Permit 41 CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00435
ii� DEVELOPMENT SERVICES DATE ISSUED: 8/29/01
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09400 SW WASHINGTON SQUARE RD
SUBDIVISION: TA SblllNGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: 175 amp re -hook for power supply to generator on rooftop.
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: 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:
PPR WASHINGTON SQUARE LLC PRAIRIE ELECTRIC INC
P.O.BOX 21545 6000 NE 88TH STREET
SEATTLE, WA 98111 VANCOUVER, WA 98665
Phone: Phone: 360 - 573 -2750
Reg #: SUP 3562S
LIC 60178
ELE 37-491C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 8/29/01 $80.30 2720010000( Elect'I Final
5PCT CTR 8/29/01 $6.43 2720010000(
Total $86.73
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: u Issued By: 1 / _L.?" 4./
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
07/17/01 TUE 17:23 FAX 593 848 3993 WASH CU. 3Lt)t; 5lvt(V1Lt S .}Juuo
S� I D� •Cv" • '- 1 e- 746.2 —(-) .
� c Electrica ermi Application
i _ try .g+v Date received /,, 0 / Permit no. , a� I..�94
rrL L r
Address:155 N. 1st AV, Suite 350 -12, Hillsboro, OR 97124 Projecvappl. no Ex date: -
OREGO' Phone: 503- 846 -3470 Fax: 503- 846 -3993 Date issued: By: - Receipt no.:
Internet Address: www.co.washington.or.us Case file no.: Payment type:
Land use approval: 3 7 , 177
I
0 1 & 2 family dwelling or accessory Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction [ t Addition/alteration/replacement 0 Other: _. 0 Partial
I
Job address:j (1 J S.W. kfAS4jn167e,.) . 1�: City: t oo Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: i Block: N/A I Subdivision:
Project name: rwz V'N 1 5 [Description and location of work on premises: €i Tpx n f Jy P5 gooJ=
Estimated date of completion/inspection: - 3) - 0 I et' ID
Job no: Fee Max
/�� ` Description Qty. (ca.) ,Total oo. ins'
Business name: pg,Rl C New residential - dngleormtdli- family per
Address: K -) &)E , ' 'Tt' 5T dwelling unit. Includes attached garage.
City: VieVOLOQ ' I State: Ge.)4 I ZIP: itGG5 Smite Included:
Phone: 26- V3-.2750 I F 360. 57 3 0 lrmail: . 1000 sq. ft. or less 125.00 4
Each additional 500 sq. ft.or portion thereof 35.00
CCBno.: ( 1 I Elec. bus. lie. no: :37- sy21(
Limited energy, 1 & 2 Family 35.00 2
City/metro tic. e 9 : N /A, Limited energy. Multi- Family 55.00 2
( ?_ g1-6 i Each manufactured home or modular dwelling
Signature of
C .
•ervis, g Bled., tan ( evoked) Date Jr? Service and/or feeder 85.00 2
Sup. elect, name (pnnt): 1 1. ALI'S -`E Ali License no:' s.„,.. S Services or feeders — install�tlon, qIN
alteration or relocation: XX 6'4,1
. l'ROl'i:l:l N OWN LIZ 200 amps or less OA .1 75.00 2
Name (print): In etzvyio 15 201 amps to 400 amps 100,00 2
f 401 amps to 600 amps ,150.00 2
Mailing address:
q�100 5,t..,. �A5)4irJ6-TOrt) :v AQl- AV 601 amps to 1000 amps 225.00 2
City: Lai . a State: aa: ZIP: 9 7. - 7 Over 1000 amps or volts 420,00 2
Phone: Fax Email: Reconnect only 65.00 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to Installation, alteration. or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 65.00 2
201 amps to 400 amps 90.00 2
Owner's signature : Date: 401 to 600 amps 125.00 2
l.{ N (i I N F HZ Branch circuits - new, alteration,
Name: A. extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder (es, each branch circuit 7.00 2 _
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: Afar— 2
Phone: Fax: E-mail: Each additional branch circuit: 7.00
. PLAN RI.VIl:1V (Please clerk all Iliat apply) Misc. (Service or feeder not included):
0 Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 50.00 2
0 Service over 320 amps-rating of 1 &2 0 Hazardous location Each sign or outline lighting • 50.00 2
family dwellings 0 Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one smrcturc new, alteration, or extension' 50.00 2
0 Building over three stories 0 Feeders. 400 amps or more •Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable iii any of the above:
0 Egress/lightingplan 0 Other: Per inspection I 1 85.00 I i
Submit 2 sets of plans with any of the above. investigation fcc
The above are not applicable to temporary construction service. Other �
Notice: This permit application Permit fee $ � d..�+ �/2
visa 0 MasterCard / � � expires !fa permit is not obtained Plan review (at 25 %) $
Credit card number: ' /` /f p prp229Z WO Y2 6 1 6 e/ 6 " 2- within 180 days after it has been State surcharge (8 %) .... $ 1.
149 FQG Ex accepted as complete. TOTAL $ OO
lY cardh der as shown on credit card T (Ail. e (�/ 'J
$� 4/0..-' (Ail. V 0000 /
Cardholder at tuft Amount
86,-73
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CITY OF TIGARD BUILDING INSPECTION DIVISION
2441-lour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested ) � AM PM BLD
Location S Q Suite MEC
Contact Person Ph - 9? d r PLM
Contractor / f Eatez&Ph SWR _,
BUILDING Tenant/Owner ELC 2v a / — ge '1.M
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 4y, / � - - IT
Post & Beam ^ (/
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL L C!` /il I? ez>C . / d !i7 D p ('�
e X / s l � ��/ �' 1 €
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
( 111)1 : 10111115
`oug
ab
Low Voltage
Fire Alarm
e aCt PART FAIL
S E'
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 9 - 1 — / Inspector Ext
Other P
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •