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Permit
CITY OF T I G A R D • ELECTRICAL PERMIT PERMIT #: ELC1999 -00531 * DEVELOPMENT SERVICES A pA.. . TE ISSUED: 9/10/99 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 4711 G' 1� PARCEL: 25101 AA -09108 SITE ADDRESS: 12559 SW 69TH AVE SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT : 030 JURISDICTION: TIG Project Description: Electrical for new building. 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: 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: SVCIFDR >= 225 AMPS: • CLASS AREA/SPEC OCC: Owner: Contractor: PORTER, DENISE VIKING ELECTRIC INC BENNETT, SUE 4326 SE WOODSTOCK 7991 SW MOHAWK ST STE 518 TUALATIN, OR 97062 PORTLAND, OR 97206 Phone: Phone: 775 -3479 Reg #: LIC 00056527 SUP 3088S ELE 26 -569 FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT BON 8/24/98 $246.00 99- 317898 Wall Cover PLCK BON 8/24/98 $61.50 99- 317898 Underground Cover 5PCT BON 8/24/98 $17.22 99- 317898 Elect'I Service Elect'I Final Total $324.72 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 ISSU D BY; //■1 / OWNER INSTALLATION ONLY The installation is being ma. - on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SURR. ELEC'N: ■QO , 1k P/ 1� i9- -+�- DATE: LICENSE NO: ce S I r Call 639 -4175 by 7:OOpm for an inspection the next business day � :°TY OF TIGARD Electrical Permit Application Plan Check# p J25SW HALL BLVD. Rec'd By f r' TIGARD OR 97223 Date Recd 'AHEM Date to P.E. v z Phone (503) 639 -4171, x304 Date to DST 9 - `b`.1 Inspection (503) 639 -4175 Print of Type Permit # 11C 0 J Fax (503) 598 -1960 rril - 6 2 ) m Oncompiete or illegible will not be accepted Called 0 1 - 10 -0 1 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of bu siness) ige Id NNETT /te6 8 764 Service included: Items Cost Sum 4' Address ) .2S slit) 6 q t 7 4a. Residential - per unit /� C� 1000 sq. ft. or Tess $ 117.75 4 City /State /Zip / I MR a 'OA \ ! 7 �` 2 Lt Each additional 500 sq. ft. or portion thereof $ 2625 1 Commercial Igil Residential ❑ Limited Energy $ 60.00 Each Manuf'd 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 V / K I IV f> E 1 EC 7 4 l / 200 amps or less $ 64.25 2 Address y-�A SF WaonSToc Su ire /8 201 amps to 400 amps i $ 85.50 air s8 2 401 amps to 600 amps $ 128.50 2 City PORT«tr✓D State o Z Zip 94'20 601 amps to 1000 amps $ 192.50 2 Phone No. .SO? 77f - 3 4 79 Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 2.4 -5 C Exp.Date 10 - I --q9 4c. Temporary Services or Feeders OR State CCB Reg. No. ,r /r, Exp.Date 3'- /d- 00 Installation, alteration, or relocation COT Business Tax or Metro No1fnm 1073- Exp.Date /2 - i f 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n _� ,L_i 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, License No. 30g_5 Exp.Date see "b" above. 4d. Branch Circuits Phone No. 7 7.5-- 3 1f'7 9 New, alteration.or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owners Name Each branch circuit • 315 $ 5.35 / /'C I , 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 if required):* panel, alteration or extension $ 60.00 3. Plan Review section f 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 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 $ r ©Q * Submit 2 sets of plans with application where any of the above apply. 7 /A Surcharge (.05 X total fees) $ Z. Not required for temporary construction services. 7.�t✓✓ Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) • $ 6j o PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ (, 7 Z 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 , $ 32. • TR i:\dsts\forms\electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 1 Date Requested l0 ested — �� 99 AM PM BLD Location ! !r-.J , c % 9_,/ Suite MEC Contact Person Vik '1,j Ph PLM Contractor f�v1 f'< < Ph 77.c 3 L79 SWR BUILDING Tenant/Owner ELC /??'- t O 3/ 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 i Drywall Nailing /_ A � Ar. ■02 !ice 4 _ Firewall Fire Sprinkler / ®�-P�? 4 ./.40-1-- 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 ELECTRICAL service UG/Slab 4\ Low Voltage Fire Alarm .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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date Inspector Ext Other Final PASS PART FAIL D NO 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 q BUP Date Re uested �� < AM PM BLD Location I 2-5C$ � D I q ` 1 - Suite MEC Contact Person t) ( Lt Ph - 77S S i, 7T) 7 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 1 7f 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 LECTRIC7 Rough In Low Voltage b Low V Fire Alarm • 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 r inspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date 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 n Date Re nested I -22-9 AM PM 1AEIL BLD Location / 2-SS (p1 /14 1 14 I4(J Suite MEC Contact Person V I /all Ph 7,c '1 /- / PLM Contractor J Ph SWR qG� G, I BUILDING Tenant/Owner ELC / ! - 1 / -- )S 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 P ART FAIL LECTRICA Service ou UG /Slab Low Voltage Fire Alarm Fin P PART FAIL SITE 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 einspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date 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 C� X BUP Date Re ested ' ! AM X PM BLD Location 1 2 Sc ( d/O 54C/e Suite MEC Contact Person V ticl4 Ph - 7 S -3 ( c . 77 PLM Contractor Ph SWR !� BUILDING Tenant/Owner l I- 41 $ ? / Retaining Wall cry (it? q - Col S Footing Access: Q pZ CO2 Foundation ( i! Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam a l l ,� _ n P Ext Sheath /Shear / � C. Int Sheath /Shear Framing Drywall N L C /99? — 00 sr3 Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling fr Roof 411M 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 BART FAIL LECTRICA, Service Rough In UG /Slab Low Voltage Fire Alarm ∎'' •AS- 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 / Iv [I 99 Ins Other — ` — — — Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.