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Permit
CITY OF TIGARD ELECTRICAL REKNIT � � . . , DEVELOPMENT SERVICES PERMIT #: ELC98 -¢1756 �a .._. - "�"d. 1 3125 SW Hall Blvd, Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 09/17/98 PARCEL: 25101.DA -00104 • SITE ADDRESS...: 13333 SW 68TH PKWY #2ND SUBDIVISION :GTE ZONING:MUE BLOCK........... LOT .............. JURISDICTION: TIG Pro j e c t De s c r i pt i on : 2nd floor JOB #77495 - -- 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/O SRVC OR FDR.: 1 PER HOUR : 0 401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 3 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 type amount by date recpt 4600 WILSHIRE BOULEVARD PRMT $ 50.00 JSD 09/17/98 98- 309231 LOS ANGELES CA 90010 SPCT $ 2.50 JSD 09/17/98 98- 309231 Phone #: Contractor: - - - -- OREGON ELECTRIC CONST /GROUP $ 52.50 TOTAL 1010 SE 11TH AVE REQUIRED INSPECTIONS - - - -- PORTLAND OR 97214 Ceiling Cover Elect'i Service Phone #: 234 -9900 Wall Cover Elect' 1 Final Reg #... 203 This persit 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 per.it will expire if work is not started within 180 days of issuance, or if work is suspended for sore than 180 'ays. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules ar: s- forth '. OAR 952-001 -0010 through OAR 952 - 001-,,; - . You lay obtain a copy of these rules or direct questions to OUNC by c 11in (5'4)245- Permittee Signature: ,,d41114_ '// Issued B_ -- - -- -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 INSTALLATION ONLY--- -.. -_. ----- --- SIGNATURE OF SUPR. ELEC' N: DATE: LICENSE NO: + + + + ++ + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + Call 639 -4175 by 7:0210 p.m. for an inspection needed the next business day + +++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + ++ + + + + + + + + + ++ + + + + + + + + + + + ++ .G 04C :t Community Development ELECTRICAL PERMIT APPLICAT �' ,�o) 13125 SW Hall Blvd. . � �c�1\Tigard, OR 97223 Permit # occn_,05-s tiv ` . " �� Phone (503 639 -4171 Date Issued "'` FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Farmer' s Insurance Number of Inspections per permit allowed Address 1 3333 SW 68th Parkway Service included: Items Cost(ea) Sum City /State /Zip Tigard, Or . 9 7 2 2 3 4a. Residential - per unit 1000 sq. ft. or less 5110.00 4 Name (or name of business) Farmer' s Ins . Each additional 500 sq. ft. or portion thereof 525.00 Commercial B "k RI~, Residential 111 Limited Energy 525.00 1 Each Manurd Home or Modular -- - - - -- Dwelling Service or Feeder 568.00 2 2a. Contractor installation only: 4b. Services or Feeders Installation, alteration, or relocation Electrical Contractor Oregon El ectr i r Grcu P 200 amps or less 560.00 2 Address 1 01 0 SE 1 1 th 201 amps to 400 amps 580.00 2 City Portland State Or, ZiP9721 4 401 amps to 600 amps 5120.00 2 601 amps to 1000 amps 5180.00 2 Phone No. 2 14-9 9 0 0 Over 1000 amps or volts $340.00 2 Job NO. 77495 Reconnect only 550.00 2 contractor's license NO. 26 -95C . 4c. Temporary Services or Feeders Contractor's Board Reg. Np. 2 0 O Installation, alteration, or relocation Signature of Supr. Elec'n Q1 ��} / /� //'.�4 200 amps or less 201 amps to 400 amps 550.00 2 L No. 2 8 41 S one No. 2 i 4 - 0 0 401 amps to 600 amps 575.00 2 L Over 600 amps to 1000 volts 5100.00 2b. For owner installations: see "b" above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per pane Address a) The fee for branch circuits with City State Zip purchase of service or feeder fee. 2 Each branch circuit 55.00 Phone No. b) The fee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 not intended for sale, lease or rent. First branch circuit 1 535.00 3 5. 0 0 Each additional branch circuit 3 55.00 1 5. 0 0 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 8 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 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 as described in N.E.C. Chapter 5 Per inspection $35.00 Per hour 555.00 - 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: 5a. Enter total of above fees 50 NOTICE 5% Surcharge (.05 X total fees) $ 2 • 5 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 2.5 Q 5b. Enter of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF vi CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. / /� ❑ Trust Account # $ pm.app III��V GA ^� 9 �1 Balance Due $ 5 2. 5 0 X CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 I �f`4q I l ( Q 'T a Date Requested 1 1- BUP -q AM PM BLD \1QA74195" Location 1 3333 4, 4) piewt tt -, Suite C acq8"vt�i0 Contact Person ,� C U Ph PLM d Fes' O2E Contractor Ph s4- uo SWR Jo4 77 off BUILDING Tenant/Owner ` % 11,4 (. -- VTn `7 Retaining Wall —Skit - ?.+iii =i Fii %S Footing © • •, 1 t Foundation Access: _ , _ AJ E _ _ COAST 77 / N Ftg Drain ' �ill//G %(ilT _ 5 SGN Crawl Drain Inspection Notes: Slab ' /[f� SIT Post &Beam ' �C.fiW �/- Aleteimi `T Z ✓'"'6o�ao Ext Sheath /Shear / /� Ina Sheath /Shear (, /CAA /��I� Framing �t,� Insulation Drywall Nailing 9F - Os-s-6 - Ft &L1 -� o Firewall Fire Sprinkler Fire Alarm L� F _ b x077 Susp'd Ceiling Roof Misc: Final ly 9 — er NFf 0 PASS PART FAIL PLUMBING Post & Beam Under Slab (P1�DQQ�� Top Out Water Service Sanitary Sewer Rain Drains Final C ✓�� PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PAS FAIL ECTR ICA Service Rough In UG /Slab Low Voltage �� Fire larm F i' 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Other Date /1/7/9 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.