Permit CITY OF T ELECTRICAL PERMIT
4 , b .4 DEVELOPMENT SERVICES PERMIT #: ELC98 -0609
' 4 DATE ISSUED: 10/08/98
- ��!� - 1 SW Hall Blvd., Tigard, OR 97223 (503)639
PARCEL: 2S101AD -02600
SITE ADDRESS...: 12625 SW 69TH AVE
SUBDIVISION :WEST PORTLAND HEIGHTS ZONING:MUE
BLOCK • LOT •031 JURISDICTION: TIG
Project Description : Installation of external sign lighting for 3' monument sign.
- -- 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..: 1
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.: 0 PER HOUR • 0
401 — 600 amp - 0 EA ADD'L BRNCH CIRC: 0 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
JOHN MCCROSKEY type amount by date recpt
14125 SW FARMINGTON PRMT $ 40.00 DEB 10/06/98 98- 309753
BEAVERTON OR 97005 5PCT $ 2.00 DEB 10/06/98 98- 309753
Phone #:
Contractor:
JOHN MCCROSKEY $ 42.00 TOTAL
12625 SW 69TH AVE
REQUIRED INSPECTIONS
TIGARD OR 97223 Elect'l Service
Phone #: 646 -9157 Elect'l Final
Reg #..:
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 ules are set f h in OAR 952-001 -0010 oug 952-001 -1987. You may obtain a copy
of these rules or direct questio to OUNC b ca ling (503)2. -1987.
!1 y : k C%���4_ .
1
Permittee Signature: L� �� Issued B
1 NER INSTA A TION ONLY
The installation is being 1•e •• •r•_•�� •.. which is not intended for
sale, lease, or ren . --11/"
OWNER'S SIGNATURE: i -. t . DATE: /e'ef-frY
ij __CONTRCTO' INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
CITY OF TIGARD Electrical Permit Application Plan Ch /
13125 SW HALL BLVD.
Recd Bn. o.b
TIGARD OR 97223 Date Recd /0 - 6 -/ �-
503 639 -4171, x304 Date to P.E.
Phone
( ) Date to DST
Inspection (503) 639 -4175 Print or Type Permit #
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: , 4. Complete Fee Schedule Below:
Name of Development Ci el /vie/ Number of Inspections per permit allowed
Name (or name / of business) / I c B. / )�Gal6C� Service included: Items Cost Sum
Address /1,a96 of
.0-- & / / I 4a. Residential - per unit
City/State/Zip �0 Gt/LD . �J ' • 97ZZ3 1000 sq. ft. or less $110.00 4
ry p Each additional 500 sq. ft. or
Commercial Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach c,; •y of ail u rent c:nses) 4b. Services or Feeders
Electrical Con tor M - _ f�f_E ' i 5 /' Installation, alteration, or relocation
ddres & 200 amps or less $60.00 2
201 amps to 400 amps - $80.00 2
l ity ''O7%!?ggra!' Zip �_� 401 amps to 600 amps $120.00 2
P one No. % rE .2"i ;,_'S 601 amps to 1000 amps $180.00 2
J • • No. - __ - ___ Over 1000 amps or volts - $340.00 2
El: c. Cont. Lice. � ���� Exp.D . e MEM Reconnect only $50.00 2
O' State ( CB Re., o. V_ Exp.''ate __ 4c. Temporary Services or Feeders
CO Busi ess T t r Metro , o. :xp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 Sign., ur. of '. upr. El: 'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
Licens No. =te see "b" above.
Phone No. 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner "nstallations: a) The fee for branch circuits with
e ' AC - C purchase of service or
Print Owner' Name V ` feeder fee.
Address A i _ 0-L. " o Each branch circuit $5.00 2
CI U J a State zip 9� b) The fee for branch circuits
t)l P without purchase of
Phone No. - 15 service or feeder fee.
First branch circuit $35.00 2
The installation is being m. de on • . perry I own which is not Each additional branch circui $5.00 2
intended for sale, I -ase •• rent. 4e. Miscellaneous
a .1 (Service or feeder not included)
X - SwRelds Signature ' /I . /i Each pump or irrigation circle $ 40 . 00 --� 2
• Each sign or outline lighting = $40.00 gb7 C 2
3. Plan Review section (if required) :* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: d�
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line 5a for a f'D
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # �
$ L7(L, OD
Total balance Due
1: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested // //G 92 AM PM BLD
Location 26,2c Suite MEC
Contact Person Ph PLM
Contractor n 'G � 7' - r - ; Ph SVUR
BUILDING Tenant/Owner / e_ ry (Ke= A ,„ , d 9? - C,7 G
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 idj VA-4, � a .C.f 7 , -
Fire Alarm
Susp'd Ceiling Z07-'L ,441 A 4. - -�� -► ?- r
Roof
Misc:
Final �QQ
PASS PART FAIL
PLUMBING
Post & Beam 1
Under Slab (li L� I
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PA —PART FAIL
LECTRICAL
Rough In
UG /Slab
Low Voltage
Fire
S_} 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA �
Approach /Sidewalk
Other Date /l /� - ' , Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.