Permit CITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2000 -00504
4�Ii� DEVELOPMENT H B ) 639 -4171 DATE ISSUED: 8/23/00
PARCEL: 2S101 DC -00300
SITE ADDRESS: 13535 SW 72ND AVE
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Temporary service for new commercial building.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC NW PROPERTIES RURAL ELECTRIC INC
9965 SW ALLEN BLVD 5285 NE ELAM YOUNG PKWY
SUITE 115 SUITE A900
BEAVERTON, OR 97005 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 -6696
Reg #: LIC 00047478
SUP 4062S
ELE 34 -82C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT CTR 8/23/00 $53.50 2720000000( Elect'l Final
5PCT CTR 8/23/00 $4.28 2720000000(
Total $57.78
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 ISSUED BY:
rl/
OWNER INSTALLATION ONLY
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: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY OF-TIGARD Plan Check #
ti Electrical Permit Application
= i3125`SW HALL BLVD. Rec'd By i
TIGARD OR 97223 - Date Recd 8z /c7)
Phone (503 ) 6x39 -4171, x304 Date to P.E.
Inspection (503) 639 -4175 Print of Type_ --
'� D Pe t rm to0 DST
�, - oaso
Fax (SQ3) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) 72nd Ave Building _ Service included: Items Cost Sum 4
Address 13 5 3 5 SW 72nd Ave 4a. Residential - per unit
City/State/Zip Tigard, Or 97223 • 1o00 sq. ft. orless S 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.75 1
Commercial la Residential ❑
Limited Energy 3 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 base). Installation, alteration, or relocation
Electrical Contractor RURAL ELECTRIC, INC. 200 amps or less $ 64.25 2
Address 5285 NE Elam Young Pkwy #A900 201 amps to 400 amps 3 85.50 2
City Hillsboro State OR Zip 97124 401 amps to 600 amps 5 128.50 2
Phone No. 503/648 -6696 601 amps to 1000 amps $ 192.50 2
Over 1000 amps or volts $ 363.75 2
.Job No_ _ 0056 • Reconnect only 3 53.50 2
Elec. Cont. Lice. No. 34 -82C Exp.Date 4c. Temporary State. CCl3Reg. No. 47478 Exp.Date Installation, �attera r o r
een; to Feeders n-
COT Business Tax or Metro No 287 Exp.Date 200 amps or less 1 $ 53.50 53.50 _ 2
( / 201 amps to 400 amps $ 80.25 2
/ 1 , Q 401 amps to 600 amps $ _100.00 2
, ^
Signature of Supr. Elec'n t 1 .f C--: Over 600 amps to 1000 volts,
_
40 -S see "b" above..
License Nct Exp.Date 4d Branch circuits
Phone No. 503/648 -6696 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 $ 5.355 _
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or Mt. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Ownef's_Signatu[a . . Earhsigaar oullinw intir 5 3, 42.75
Signal circuit(s) or a limited energy -
3. Plan Review section (if required).* I. alteration or extension $ 00.00
r abelstlor $ 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over •
4 onnorenesiclentrat Mei in 'one structure'
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 emits 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 $ 53.50
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 4.28
Notrequireckfortamporarr construction services. Subtotal $ pf
5b. Enter 25% of line 5a for
NOTICE Plan Review if recuired(Sec $ 0
• PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 57.7
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 15 COMMENCED. Total balance Due g 57.78
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
1
• / BUP
39, Date Requested g":0 '7'9 AM PM BLD
Location ( 4 7 e - 3'' j G!) 72,m, A/ Suite MEC
Contact Person Ph t' V2 66 9t, PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC �, ' •;' -� S� 7
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 z Zer,
Roof
Misc:
Final
PASS PART FAIL -
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL L e e _ i - O.S - csL r
MECHANICAL
& Beam 2e i f e p/b mac'' °'`�
Rough In .S /cc'if «.� /ly 6b .�.,� re % �5
Gas Line
Smoke Dampers
Final
PASS PART FAIL
,E [L
Service '�ir��
Rough b ( / ✓�
Low Voltage
Fire Alarm
.e•
•ART 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
Other Date Z Inspector `ja■„It ` Ext
Final
PASS PART FAIL D NOT REMOVE this inspection record from the job site.