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Permit CITY OF T PERMIT PERMIT #: ELC2000 -00027 X711,' DEVELOPMENT SERVICES DATE ISSUED: 01/20/2000 tell 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 101 AA -TTOOA SITE ADDRESS: 12123 SW 69TH AVE SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE BLOCK: LOT : OOA JURISDICTION: TIG Project Description: Singal circuit or limited energy panel. 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: 1 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: 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: TIGARD CORPORATE CENTER LP STONER ELECTRIC 15400 SW MILLIKAN 2701 SE 14TH BEAVERTON, OR 97006 PORTLAND, OR 97202 Phone: Phone: 233 -3631 Reg #: LIC 00044823 SUP 4025S ELE 26 -122C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT GEO 01/20/200C $60.00 00- 321267 Elect Final SPOT GEO 01/20/200C $4.80 00- 321267 ORIGINAL Total $64.80 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 AO ISSUED BY: ee%i /iii/ OWNER INSTALLATION ONL 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' J DATE: / I" -84 LICENSE NO: Call 639 -4175 by 7:OOpm for an inspection the next business day CITY Of TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By TIGARD OR 97223 RECEIVED Date Recd Date to P.E. Phone (503) 639 -4171, x304 JAN 18 2000 Date to DST Inspection (503) 639 -4175 Print of Type Permit #0 -0O°g Fax (503) 598 -1960 Incomplete or illegible will noCIMANINIMPFkLOPMENT Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development �a aid Number of Inspections per permit allowed Name (or name of business) Service included: Items Cost Sum Address &Dh A /2 z 3 64,3 6 9 z 4a. Residential - per unit � 1000 sq. ft. or less $ 117.75 4 City /State /Zi J , ,..g , � ,,p /C 97ZZ3 Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial 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 ) Installation, alteration, or relocation Electrical Contractor ? .4.46 ,`WLC. 200 amps or Tess $ 64.25 2 Addres 2.7o 1 �� /447:3- 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps $ 128.50 2 Ciry W -Je7? .4 7 State 45, Zip 9 7702 601 amps to 1000 amps $ 192.50 2 Phone No. - r2)3 -- 2-3 3 ‘,3 I Over 1000 amps or volts $ 363.75 2 Job No. «7a `'-E Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 24-'22 Exp.Date id /e 1Az 4c. Temporary Services or Feeders OR State CCB Reg. No. 4482,3 Exp.Dateo3 /24;/oa Installation, alteration, or relocation 200 amps or less $ 53.50 2 COT Business Tax or Metro No. (o � Exp.D tee' �ai�c>0 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, see "b" above. License No. 34145 Exp.Date /o lot 4/ 233 -3 , 4d. Branch Circuits Phone No. 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 Each additional branch circuit $ 5.35 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 3. panel, Labels alteration or extension / $ 60.00 ( . Plan Review section (if required):* Minor Lael (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 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 $ ,. ,. oo * Submit 2 sets of plans with application where any of the above apply. DA Surcharge (.05 X total fees) $ 4. 0 Not required for temporary construction services. Subtotal $ 64.80 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ CI PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 4 By IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # ,p AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ,6 i. 8b is \fists \forms \electric. doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 4 -H6ttr Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested / (r( 0 AM PM BLD • Location / 2/ Z 3 Sw �� ✓-( Suite / MEC Contact Person Ph U/ z L PLM Contractor Ph SWR BUILDING Tenant/Owner ELC )riOU .06 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing 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 ECTRICA[ Service Rough In UG /Slab L /'^' Low Voltage Fire Alarm PAS 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 / / 0 1 © AO Inspector Ext Other Final PASS PART FAIL DO 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 SA d- AM PM BLD Location .1 2 ,/ y ` Suite MEC Contact Person Ph ?.$9 -- 7 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Ze'i't 4007 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall Fire Sprinkler .0 � � �� � - -- -- 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 P_ART FAIL LECTRICAL. Service - Rough In UG /Slab croT4Vola Fire Alarm Final PASS PART - SITE 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 .� "' Inspector �t� Ext Other Final PASS PART FAIL DO 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 S Z _ Ob AM PM BLD Location / Z ( Z 3 (D )4u(- Suite MEC Contact Person PAY) Ph g Lo Zq S Z PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 7e -00017 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear int Sheath /Shear Framing In=ai ling , , l / ` V J A-LX$ Ce-t_. ( I 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 TRIC Se e gh ab • 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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA s Approach /Sidewalk Date c Z� v Inspector Ext Other '� Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.