Permit A CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98 -0468
13125SW Hall Blvd., Tigard, 0R97223 (503) 6394171 DATE ISSUED: 08/10/98
PARCEL: 2S101AA -06400
SITE ADDRESS °••:12323 SW 66TH AVE
SUBDIVISION •WEST PORTLAND HEIGHTS ZONING:C —G
BLOCK • LOT °024 JURISDICTION: TIG
Pro.j ect Description : Addition of 40 branch circuits to commercial tenant.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS : 0 0 — 200 amp • 0 PUMP/ IRRIGATION ° 0
EACH ADD'L 500SF °..: 0 201 — 400 amp ° 0 SIGN /OUT LINE LTG•.: 0
LIMITED ENERGY • 0 401 — 600 amp ° 0 SIGNAL /PANEL • 0
MAW. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10) °..: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp ° 0 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 — 400 amp ° 0 1st W/0 SRVC OR FDR.: 1 PER HOUR : 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 39 IN PLANT : 0
601 — 1000 amp 0 PLAN REVIEW SECTION
1000+ amp /volt 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only ° 0 SVC /FDR >= 225 AMPS ° °: CLASS AREA /SPEC OCC.:
Owner: FEES
ELTON ° TING — WILLIAM R SOUTHARD type amount by date recpt
603 VICTORY AVE PRMT $ 230.00 DLH 08/10/98 98- 308130
STE 100 5PCT $ 11.50 DLH 08/10/98 98- 308130
VANCOUVER WA 98661
Phone #:
Contractor:
RURAL ELECTRIC INC $ 241.50 TOTAL
5285 NE ELAM YOUNG PKWY
REQUIRED INSPECTIONS
HILLSBORO OR 97124 Ceiling Cover Elect'1 Service
Phone #: 648 -6696 Wall Cover Elect'1 Final
Reg it..: 000474
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-01 -0010 through OAR 952- 001 -1987. You may obtain a copy
of these rules or direct questions to DUNG by calling (5031246 -1987.
Permittee Signature: /1 ,9/L Issued By: ( .ram.
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: '7'/ f9-Pintie4- -7/ d/ DATE: /d /! g
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW HaII:Blvd.
Tigard, OR 97223 RECEIVED Planck/Rec. #
Permit # ctC 9rP- D 9 6 P
o' ' Phone (503) 639 -417U r 10 1999 Date Issued ? /'i 5P
- FAX (503) 684 -72
CITY OF TIGARD TDD No. (503) -27 Issued by
Inspection (503) 6 i4�i75 DEVELOPMENT � .
1. Job Address: h ,, n / 4 ,�y�� eO. 4. Complete Fee Schedule Below:
Name of Development(. �W(,/J 1" A ' Number of Inspections per permit allowed
Address J& 113 ?v W4V v ) Service included: Items Cost(ea) Sum
City /State/Zip (W c.-d / �� 4a. Residential • per unit 4
1000 sq. ft. or less $110.00
Name (or name f business) Each additional 500 sq. ft. or
portion thereof $25.00 1
-
Commercial Residential ❑ Limited Energy $225.00 - Each Manuf'd Home or Modular 2
Dwelhng Service or Feeder $68.00
2a. Contractor installation only: . • 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor Rura 1 P 1 P r^.t r i r7., T n n _ 200 amps or less $60.00 2
Address 5285 NE Elam Young Parkway #A9 t 0 201 amps to 400 amps $60.00 2 - 401 amps to 600 amps $120.00
City Hi 11 sboro State OR Zip 97124 601 amps to 1000 amps 5180.00 2
Phone No. 6 4 8-6 6 9 6 Over 1000 amps or volts 5340.00 2 •
Contractors License No. 3 4 -82r / Reconnect only $50.00
o 9
Reg. /
Contractor's Board Re . No. 4 7 4 7 R 1 i� 99 4c. Tem porary Services or Feeders
T Installation, alteration, or relocation 2
Signature of Su pr. EIeC'n 200 amps or less $50.00 2
License No. p - Phone No. 648-6696 201 amps to 400 amps 575.00 2 -
401 amps to 600 amps $100.00
/djf - ✓ Over 600-amps to-t000 volts
2b. For owner in& nations: sea 'b' adore.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address • a) The tee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The tee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee' I 2
not intended for sale, lease or rent. First branch circuit $35.00 ,
Each additional branch circuit y $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2 - Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more -
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. C hapter 5 Per inspection n35.00
Per hour $55.00
-
In Plant 555.00
Submit 2 sets of plans with application where any of the above .
apply. Not required for temporary construction services. 5. Fees:
NOTICE
5a. Enter total of above fees $ ®r
5% Surcharge (.05 X total fees) $ / . ..in
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
Subtotal
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS $
COMMENCED. ❑ Trust Account # $
Balance Due $ 02
woretcomdrAsioc-pmiapp
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
2,8l r
j Date Requested BUP
r /� �/ / �qn AM PM BLD
Location / 3 c Z4_) b& / l Suite - MEC
Contact Person &J'1,/I ( , Ph 647 ?6.7 PLM
Contractor &VLL C &e- CD,Lc_' Ph SWR
BUILDING Tenant/Owner FARM 5/9_6 / ELC � 0 1 /6g
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 � i 4 'J /G/L_ P 4-5 5
Firewall
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
p_Ass- FAIL
LECTRICA
Rough In Caily
UG Stab
Low Voltage cow
1
Fire Alarm
Fin.
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 Date a 3/ " 9? Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF "'GAR' D BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested l (90 AM I-PM BLD •
Location l )_ 3 Z 3 6l B r4 Suite MEC
Contact Person c Ph p / PLM
Contractor / j Ph 6 zf0 "� (P6 96' SWR ��/ (,�'
BUILDING Owner ELC ' 0
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 A) �Z C''-ei9—
Firewall (•
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
ELECTRICAL
Service ` c ol()
Rough In W
UG /Slab
Low Voltage
Fire Alarm
- ART FAIL
FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date 1 l n
Other ?d" Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE 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
13'8 Date Requested y-27-9? AM BLD
Location 12 23 S60 W Ave Suite MEC
Contact Person /(6714 n " Ph PLM
Contractor F < Ph & 662% SWR
BUILDING Tenant/Owner P5'1 M S 1/•- [ S Q e l'?
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 g C!4' ( U l ailin
Firewall D
Fire Sprinkler V. A4oftiL.. _
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
-
PA FAIL
jLECTRICAL -
Service
Rough In
UG /Slab Cinreti„.
Low Voltage
Fire Alarm
Final
PASS PART ep
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date 2- Inspector D ` ns
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.