Permit CITY O TIGARD ELECTRICAL PERMIT 619
PERMIT #: ELC1999 -00
>� DEVELOPMENT SERVICES DATE ISSUED: 10/20/1999
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S136DD-02600
SITE ADDRESS: 11705 SW 68TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING:
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Install 201 amp to 400 . amp service /feeder and 15 branch circuits.
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: W /SERVICE OR FEEDER: 15 PER INSPECTION:
201 - 400 amp: 1 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:
RURAL ELECTRIC INC
5285 NE ELAM YOUNG PKWY
HILLSBORO, OR 97124
Phone: Phone: • 648 -6696 ORIGINAL
Reg #: LIC 00047478
SUP 4062S
ELE 34 -82C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT KJP 10/20/199C, $165.75 99- 319207 Elect'I Final
5PCT KJP 10/20/1990 $13.26 99- 319207
Total $179.01
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. Q
PERMITTEE'S SIGNATURE - l tij-e t ISSUED BY: X Cc/2z j c,. 1 ,,,, _il, ,..)
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: C ‘ " DATE: / / 9 9
LICENSE NO: Y06.2 -S
Call 639 -4175 by 7:OOpm for an inspection the next business day
RECEIVED
•- • our 1
4 4928imunity Development 1 ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
CO . , UNITY DEVELOP OR 97223 n A . ('Planck/Re
' I Permit # tL, C 1 flyf-t - 00‘1q
,i iI Phone (503) 6394171 J.)' Date Issued
�''` FAX (503) 684 -7297 �` ��`
CITY OF TIGARD TDD No. (503) 684 -2772 ' �.1� ISSl1ed by
Inspection (503) 639 -4175 VVV - 1 1
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Mountain Pacific Machinery Number of Inspections per permit allowed
Address _ 117.05 SW 68th Ave Service included: Items Cost(ea) Sum
City /State/Zip Tiaard, Or 97223 4a. Residential - per unit 4
1000 sq. ft. or less 5110.00 .
Name (or name of business) ' additional 500 sit. ft or
( ) portion thereof 525.00 1
Commerciale Residential ❑ Limited Energy 525.00
Each Manurd Home or Modular 2
Dwelling Service or Feeder 568.00
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor Rural R1Prfrir. Tnr_ 200 amps or less $60.00&S.yO 2
Address 5285 NE Elam Young Parkway #A9(0 201 amps to 400 amps Z - , 5110700 ssc 2
401 amps to 600 amps 5120.00 2
City Hillsboro , State OR Zip 9 71 2 4 601 amps to loon amps ---
5180.00 2
Phone No. 648 -6696 Over '000 amps orvolts 534000 2 •
Contractor's License No. 34 -R2C cu' Reconnect ordy 550.00
Contractor's Board Reg. No. 4 7 4 7 R ■t" 4c. Temporary Services or Feeders
^ �^ Installation, alteration, or relocation 2
Signature of Supr. Elec'n ? �4 ' !/�- 200 amps or less 550.00 2
Phone No. 6 4 R - 6 6 9 6 201 armpit to 500 amps 55.00 2
License No. 4 0 6 2 -S 401 amps to 600 amps 5
- -- - A./ -. . Cver 600 amps to 1000 volts -
2b. For owner installations: see •b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with 2
City State Zip P he branch d e to o r aseae. Ass. __ 1 Q
Phone No. b) The fee for branch circuits without ��+'
The installation is being made on property I own which is Purchase of service or limier lee. 2
not intended for sale, lease or rent. First circbrt 53s.00
2
Each ac t h additional branch circuit q:--- 5frea
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each Pump or irrigation circle 540.00 2 - Each sign or outline lighting 540.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension 540.00
4 or more residential units in one str ucture Minor Labels (10) 5100.00 -
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. Ch apter 5 p er inspection 5,�
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 $ (�('�
'7
8$$1'/, Surcharge (.05 X total fees) $ 13 z
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtota $ 16--40 i7 , of
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b Enter of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reevivi ew if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # $ 0
17t. ad
Balance Due $
weetcandrAlisocrmapp
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
// BUP
Date Requested /I,, a�3 7 AM PM BLD
Location I 1 I: J Lo /// 05 71 Suite yy MEC
Contact Person 17t5 1/ Ph 60 I J � 2 / (2 PLM
Contractor Rt /L. Ph SWR
BUILDING Tenant/Owner LAMP_ --Lit i _
, Retaining Wall / ELR r g igq- (oCo
Footing Access:
Foundation FPS
Ftg Drain t' j1/ " la/tie-rzy, SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
In
Notes: Nailin U i �
Firewall
Fire Sprinkler
Fire Alarm _ / _
Susp'd Ceiling // Pri - zICQ
Roof
Misc:
Final
PASS PART FAIL 0
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
C RI
Service
Rough In
UG /Slab
Low Voltage
L -
Fire Alarm
40 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 03 Inspector % Ext
Other —�—
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.