Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00697
DEVELOPMENT SERVICES DATE ISSUED: 9/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S115AB -01900
SITE ADDRESS: 16200 SW PACIFIC HWY D ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT : JURISDICTION: TIG
Project Description: (5) branch circuits and low voltage for data in "Take Care Health System" area.
Job No. W15107
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: 1
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: 5 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:
BIT HOLDINGS LTD PARTNERSHIP CHRISTENSON VELAGIO, INC.
BY FORUM PROPERTIES INC 1631 NW THURMAN ST. STE 200
FIVE CENTERPOINTE DR STE 290 PORTLAND, OR 97209
LAKE OSWEGO, OR 97035
Phone: Phone: 503 - 419 -3600
FEES Reg #: LIC 64137
ELE 26 -1174C
Description Date Amount SUP 1994S
[ELPRMT] ELC Permit 9/20/2005 $148.45
[TAX] 8% State Surcharge 9/20/2005 $11.88 REQUIRED ITEMS AND REPORTS
Total $160.33
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
suspende. • - . - • •n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules - - set forth in OAR • It 1 -00 • hrough OAR 952 - 001 -0100. You may obtain copies oft - rules or direct questions to OUNC at
503 46 -6699 +r 1 -800 -3 0
Iss ed By: ! - Permittee Si • • • / c�-V
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 I STALLATION ONLY
SIGNATURE OF SUPR. DATE:
LICENSE NO: / Q' FVs
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.
SEP -19 -2005 MON 11:40 AM CHRISTENSON VELAGIO FAX NO. 95034193695 P. 01
..EI ctrical Permit AI1plic 1.01(0141(T l Sl_ U,NI,l C
City of Tigard EIVE 9 it os is, a f PermitNo.: ��v,w�"061&
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
�Ep 19 2 '', ti -! 'J I I .. Dame
Inspection Line: 503.639.4175 s '! i Dote Ready/ay: b'1 See Page 2 for
NLl l Tn ri'
Internet: www•ci.tigard.or.us Nodtled/Methad: ( t as Supplemental information
• 1:, fi': 7 .x,�(�'- A^�^���i'�r�,•S_��i��", c � F `' - •- .� .
.�':. sl�:•,tSti ":,.•:: -Fl I ° a'n a4 • !ii'G Ai:. x41 J. 41 , . - '.: 4 ' . "': nrw .
❑ Ncw construction InAddition /alteration /replacement Please check all that apply:
['Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other. ['Service over 320 amps - rating ❑Bulldog over 10,000 sq. ft • 24:W;46-... ,. ...4 ' ! ``•: c'.5 L' ; ,'J 6 . 1 $ _ s" i+ a !1 :-, .::'S ap : ' 0. :94 �w of 1- and 2- family dwellings 4 or more new residential
O .1- and 2- family dwelling commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders. 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structui or
:� x.. �,�,,,� rcue , rte ,. Y� RV park
VAg S . ` :1 17i l �' al '�.' " ; gt Oft •n :#:';'''.7,.. • .tFr?,4r. • '•: b . . 4: , . '" . a . n . ,. ['Other:
Job no.: W15107 J Job site address: 16200 SW PACIFIC HWY ❑ Healthcare facility
Submit z sets of plans with any of the above.
City/State/ZIP: TIGARD, OR 97 224 The above are not applicable to temporary construction service.
: RITE - AID STORE Niel . ,.?.: ..-04k,BEE li CIaiel 1 - 'I s L l it
Suite/bldg /apt. no.: I Project name: pncrtpdea Qty, Fee, Total
Cross street/directions to job siteQUE ST ION S ?TOM KOSMAS (503) 260 - 4269 New residential single -or multi - family dwelling unit.
- Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: l Lot no.: Ea add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non - residential 75.00 2
1 awe I }.,• r ��^ 47 �W! l Y I
gK y, t; , / }ilr ;.. ..: .:..
�'��n - ~ fi��Yb7�,r',.:." /,'�`� }! °rrli;? •, . p�y��: J3!. � ,`eDIX�%.7.F.��M!�.'�'r_'... '_ •! �: Yi•.. .'.' �. 4. ..i;`C.�. , ....4.wf.. '.. {:.: ., .: - Each manufactured or modular
ELECTRICAL CIRCUITS AND LOW VOLTAGE DATA FOR dwelling, service and /or feeder 90.90 2
" Services or feeders Installation, alteration, and/or relocation
TAKE CARE HEALTH SYSTEM AREA 200 amps or less 80.30 2
.. .Ha 201 amps to 400 amps 106.85 2
I ����' y ' �� �I� • r F. .,
;li r a ,k or''siY ;�.;i"FW j� � I: po; .:a: 401 amps to 600 amps 160.60 2
• Name; 60l 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 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, rcnt, or exchange, according to ORS 447.449, 670, and 701. 401 amps to 600 amps _ 133.75 2
Owner signature: _ _Date: Brunch circuits - new, alteration, or extension, per panel
1. E • t-1 c . • "APO ,.: A. Fix for branch circuits with
�rµ C: '��.���I ° +'sry "_s?^�•",'I' A�.. d)<SQ::+�G ? > •.
�_•�, -�_ f� 'ti .. service or feeder fee, each
Business name: branch circuit 6.65 2
- B. Fee for Branch circuits
Contact name: without service or feeder fee. 1 46.85 +6. 2
each branch circuit
Address: Bach add') branch circuit 4 6.65 26. 2
City /State/ZIP: Miscellaneous (service or feeder not included)
- Pump or irrigation circle 53.40 2
Phone: ( ) _ Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited- 75.
•, '-r t r .�; �,. r••- M,'h rr .a,,, •: , 11 energy panel. alteration, or
r � 3 rJ. �all� RF.. ZN, rCOINR�1( �l�+ iri+ tn: �j+? y,•. 4Tt�idi;: S?t`?Qr.;:r7:JF %{v:��9
extension. Dcnb
scc D ATA 1 Page 2 75.00 2
Business name: CHRISTENSON VELAGIO, INC. -
Address: 1631 NW THURMAN ST 2ND FL Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/21P: PORTLAND. OR 97209 - 2558 Investigation per hour (I hr nun) 62.50 '
Phone: (503) 419 1 industrial plant per hour 73.75
Pax: (503) 419 - 3333 , w .:f .; A, ?
. CCB Lic.: 64137 Electrical Lic.: _ 174C / Suprv. Lic f 1994S Subtotal 148.45
Suprv. Electrician signature, required: / for Plan review (25% of permit fee)
Print name: ROBERT ANT
Date: 9/19/05 State surcharge (8% of permit fee) 11.88 TOTAL PERMIT FEE - x
�
Authorized signature: This permit applieattoe expires If a permit Is not obtained within 190
days after It has been accepted as complete *VI **
Print name: I Date: • Fee methodology set by Trt - County Building ln4tuey Service Roan!
`. Number or inspections per permit allowed.
tBuildbgtPennits5ELC.PcrmitApp.doc 12/03 440-4515T( 10/02/C0M/114EO
CITY OF TIGARD -
BUILD1NG DIVISION . #: ELC2005 -00697
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005
Phone: (503) 639- 4171 I �i�
Inspection Requests (24 Hrs.): (503) 639 -4175 . �!�+L `__-
w y
INSPECTION WORKSI ET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 9
SITE ADDRESS: 162" SW PACIFIC HWY D CLASS OF WORK:
SUBDIVISION: TlGA "D TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: RITE D
DESCRIPTION: (5) bran, circuits and low voltage for data in 'Take Care Health System" area.
Job No. - 15107
OWNER: BIT HOL NGS LTD PARTNERSHIP. PHONE #:
CONTRACTOR: CHRISTE ON VELAGIO, INC. PHONE #: 503 -419 -3600
Inspection Request Scheduled F• : Date: 10/27/2005 Pour Time:
Code # • - : - - ID escripti. • • ' Contact # Message
199 Electrical final 019544 -01 503-260.4269 Y
Corrections /Comme s ns ructions:
P :-_c c\) co■)n1 a _,
1RPASs ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED rr ,,''
1.4
Inspector: -'A4t� 1\1B L..E Date: NC11 -11 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00697
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005
Phone: (503) 639 -4171 rh
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I L
INSPECTION WORKSHEET FOR DATE: 10/26/2005 TIME: 7:07AM PAGE: 15
. SITE ADDRESS: 16200 SW PACIFIC HWY D CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: RITE AID
DESCRIPTION: (5) branch circuits and low voltage for data in 'Take Care Health System" area.
Job No. W15107
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: CHRISTENSON VELAGIO, INC. PHONE #: 503 - 419-3600
Inspection Request Scheduled For: Date: 10/26/2005 Pour Time:
Code # Inspection Description •;;# Contact # Message
199 Electrical final 019407 -0 . 503-260 -4269
Corrections /Comments /Instructions.
.. Rol + pv A k■ztyvv,‘"1
5�-Pike • Ptptee■)14 w 1
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 -24y
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Z".,@ag'j
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 `'III
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1 la 'Lop }Ptk,c sF-1 C` NA v4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 424 I OI 2j 05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/Comments/Instructions:
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‘NstOe W►
•
us A i't F ore, c a N RP ea. E old.
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
LA FAIL 1% CALL FOR INSPECTION X, ADDITIONAL FEES ASSESSED
Inspector: �� / Date: t Of 2.J Phone #: (503) 718- LA.
CITY OF TIGARD ELC2005.00697
BUILDING DIVISION PERMIT #: 9/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED:
�
Phone: (503) 639 -4171 u��
Inspection Requests (24 Hrs.): (503) 639 -4175 ill..
10/24/2005 7:02AM 13
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
16200 SW PACIFIC HWY D
SITE ADDRESS: TIGARD TOWNE SQUARE CLASS OF WORK:
SUBDIVISION: RITE AID LOT #: TYPE OF USE:
PROJECT NAME: (5) branch circuits and low voltage for data in 'Take Care Health System" area.
DESCRIPTION: Job No. W15107
BIT HOLDINGS LTD PARTNERSHIP,
OWNER: CHRISTENSON VELAGIO, INC. PHONE #: 503- 419 -3600
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
Ccgg # Ir garicarfDaelscription 9g10201 8-6-269 Melage
Corrections /Comments /Instructions:
❑ PASS ❑ PARTIAL APPROVAL '1 CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ IDITIONAL FEES ASSESSED
Inspector: Pit6 Date: JO / Phone #: (503) 718- 1-4
CITY OF TIGARD l . , , ■ •
BUILDING DIVISION PERMIT #: ELC2005 -00697
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2006
Phone: (503) 639 -4171 r1 , i A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/6/2006 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 16200 SW PACIFIC HWY D CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: RITE AID
DESCRIPTION: (5) branch circuits and low voltage for data in 'Take Care Health System" area.
Job No. W15107
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: CHRISTENSON VELAGIO, INC. PHONE #: 503.419 -3600
Inspection Request Scheduled For: Date: 10/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 017536-01 503-260-4269 N
(► Oc ? oN0 6 7)
Corrections /Comments /Instructions:
lb
N O & 0 c:i3.5)
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G . N ► Date: 5- 1q Phone #: (503) 718-