Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00247
�
- 13125 L , DEVELOPMENT H BMEN ) 639 -4171 DATE ISSUED: 5/11/00
PARCEL: 25101 DA -00105
SITE ADDRESS: 13009 SW 68TH PKWY C
SUBDIVISION: HOMESTEAD VILLAGE Ci ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of 10 branch circuits, Job No. 8108.
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: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 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:
HOMESTEAD VILLAGE INC PHOENIX ELECTRIC CO
ATTN: PROPERTY TAX DEPT 7379 SW TECH CENTER DR.
7777 MARKET CENTER AVE TIGARD, OR 97223
EL PASO, TX 79912 G1NAL
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 5/11/00 $85.65 0002104 Elect'I Final
5PCT DEB 5/11/00 $6.85 0002104
Total $92.50
This Permit is issued subject to the regulations contained in the Tigard Muniapal Code, State of OR. Speaalty 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 co - s of these • -s or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE K ✓ ISSUED : : / _ j � / .
O NER INSTALLATION ONLY
The installation is being made o, roperty I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF / SUPR. — - DATE:
LICENSE NO: ii `7 5
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY_ OF TIGARD Plan Ch ck #
131'25SW HALL BLVD. Electrical Permit Application
Recd By
TIGARD OR 97223 Date Recd /! -00
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST I /
Inspection (503) 639 -4175 Print of Type Permit # Eip 265 .0 - cx 34 7
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: ' /l �11 4. Complete Fee Schedule Below:
Name of Development home J 4 v I J J r. Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
Address 13czx1 .SC.) 6 $ tti n4 ,x y 4a. Residential - per unit
! 1000 sq. ft. or less $ 117.75 4
City /State/Zip T c 9 (CL / 0 k Each additional 500 sq. ft. or
J portion thereof $ 2625 1
Commercial El Residential ❑ Limited Energy $ 60.00
Each Manufd 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 Pito ens Eicc4/`n 200 amps or less $ 64.25 2
Address 73 79 3) Ted etA. A0. 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City �e,r 4 State o Zip 9222.1 601 amps to 1000 amps $ 192.50 2
Phon o. 6,5 y 36 Ov Over 1000 amps or volts $ 363.75 2
Job No. Q1Of3 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. .3''/-a 17 C. Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. S2264 Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 0 401 amps to 600 amps $ 107.00 2
°� Over 600 amps to 1000 volts,
�/ � see "b" above.
License No. Y /Vo.S Exp.Date
Phone No. 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 $ 37.50 ,3 O
Each additional branch circuit $ 5.35 g , •
. /
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
if required):* panL alteration or extension $ 60.00
3. Plan Review section
Minor Labels (10) $ 905°'00'
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over /pp•oo
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 In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: /
5a. Enter total of above fees $ � 6,s
* Submit 2 sets of plans with application where any of the above apply. gel) .B% Surcharge (,9&X total fees) $ ,
Not required for temporary construction services. Subtotal ff $
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 11 Pte.)
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS 1J Trust Account # f d tf 9
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ! ) -S'
i:\dsts\forms\electric.doc 60 0 a /0 C/
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (. 7V) 0 AM PM BLD
Location 1300 q c!/ Suite MEC
Contact Person Ph 2.6 7'tii (-0 PLM
Contractor 11110 . .' . ' ' - _ Ph SWR
BUILDING Tenant/Owner ELC 1100 1900
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab - C_i /I° . SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
•
Insulation
Drywall Nailing
Firewall
Sprinkler Sprinkler C44-
Fire Alarm
Susp'd Ceiling
CIO
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 P FAIL
ECTRICAL
Se
Rough In
UG /Slab
Low Voltage
Fi e • larm
/i
440 *ART 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
Other Date 6 Zi/o- Inspector Ext
Final
PASS PART FAIL O 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
Date Requested 5/ 1 AM _ PM BLD
Location O -1 - b c� - �" Mite 6 / MEC
Contact Person �J I 1 1\A
70'1 - Ph -" / t' P S (, PLM
ll
Contractor - �'(D >� J/ ' Ph SWR
BUILDING Tenant/Owner
ELC "O - 00 7
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: ^ SGN
Slab Pf?(:)K- SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation --
Drywall Nailing _ � _ _ L . '
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
E ECTRICA�
Servi -
oug
UG Slab
Low Voltage
Fire Alarm
F'
P SV 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 i
Other Date c / 6 fi Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.