Permit ._ CITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2003 -00063
DEVELOPMENT SERVICES DATE ISSUED: 2/11/03
13125 SW Hall Blvd., Tis:lard. OR 97223 (503) 639 -4171 PARCEL: 2S112AA - 00300
SITE ADDRESS: 14200 SW 72ND AVE
ZONING: I -H
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: ( tr69.# r e +f G R Cka- FoR fr t E e • c , P p tom}/ "7 X02 //A. j /*--/1 &.L
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 HMI 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: 1 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:
GERBER LEGENDARY BLADES BECK ELECTRIC INC
14200 SW 72ND AVE 9318 SE CHURCH ST
PORTLAND, OR 97223 CLACKAMAS, OR 97015
Phone: Phone: 656 -7396
Reg #: SUP 1326S
LIC 00002629
FEES ELE 3 -5C
Description Date Amount
Required Inspections
[HRELC] Hourly Electrical 2/11/03 $175.23
[HRTAX] Hourly Rate Tax 2/11/03 $12.27 Elect'I Final
Total $187.50
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in 0 - - 0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -800- 2 -2344.
Iss ed By: C I GI-Z -mil Permit Signature: !
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lea. e, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ) -0- - r DATE:
LICENSE NO: /
Call 639 -4175 by 7:OOpm for an inspection the next business day
E iect - icai Perini[ App
Date received: a 1/ 4� Permit no.: ` ,� O
;- ?.. _ Ci ty Of 'Tigard I Project/appl. no.: Expire date:
.A.
Add 13125 SWHall�lvr ��n c 3 - -- -- —
City ofTigard Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598-1960 FEB 11 200 Case file no.: Payment type:
Land use approval: (;ITY or TIG
. r a:_ , 'ilit'E OF; PERAIff
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
O New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
, > .. r• r, .r•P t ,.. gIlilCVI(1V[tITY01i1 ;.t':l:. .ia.wktu tv'n'✓.;t+..`vt,+^t.$.;-
Job address: i Q0 t tA) r 9 a .1 G,4,44. Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: 'Subdivision:
Project name: I Description and location of work on premises: r4A4 m 1 u
Estimated date of completion/inspection: -- ...Q
•, , ,, , ;: ,; ,. C.O.NIgAcP4 1-AgeLIC TION ,, .,, : _ FEE SCHEDULE
Job no: Fee Max
Business name: j c _[ (y t t _ � i i Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address: Cj IC; ;, (_k.t(rs =k_ dwelling unit Includes attached garage.
City: C.\0 C,K!"tvvV c,L, State:C,te_ ZIP: cl'70):j Serriceincluded:
Phone: 1 - 1,--f:,( 1 35/4, I Fax:(", �(r'13 6 0 1 E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: U r , / I Elec. bus. lie. no: _5 C
Limited energy, residential 2
City /metro lic. no.: //,f..5,-->i Limited energy, non- residential 2
iii� Each manufactured home or modular dwelling
Signature of supervising etec ' an ( rred) Date Service and/or feeder 2
Sup. elect. name (print): /./- , .1 . .�,.) 1 - irv1 License no: r c, �^icesor feeders — installation,
alteration or relocation:
PROPERTY OWNER - 200 amps or less 2
Name (print): o� ' {.I fl.` 201 amps to 400 amps 2
Mailing address: p O lg k 2 3
401 amps to 1 00 amps 2
f \ 601 amps to 1000 amps 2
City: N�tu I State:Ot. I ZIP: q 734, tf Over 1000 amps or volts 2
Phone: 4,75,514? 8 I Fax: E -mail: Reconnect only - 1
Owner installation: The installation is being made on property I own Temporary services or feeders - -
which is not intended for sale, lease, rent, or exchange according to tnstatlation , alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps i 2
Owner's signature: Date: 401 to 600 amps 1 2
r Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: 'ZIP: B. Fee for branch circuits without purchase
Phone: Fax E -mail of service or feeder fee. first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply):. Misc. (Service or feeder not included):
O Service over 225 amps-commercial 0 Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps-rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
❑ System over 600 volts nominal more residential units in one structure alteration. or extension* 2
❑ Building over three stories O Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. - Per inspection 1 j i j
Submit sets of plans with any of the above. Investigation fee ■
�
The above are not applicable to temporary construction service. Other ['(L PAi,� C Sf'(K A f � ,4.'�0,
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Petrol[ fee � $� `
O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. / / within 180 days after it has been State surcharge (8 %) .... $
Exp1ts accepted as complete. TOTAL $
Name of ca'dbolder as shown on credit card
S
Cardholder signature Amount 40 -4615 (6/00000M)
' Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete_F_ee_ScheduleBelo_w -: _ - - -- - -- --Restricted. Energy -FFe..... --------------- -- - - - — $75.00 - --
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit �
1000 sq. ft. or less $145.15 4 I 1 Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Garage Door Opener
Dwelling Service or Feeder $90.90 2 In
Services or Feeders El Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 ❑
201 amps to 400 amps $106.85 2 Vacuum Systems
401 amps to 600 amps 5160.60 2 Other
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts • • • $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
. 200 amps or Tess $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2 Check Type of Work Involved:
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts,
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New. alteration or extension per panel
a) The fee for branch circuits
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $6.65 2 0 Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service 0 Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 HVAC
Each additional branch circuit _ $6.65 .
Miscellaneous ❑ Instrumentation '''
(Service or feeder not included) . .
ncluded) "
Each pump or irrigation circle $ 53.40 El Intercom and Paging Systems .
Each signor outline lighting $53.40 • • • , . •
Signal circuit(s) or a limited energy Irrigation Control'
panel, alteration or extension $75.00
Minor Labels (10) $125.00 ❑
Medical
Each additional Inspection over
the allowable in any of the chi,-....i.. . Nurse Calls
Per inspection $62.50
Per hour $ 62 . 50
El Plant $73.75 Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
•
Enter total of above fees $ ❑ Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee No licenses are required. Licenses are required for all other installations
See "Plan Review" section on $
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
•
❑ Trust Account # • 8% State Surcharge $
Total Balance Due $
i :',dsts\formcklc- fees.doc 10/09/00
CITY OF TIGARD ' 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ._3-8 AM PM BUP
Location l f a o d 7a '11G' Suite MEC
Contact Person haelleh ( ) SSP " 8.3 PLM
Contractor Ph ( ) SWR 3 BUILDING Tenant/Owner 3
) ELC - d oO (03
Footing ELC
Foundation Access:
Ftg Drain ELI QO
Crawl Drain
Slab Inspection Notes: ; sign? SIT
Post & Beam � ,c..0�.
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 0 9' I - 4_ ( 4b
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In (- •
Water Service
Sanitary Sewer
J Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA .: I ( _ 03 I Ext
Approach/Sidewalk Date Inspector
Other:
Final DO NOT REMOVE this inspection record from a Job site.
PASS PART FAIL