Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00115
DEVELOPMENT SERVICES DATE ISSUED: 3/27/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AA -00300
SITE ADDRESS: 14200 SW 72ND AVE
SUBDIVISION: ZONING: I -H
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one service over 1000 amps or volts and 3 branch circuits.
Job No. 27715
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/ SVCI FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 3 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: 1 > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ASGARD L L C BECK ELECTRIC INC
c/o GERBER LEGENDARY BLADES 9318 SE CHURCH ST
14200 SW 72ND AVE CLACKAMAS, OR 97015
PORTLAND, OR 97223
Phone: Phone: 656 -7396
Reg #: SUP 1326S
LIC 00002629
• ELE 3 -5C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT DEB 3/20/00 $379.80 0000774 Wall Cover
PLCK DEB 3/20/00 $94.95 0000774 Elect'I Service
5PCT DEB 3/20/00 $30.38 0000774 $505.13 Elect'I Final NA Total
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 e'ir IvlAkfla ISSUED BY: 6 1 , A dl oic ,„,_,
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: /3/"\_ DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
uoiu:iias mu:v 11 :'LD t'AA DUJ Dmm .uoU l iiy UP 11UANu tgJUUz
• N
CITY OF TIGARD Plan C eck#
Electrical Permit Applicat; )
1' HALL BLVD. ® Recd :y
�' RE�E Date Recd 5457,00
TIGARD OR 97223
Date to P.E. 3 -, OCJ
Phone (503j639-4171, x304 till* 16 2 Date to DST , 1
Inspection (503) 639 -4175 Print of Type MENt Permit#
Fax tLC . OD0 - Gib //5
(503) 59 -1900 DEVELOP /
( ) Incomplete or illegible will (tyYaga cepted Coiled
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Cl e 4L e Z /a ci- t5 Number of Inspectionsper permit allowed
Name (or name of business) S13 04 Service Included: Items Cost Sum Z
Address / 3u) 72- 4a. Residential - per unit
Ci /State/Zi y p ! lJ /L 972-23 1007 sq. rt. or less $ 117.75 4
tY p Each additional 500 sq. ft. or
• portion thereof $ 26.75 1
Commercial Jo Residential ❑ Umited Energy $ 60.00
Each Manufd Horne 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 (: /(, 200 amps or less 5 64.25 2
tr
Address /3/, -56 Cwtr c 201 amps to 400 amps S 85.50 2
401 amps to 600 amps $ 128.50 2
City alt (c Ka o i <.S State O i'L Zip 170/5- 601 amps to 1000 amps $ 192.50 2
Phone No. &570-735i, Over 1000 amps or volts i $ 363,75 3 / - . 77 2
Job No. .g 7 7 /5- Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3-5 Exp.Date iG - i -00 4c- Temporary Services or Feeders
OR State CCB Reg. No. a-C, �? 4•.Date // - / -GO Installation, alteration, or relocation •
COT Business Tax or Metro No. 5 - . E i•.D.te I) -1-00 200 amps or less 5 53.50 2
201 amps to 400 amps 5 80.25 2
/ 401 amps to 600 amps S 107.00 2
Signature of Supr. Elec'n / Over 600 amps to 1000 volts,
see "b" above,
License No. 26-5 Exp.Date /O - / -6- 4d. Branch above.
•
Phone NO, C> SZa .. 7 3 `1 !r New, alteration or extension per panel
a) The fee for brencreuita
h'd .. .
•
2b. For owner installations: with purchase of service or • . '
feeder fee. r
Print Owners Name Each branch dreuit 3 $ 5.35 /‘ . C� 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee
Phone No. First branch circuit S 37.50
Each additional branch arcult S 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 S 42.75
Owners Signature Each sign or outline lighting • $ 42.75
Signal dreuit(s) or a limited energy
(if required):*
panel. alteration or extension $ 60.00
3. Plan Review section
(� 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 5 50.00
• .
_ Per hour S 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- E nte total of ab ove fees $ 3 ?
t Submit 2 sets of plans with application where any of the above apply. (.05 X total fees) S , .$ � j�
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line Sa for �••
NOTICE Plan Review if required (Sec. 3) 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WftHIN 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 . 13
is ,dstslfonns \electric. doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
BUP
Date Requested 49/1 (,v AM K PM BLD
Location ( (()+ - 7 2 J.11� Suite MEC
Contact Person 640 C4., Ph Le 9.0 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ( 1%Y-A , ELC c-t k hr, 00 1 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 [ C
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
Serer
Rough In
UG /Slab
Low Voltage
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk pp
Other Date (0 /3/71) Inspector Ext
Final
PASS PART FAIL D 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 AM PM BLD
Location ('(?D v 73 - 1\ ' ‘k Suite MEC
Contact Person ,fib kY\ / i�C fl.[C � t C-- Ph ce 570 " 7.3% PLM
Contractor Ph SWR
BUILDING Tenant/Owner Q0� kLS ELC c9 t(.S
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing Ag A
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
4420 - CAL
n
UG /Slab
Low Voltage
Fire Alarm
Fin
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
Other Date S - %ST � Inspector �` _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
- -.. ! -
Art -mon- ~ T w - '
o ie cto ,® twt GROUND FAULT SYSTEM
•
t• TEST REPORT
r
CLIENT: r6 .ENGINEER EIUO� NUMB. :
rk E(ec iv , L � . 1'1 � erta� A - ) n' /7 7
LOCATION: 1 v z oo , s, 1 Z N d WITNESS: DATE: U G O (7
SWITCHGEAR DESIGNATION: �n TEST EQUIP. ASSET # CALIBRATION DATE:
• 1 I lc) - 1/
- FIELD DATA
SWITCHBOARD MANUFACTURER SHOP 1 �� ORDER NO. UL N
7- 7SS II 1 3
MAIN OVERCURRENT DEVICE MFGR. 6
CIRCUIT BREAKER ❑ FUSED SWITCH
TYPE MODEL /CAT. NO. CURRENT RATING SYSTEM VOLTAGE VOLTAGE RATING
41 T • C • IS k LO 3(. ) -))zoo / Do o -- ` - /So /z 77 1/2! L 1 66 v tL4 (
GROUND FAULT SYSTEM 6 2Sf U` ( MFGR. ' rY i
❑ NEUTRAL - GROUND STRAP ZERO- SEQUENCE 6- C
MODEL ,.— CAT. NO. PICK -UP RANGE TIME RANGE SENSOR/C.T.
.1— /A 4 .V.G1 l 2q) -Rol) 1 - ' j -- 1zo„
AS FOUND SETTING 1 AS LEFT SETTING 4... SETTINGS SUPPLIE • BY
PICKUP NT � Z ! /� TIME vv C URRENT 7 /v TIME / OV A $ cx, 1
CURRENT
INSPECTION
' SERVICE ENTRApICE CONDUCTORS MAIN BONDING JUMPER 4 GROUND ELECTRODE CONDUCTOR
;�. - /I // � 4 /..PER PHASE I 7i )- .--Z /-i L U AWG ❑ MCM
OC NE TRAL - GROUND LOCATION CONTROL POWER TRANSFORMER
ORRECT ❑ INCORRECT ❑ CORRECTED BY CONTRACTOR N A- VA
MONITOR /TEST PANEL OPERATION OTHER
CORRECT ❑ INCORRECT ❑ CORRECTED
ELECTRICAL TESTS
BREAKER/SWITCH REACTION TIME (RT) REDUCED VOLTAGE TEST (55% RATED VOLTAGE)
/ 6 0ECONDS ❑ CYCLES `4 Er CORRECT ❑ INCORRECT
PICK -UP CURRENT PICK -UP CUR NT MINUS 25% ( / Li° AMPS)
"' 3 I . Z AMPS NO TRIP (CORRECT) ❑':TRIP (INCORRECT)
SYSTEM NEUTRAL INSULATION RESISTANCE TO GROUND OTHER``'-
g ! MEGOHMS
PRIMARY CURRENT , _ PERCENT TOTAL REACTION RELAY MFGR.
AMPERE -TURNS PICK -UP U • TIME TIME TIME TOLERANCE
TIME-CURRENT ' ' O O
CALIBRATION 3 67 C. - l / ,6 1 Z v 2 � /
• TESTS L/p v ` / 2 Qv , / 7
1 -
REMARKS
6D (l e - f' .1 ( -I- 2,- P� kav- `,I c. S L, 01„,, T , .Ifrt * k a li T 7 1.0., .2
1 rnv, li0 AV C, ( ( v t -1 GLe.se --ruv, r - {•'oys l 1.1 G (..../ r
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°1990 ETI - - PAGE OF •