Permit • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00032
i "� DEVELOPMENT SERVICES DATE ISSUED: 1/21/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DA -00100
SITE ADDRESS: 11308 SW 68TH PKWY
SUBDIVISION: ZONING: MUE
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Electrical TI
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: SIGNAUPANEL:
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: 29 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:
BENENSON 68TH PARKWAY OREGON ELECTRIC CONST /GROUP
KEY LLC, THE 1010 SE 11TH AVE
BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214
WORCESTER, MA 01615
Phone: Phone: 234 -9900
Reg #: LIC 203
SUP 1302S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 1/21/00 $192.65 00- 321316 Elect'I Final
SPCT BON 1/21/00 $15.41 00- 321316
ORIGINAL
Total $208.06
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 SIGNATURE 61/1 1 tiv ied ISSUED BY: 6 iviotata____
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: ! £I!(� DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY.OF TIGARD Plan Chedc
'13125 SW HALL BLVD. Electrical Permit Application Recd By
RECEIVED
TIGARD OR 97223 Date Recd I , Z I'
Phone (503) 639 -4171, x304 JAN 21 2000 Date to P.E. N
ik
Ins Inspection (503) 639 -4175 Date to DST
P ( ) Print of Type Pem,it # ett.2.105 - 7
Fax (503) 598 -1960 COMMUNITY DEVEL I ncomp lete or illegible will not be accepted Called
1. Job Address: I - - DO 4. Complete Fee Schedule Below:
Name of Development Tigard Data Cent-Pr Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum 4 '
Address 1 1 1 0 8 Sw A R t h p 4a. Residential - per unit
City/State /Zip Tigard, OR 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
Commercial ® Residential ❑ portion thereof $ 26.25 1
Limited Energy $ 60.00
Each Manned Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration. or relocation
Electrical Contractor Oregon Electric Group 200 ampsorless $ 64.25 2
Address 1 01 0 SF 1 1 t-h AvP 201 amps to 400 amps $ 85.50 2
City Portland State OR Zip 9 7 21 4 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. 2 3 4-9 9 0 0 Over 1000 amps or volts $ 363.75 2
Job No. 2 6 ak � C Reconnect only $ 53.50 2
Z
Elec. Cont. Lice. No. Exp.Date P 4c. Temporary Services or Feeders
OR State CCB Reg. No. 2 0 3 Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro N Exp.Da 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n Li 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
•
see "b" above.
License No. 2 0 6 4 5 Exp.Date
Phone No. 2 3 4 - 9 9 0 0 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address • b The fee for branch circuits
without purchase of service
City State 'Zip or feeder fee.
Phone No. First branch circuit 1 $ 37.50 3 7.50 _
Each additional branch circuit 2 9 $ 5.35 'L5 5 . 1 5
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not induded)
Each pump or irrigation circle _ $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
, panel, alteration or extension $ 60.00
3. Plan Review section (if required). * Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal QED In Plant $ 59.00
Classified area or structure containing special occupancy a
described in N.E.C. Chapter 5 5. Fees:
6a. Enter total of above fees $ 1. 2 . 6 5
* Submit 2 sets of plans with application where any of the above apply. 8%1% Surcharge (.05 X total fees) $�
Not required for temporary construction services. Subtotal
$ 208.06 - .
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ _208. 0 6
is \dsts \forms \el ectric.doc
ffi CITY OF TIGARD BUILDING INSPECTION DIVISION - -
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST,- -
•. 4,11z, BUP
Date Requested AM PM BLD
Location /! t& Su) 't" Suite MEC
Contact Person Ph 99" - Z7e7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC leefe -Cal
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear //f l ( 50 444 AA /1 ,�(- V Ad
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
/�' e
Misc: v
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
Rough In
UG /Slab
Low Voltage
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date 7o fl l Inspector Ext
Other
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.