei .Gl� Plan review (25% of permit fee) . •-�.
Print name: Joey /� State surcharge (8% of permit fee) ...S i ili
y Vi t acco Date: _ v _a / u TOTAL PERMIT FEE - 79, 33
Authorized signature: This permit application expires if a permit is not obtained within 180
f days after it hap been accepted as complete
Print name: . 1 Date: • Fee methodology set by 'lb-County Building Industry Service Board
- CC Number of inspections per permit allowed
1. 1BuiIding \PunttiLtiELC- PerInlAppdoe i2/Oa 440.46 I5T(10/02/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING . Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
�i BUP
Received Date Requested O 1 - 3 AM PM BUP
Location / % A . 5 Q • Suite LA,--C-6 / MEC
Contact Person i c:( ° Ph ( ) 3 1 (- / `' PLM
Contractor Ph ( ) SWR �,,
BUILDING Tenant/Owner ELCc� ,� 1 _ — co (�
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors MAW
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation �, V r N kZ j
Drywall Nailing ��
Fire wall
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
Fir larm
•A PART FAIL
111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line 1 3 ADA Approac h /Sidewalk Date I3 ` � Inspector J � , frpwrI'yEX t
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL