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Permit
, p,. 41■0 CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC98 -0541 % F ,� �i ; DEVELOPMENT H OPMEN SERVICES OR T DATE ISSUED: 09/11/98 13125 SW PARCEL: 2S101DA -00104 SITE ADD RESS...: 1 3333 SW 68TH PKWY #4TH SUBDIVISION •GTE ZONING:MUE BLOCK LOT • JURISDICTION: TIG Project Description : Installation of 5 branch circuits. - -- 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 MANF. 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: 4 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 FARMERS INSURANCE HOLDING CO type amount by date recpt 4680 WILSHIRE BOULEVARD PRMT $ 55.00 DEB 09/11/98 98- 309061 LOS ANGELES CA 90010 5PCT $ 2.75 DEB 09/11/98 98- 309061 Phone #: Contractor: ELECTRICAL CONTRUCTION CO $ 57.75 TOTAL PO BOX 10286 REQUIRED INSPECTIONS - - - - -- PORTLAND OR 97296 Ceiling Cover Elect' 1 Service Phone #: 224 -3511 Wall Cover Elect'1 Final Reg #..: 049737 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 - 001 -0010 OAR 952 -001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (5O3)246 -1987. Permittee Signature: ' ignature: ....A8,244kLOP__ Issued c : J ` OWNER INSTALLATION ONLY The installation is being made on property I on which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INS ALLATION ONLY v SIGNATURE OF SUPR. ELEC'N: t6-�'� : 9 DATE'// � LICENSE NO: agI 0 (D 6 + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ . Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++ 1 11:53 $`503 684 7297 c:'ITV OF TIGARD t711 002..002 Job# 78366 eV 9 -3 -98 Community Development O �j ECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. �(, , j 6C ?R Tigard, OR 97223 Pe rmit # L . :sued �1 '1/ r ','� 1�; Phone (503) 639 -4171 R�C� FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 S E P 1. _ 1999 Inspection (503) 639 -4175 1. Job Address: C ^! !� E 4 LL Com plete Fee Schedule Below: Farmers Insurance Name of Development 13333 SW 68th Parkway Number of Inspections per permit allowed Address 13333 SW 68th Parkway - 4th Floor Service included: Items Cost(ea) Sum City/State /Zip Tigard, OR 4a. Residential - per unit 1000 sq. ft. er less 5110.00 4 Name (or name of business) Farmers Insurance Each additional 500 aq. M. or • portion thereof 525.00 1 . Commercial © Residential Cl Limited Enervr Eactt Mainers' Home or Modular Owa1Ung Service or Feeder 588.00. 2 - 2a. Contractor installation only: 4b. SerViOeS or Feeders Electrical ContractorELECTRICAL CONSTRUCTION CO. installation, eaereua+. or relocation 2 200 amps or less 360.00 Address P.O. BOX 10286 _ 2ot amps to 400 amps Smog 2 City _ PORTLAND State OR Zip 97296 401 amps to 600 amps 5120.00 2 2 601 amps to 1000 amps 3160.00 Phone No. (503)224 -3511 .-1 over 1000 amps or volts 33 2 Job NO._ 78366 i Reconnect only Sso.00 2 All contractor's license NO. 26 -45C I 4c. Temporary Services or Feeders Contractor's Board Reg. No. 497 %//_ /_ Installation. aneracwn, or relocation Signature of Supr. Elec'n A jL�WA1T.- 200 amps el tees 2 201 amps to 400 amps 350.00 2 License No. 7986s 'hone No(503)214 -aila 401 amps to 600 amps 375.00 Over 600 amps 10 1 000 vote 5100.00 2b. For owner installations: see 'V above. 4d. Branch Circuits Print Owner's Name New, aRerattee er extension per pane Address a) The tee for branch cirCUtra with 2 City State Zip purchase el service er feeder fee. Each blanch Circuit 56.00 Phone No. b) The fee ter Winch costala without The installation is being made on property I own which is purchase &service or feeder fee. 2 Eac not intended for sale, lease or rent. branch cn 1 E35.00 3 00 - Owner's aeh aeeltlenai b branch eoeua 7 7 4 --- ss.00 Owner's Signature 4.e. Miscellaneous (Servlee or feeder not Included) 2 2 3. Plan Review section (if required): Each pump or irrigation circle , 540.00 Eau+ eIgn or eutttne egMing 540.00 Signal circuit(e) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension 340.00 4 or more residential units in one structure 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 es described in N.E.C. Chapter 5 Perinspection 335.00 Per noun 5 In Plan) 555.00 Submit 2 Sets Of plans with application where any of the above apply. Not required for temporary construction serviceS. 5. Fees: NOTICE Sa. Enter total of above fees $ 55.00 5% Surcharge (.05 X total fees) $ 2.75 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 6b. Enter 25% of line A for Plan Review if required (Sec.3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. .... A.o.aie wo 0 Trust Account # S v...•or Balance Due $ 57.75 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP v n �1 q ^ r` � � T 1 1 Date Requested / C p '� l AM PM BLD Location / 3 3 3 3 O# tOO Suite MEC Contact Person Ai( Qom, Ph PLM Contractor Ph SWR c- BUILDING Tenant/Owner FAQ - � / NS r ELC V �J , Retaining Wall ELR Footing Access: Foundation 6 1 FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post Beam , / Ext Sheath/Shear (.f' Int Sheath /Shear Framing Insulation Drywall Nailing Cf1/ - PA-Si Firewall Fire Sprinkler Fire Alarm ` pp 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 P FAIL 4S TRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Fi 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 D ate / Other - �6 " ? ? Inspector , L _ Ext Final PASS PART . FAIL DO NOT REMOVE this inspection record from the job site.