Permit A. , CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00538
_
� , r4 DEVELOPMENT SERVICES DATE ISSUED: 9/11/00
" '` _' - I- 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09640 SW WASHINGTON SQUARE RD G -11
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: 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: 20 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 OK ELECTRIC CO
P.O. BOX 21545 777 E 4TH ST
SEATTLE, WA 98111 MCMINNVILLE, OR 97128
Phone: Phone: 503 -472 -5700
Reg #: SUP 434S
LIC 00002117
ELE 36 -10c
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Final
PRMT CTR 9/11/00 $213.30 2720000000(
5PCT CTR 9/11/00 $17.06 2720000000(
Total $230.36
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 OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATUR 4 �l ISSUED BY: r
' OWNE 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
09/08/00 FRI 16:23 FAX 503 598 1960 CITY OF TIGARD Z002
CITY OF TIGARD Electrical Permit Application Plan Check #
,
'13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Rec• - ll -e - 0
Phone (503) 639 -4171, x304 Print of Type Date to P.E.
Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # &L 4n 0 g
Fax (503) 598=1960 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ,.. tJ . o N .. �e�% Number of Inspections per permit allowed
Name (or name of business) iii - - (I Service included: Items Cost Total
Address %g4DS113 1)JP t 6J(- cT)o,, f�R R 0 - (e i - (/ 4 a. Residential - per unit
1000 sq. ft. or less $147.15 4
City /State/Ztp b C - , O - Z Cf 1 CZ-5 Each additional 500 sq. ft. or
portion thereof $33.40 1
Commercial ® Residential ❑ Limited Energy $75.00
Each Manufd Home or Modular f
Dwelling Service or Feeder $90.90 2
2a. Contractor installation only: 4b. Services or Feeders
(Prior to pemnit issuance, applicants must provide contractor license Installation, alteration, Or relocation
Information for COT data base). n 200 am s or less
Electrical Contractor t )4 -. S 17- 0th p $80.30 ,. C 2
201 amps to 400 amps $106 85 2
Address/77 1 (-471 5 - 401 amps to 600 amps $160.60 2
City IL\C14.t 0 i 3It.Le State (Qg- Zip Q7lZ 601 amps to 1000 amps $240.60 2
Phone No. - i-(TZ -S7pa Over 1000 amps or volts $454.65 2
Job No. Ce53 Reconnect onl $66.85 2
Elec. Cont. Lice. No. '/O - /D- Exp.Date 1c› -( - bb 4c. Temporary Services or Feeders
OR State CCB Reg. No.7 I 1 - 7 Exp.Date 6, - 3 - 64. installation, 200 amps or a or less les or relocation
$66.85 2
COT Business Tax or Metre o. I p.Date 201 amps to 400 amps $100.30 2
,/ 401 amps to 600 amps $133.75 2
Signature of Supr. Elec'n , _ Over 600 amps to 1000 volts,
see "b" above.
License No. 4 3 4 - S Exp.Da e b--1.--c l 4d. Branch Circuits .
Phone No. 3- x-172 - S 7D C) New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or
2b. For owner installations: feeder fee.
Each branch circuit Zo $6.65 l 33 • cc' 2
Print Owner's Name b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
First branch circuit $46.85
Phone No. Each additional branch circuit $6.65
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not inducted)
Each pump or Irrigation circle $53.40
Each sign or outline lighting $53.40
Owner's Signature Signal circuit(s) or a limited energy
panel, alteration or extension S75 00
3. Plan Review section (if required):* Minor Labels (10) $125.00
Please check appropriate item and enter fee In section 58. 4f. Each additional inspection over
the allowable in any of the above
4 or more residential units in one structure Per Inspection $62.50
• Service and feeder 225 amps or more Per hour $62.50
System over 600 volts nominal In Plant $73.75
Classified area or structure containing special occupancy as 5. Fees:
described in N.E.C. Chapter 5
66a. Enter total of above fees $ Z 1 7 70
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 1 7 . C,6,
Notre required for temporary Subtotal $ Z3o .3r,„
q porary construction services.
5b. Enter 25% of line 5a for
NOTICE Plan Review If required (Sec. 3) $
Subtotal $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR ❑ Trust Account #
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Total balance Due $ z
AT ANYTIME AFTER WORK IS COMMENCED.
i:\dsts\forms\electric rev.doc - 8/00
CITY OF'TIGARD BUILDING INSPECTION DIVISION MST
• 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
q
Date Requested AM PM BLD
Location 96 7 O sw / Suite MEC
Contact Person ( I Ph C.� C700 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 4/7Z Q
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall V •
Fire Sprinkler — _ • l i`
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
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
P FAIL
(ELE IC
Service
Rough In co )
UG /Slab l / / y�q(_J v
Low Voltage
Fire Alarm
Fin
S ART FAIL
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 Sr Other Dateless Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OFTIGARD BUILDING INSPECTION DIVISION --
24 -Hour Inspection Line: 639 -4175 Business Line: 639 ma •
BUP
Date Requested g' 7 .4 AM PM BLD
Location 9q.1) 5 w Gr/G 4 77 • Suite G' MEC
Contact Person // Ph 5 ) q 7Z SGU PLM
Contractor Ph `7 - 3 SWR
BUILDING Tenant/Owner (� e-14 /71 --,./44-&-f ELC .2 o - 6& 5 3I
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire Sp i
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
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
,zEC�CTRICAL�
Service
Rough In 1
UG /Slab
Low Voltage
Fire Alarm
F e PART FAIL
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 r inspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date ZD Ell Inspector Ext
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / -1, AM PM BLD
Location ?f,4 (to 314 14)45 1 1 5/ /- Suite MEC
4/
Contact Person / Ph 2 z - 3 7GU PLM
Contractor e Ph SWR
BUILDING Tenant/Owner ELC .2('€ u —6".°5-3°Y
Retaining Wall ELF 1-41N 9D "010L(.1 7
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing t
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
4,0
Misc:
Final
PASS PART FAIL
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
T FAIL
ELECTRIC
Service
Rough In
UG /Slab
Low Voltage
Fir larm
Fi
S PART FAIL
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
Other Date / /4 70 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.