10300 SW GREENBURG ROAD STE 270 I
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10300 SW GREENBURG ROAD
SUITE 270
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 —�--------
BUP
Date F'equestteed -Z-- AM _-PM BLD ^— — --- - -
Location_ U 3 00 Sc - �y�/� vl Suite 6 MEC
Contact Person _ --__ Ph G 2 _3 3� PI-M
Contractor Ph _^ S11VR
BUILDING Tenant/Owner _ FIX /'GG
Retaining Wall
Footing Access: -- —
Foundation FPS
Ftg Drain --- ------ SGN
Crawl Drain Inspection Notes — -- —
SlabSIT
Post&Beam
Ext Sheath/Shear
Int Sheath!Shear ----------i—
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —
Roof
Misc.
Final
PASS PART FAIL ---- -s /
PLUMBING _ 5` s
Post& Beam -- �
Under Slab
Top Out ----- --- ��
Water Service o/
Sanitary Sewer —`
Rain Drains
Final
PASS PART FAIL _
MECHANICAL v
Post& Beam ---- --
Rough In
Gas Line -
Smoke Dampers
Final -
PASS PART FAIL
Service .�
Rough InCel//0'7
UG/Slab G vvLow Voltage
Fire Alarm
Fi
S PART FAIL
Hackfill/Grading --- _ - --- _
Sanitary Sewer
Storm Drcin [ J Reinspection fee of$ required before ntayt inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f ]Please call for reinspection RE: _ — [ ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other
DateZZ 4J Inspector ! / Ext
Final
PASS PART FAIL [3O NOT REMOVE this inspection record from the job site.
CITY OF T I G A R D yV_____ELECTRICAL PERMIT
/ (',0'(�� PERMIT M ELC2001-00123
DEVELOPMENT SERVICES a^ ov DATE ISSUED: 3/2/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 2.70
SUBDIVISION: LINCOLN UNE/RED LOBSTER/CASA L ZONING: C-P
BLOCK: LOT : JURISDICTION: 'FIG
Prriect Description: Tenant Improvement
--RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: _ PUMPARRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: S(GN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANE HM/ SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
`SERVICE/FEEDER BRANCH CIRCUITS
--------- __ _r _ _ _ 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 amr): _ PLAN REVIEW SECTION
1000+amp/volt: , >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only; _ SVC/FDR >= 225 AMPS__ CLA.3S.AREA/SPEC OCC:
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV WILLAMETTE ELECTRIC INC
BY NORRIS. BEGGS + SIMPSON PO BOX 230547
10300 SW GREENBURG RD STE 200 TIGARD, OR 97281
PORTLAND, OR 97223
Phone: Phone: 624-3631
Reg#: LIC 75059
SUP 1965S
ELE 34-283C
FEES Required !nspections _
Type By Date Amount Receipt
_ Ceiling Cover
PRMT CTR 3/2/01 $60.15 2720010000( Wall Cover
5PCT CTR 3/2/01 $4 81 2720010000( Elect'I Final
Total $64.96
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 ATTENTIOIJ: Oregon law requires you to follow riles adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-00 0 You may obtain copies of these rules or direct questions to OUNC at(503)
7.48.1987.
PERMITTEE'S S;GNATLIRE ISSUED BY:
6WNER 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 S{UPR. ELEC'N: BATE:
LICENSE NO: /y�� �� �_ � ------------..�
Call 639-41 r5 by 7:00pm for an inspection the next business day
Electrical Permit Applicat ion
Uatereceived: Pennit
City of Tigard Project/appl.no.. E.tpiredate:
Ciryoffigard Address: 13125 SW Ilail Illvd,'I ij�aid,OR 97223 pate issued: By. Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file nu.: Payment type:
Land use approval: __ ----__--- . ---
TVPEOFPERMIT-' ,
U I &2 family dwelling or accessory U Comntercial1industnal U Ntulu-lantily ATenant improvement
U New construction U Add ition/alteralion/replacement ❑Other: U Partial
1 : 1
Job t.ddress: i _ I Bldg.no.: Suite no.: 4 1Tax map/tax lot/account no..
Lot: [clock: Subdivision: V _
Project -,r'— ecce- Description and location of work on premises: 14,,�,� •,,,,f
Estimate)da(
SCHEbULE
CONI 11A(T011 APPLIUM]ON
Job no: Atex
L Desert lion Ql). (ea.) total no.hrsJ,
BUSlne99 name: I,v} I I N M 1�p �!t qtr L !�/" ` New rrsidendal-single or multi-4mlly per
Address: C /� ,� Z; dnellinrunit.Inchnkmeltachedgaage.
City: , Stale: ti ZIP: Servicrbhcluded:
Phone: L t-�, — I ax: .t 2 3S' Email: 1000 sq.ft,or less
Each additional 500 sq.ft.or portion thereof
CCB no.: '�q?J — Elec.bus.Ile.no: 3 - 7 C Limited energy.residential 1
City/metro lie.no.: 5'y Limited energy,non•residential _-- - 2
Each manufactured home or modular dwelling
Service and/or feeder
Signature of su .rvisin clrician(re aired) bate -- __?—
` L401
cesorfeeders-loslallation,
Sup.elect name(print): ,, License no:e 4 5tion or relocation:
mps or less 2mps to 400 amps 2
Name(print) mpsto600amps2
Mailing address: nips to 1000 amps 2
City: ' udc: ZIP: l(xx)ampsorvolu __ 2
Phone: I'ax: mct
E-mail: Rcc,neonl I
Owner installation:'17ie installation is being made on property I own Temporary a perces or feeder-
buxlAllallon,alteration,or rclacalfom:
which is not intended for sale,lease,rent,or exchange according to 200 snips or less _ _ 2
ORS 447,455,479,670,701. i01 amps to 400 amps _ 2
Owner's 91 1181UrC: DAIC: 79i
nm s 2
lrculls-nion per panel:
Name: r branch circuits with purchase of
Address: e or feeder fee,each branch circuit 2
City: State: ZIP: r branch circuits without purchase y'ice or feeder fee,rarerbranchcircuit: 2
Phone: Fax. -mational branch circuit. Z_ i 3'
V1 19 1171 Muse.(Service or(ceder not Included)-
U Service over 225 limps-comrrrrcial U Health-care facility Each pum nr irrigation circle 2
U Set,,ice over 120aohps rstingn;t&2 U IlaverdousImation Each sign or outline lighting
family dwellings U Ilnllding over 10,000 square feet four or Signal citcuit(s)or a limited energy panel,
USystem over 6Wvolts nr�mioa rhoreresidential units inone structure alteration,orestension• 2
U Building over threestorics U Feeders,4Wvnpsormore *Description:
U Occupant load over 99 peranns U C.lanufactured structures or RV park Fach additional Inspection over the allowable In any of the obw e:
U EgresMightingplau U tither -- perinspection F—T-r,S�--
L �ribmit___sets of plans with any of the above. Investigation fee—y
The above are not applicable to temporary construction service. other
Permit fee.....................$
No,all)uris&fiom accept credit cods,plena call iunuliuion for more information'. Notice:This permit application
U Visa U MasterCard expires if a permit is not obtained Plan review(al ___ 96) $
Credit cud number / / within 190 days alter it bas been State surcharge(8%) ....$
Esping accepted as complete. TOTAL .......................S —
Naroe c r n n ar c 't t $
Cudtrolckr Nsrhnurc Amount _ 440.1615(6MCOM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential•per unit
1000 sq it or less $145 15 4 Audio and Stereo Systems
Each additional 500 sqit or
portion thereof $33.40 1 E] Burglar Alarm
Limited Energy $75.00
Each Manufd Home or ModularGarage Door Opener'
Dwelling Service or Feeder $9090 2 El
Services or Feeders Heating,Ventilation and Air Conditioning Systr in'
Installation,alteration,or relocation
200 amps or less $80.30 2 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
60 amps to 1000 amps �— $240.60 2 Other
Over 1000 amps or volts $454.65 2 ---— -------- - - —
Reconnect only `— $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Inslallation,alteration,or relocation .. $75.00
200 amps or less $86.85 2 Fee for each system.................................................... ..
201 amps to 400 amps _ $100.30 2 (SEE OAR 918-260-260)
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see"b"above.
Audio and Stereo systems
Branch Circu!ts
New,alteration or extension per panel Boil�i Controls
a)1lie lee for branch circuits
with purchase of service or
feeder fee. Clock Systems
Each branch circuit 56.65_ 2
b)The fee for branch circuits Data Telecommunication Installation
without purchase of service
or feeder lee. —� Fire Alarm Installation
First branch circuit _� $46.85
Each eddllional branch circuit $6.65 HVAC
Miscellaneous
(Service or feeder not Included) Instrumentation
Each pump or Irrigation circle $53.40
Each sign or outline lighting $53.40 — Intercom and Paging Systems
SIgnal circulf(s)or a limited energy
panel,alteration or extension $75.00
Minor Labels(10) _ $125.00 Landscape Irrigation Control'
Each additional Inspection over Medical
the allowable In any of the above
Per inspection $62.50 --- Nurse Calls
Per hour _ $6250
In Plant $73.75 ❑
Outdoor Landscape Lighting'
Fees:
Protective Signaling
Enter total of above fees $
�] Other
8%Stale Surcharge $
_Number of Systems
25%Plan Review Fee
See`Plan Review"section on $ ' No licenses are required Licenses are required for all other installations
front of application. _—
Total Balance Due $ Fees:
Enter total of above fees $
❑ Trust Account N— —
8%Slate Surcharge s
Total Salance Due $
t:4lsts\fumukic-fccs.doc 10/09/00