Permit CITY OF TIGARD ELECTRICAL PERMIT
i
i,�,.rop.,,ry A, DEVELOPMENT SERVICES PERMIT #: ELC98 -0520
I' DATE ISSUED: 08/28/98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-0171
PARCEL: 2S112AC -02100
SITE ADDRESS...:14915 SW 72ND AVE
SUBDIVISION :FANNO CREEK ACRE TRACTS ZONING:I —L
BLOCK LOT °047 JURISDICTION: TIG
Project Description: Image ®ax
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 — 200 amp - 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
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.: 1 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
IMAGEMAX type amount by date recpt
14915 SW 72ND AV PRMT $ 35.00 JSD 08/28/98 98- 308702
TIGARD OR 97224 SPCT $ 1.75 JSD 08/28/98 98- 308702
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 36.75 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS
TIGARD OR 97223 Ceiling Cover Elect'1 Service
Phone #: 684 -3600 Wall Cover Elect'1 Final
Reg #..: 000522
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 wit roved plans. This permit will expire if work is not star within 180
days of issuance, or if work is suspended for more t 180 ays. • • a ION: Oregon law requires you to follow the ules adopted by
the Oregon Utility Notification Center. Those rules are se fort
o OAR 952- 001 -0010 through OAR 952- 001 -1': may obtain a copy
of these rules or direct questions to WC by allin, ( ), -1'
Permittee Signatu, e: Issued By:
IP
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 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
AUG -28 -98 FRI 02:52 PM PHOENIX ELECTRIC CO FAX NO. 15036843611 P. 02
Checitt
CM OF TIGARD Electrical Permit Application Rey,
13125 SW HALL BLVD. Recd
Rec'd=
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Date to DS
Print or Type Permit # LC. y - -Ucza
Inspection (503) 639-4175 Incomplete or illegible will not be accepted Called YI/1
Fax (503) 684 -7297 •
1. Job Address: 4. Complete Fee Schedule Below:
Number of Inspections per permit allowed
Name of Development '
Name (or name of business�.a Y�
-VV C.� Service Included: hems Cost Sum
1
1, \C1
�_ 1 \ ‘411 4a. Residential . per unit
Address \` '). \3� \ 1000 sq. ft. or less 5110.00 4
� 91 �� 4, Each additional 500 sq. It. or
City /State /Zip portion thereof 525,00 1
Residential ❑ Limited Energy $25,00
Comfnerci ` Each Manul d Home or Modular
` , ' ` ' , tv�t Dwelling Service or Feeder 568.00 .2
2 C Contractor i nsttall h only: 4b. Services or Feeders
(Attach copy • ` II current !icon: s) Installation, alteration, or relocation
Electrical Contract... ��•�• - � 's" • 200 amps or less 560.00 _ 2
.{,, W � �. • ✓ 201 amps to 400 amps 580.00 2
Cittcsss_' �'1 _Z da 401 amps to 600 amps 5120.00 2
Phy �. . State 601 amps to 1000 amps $180.00 2
P N • o � • ` ii rMi .0 Over 1 000 amps or volts $340.00 - 2
Job No. do,- - Reconnect only $50.00 2
Elec. Cont. Lice. No. _ . Ta Exp.Date
4c. Temporary Services or Feeders
OR State CCB Reg. No. 4-7),K7'6 �p� t• Date Installation, alteration, or relocation
COT Business Tax or Metro No. P 200 amps or less $50.00 2
201 amps to 400 amps $75.00 --- 2
Signature of Supr, Elec'n 401 amps to 600 amps 5ioo.00 2
Over 600 amps to 1000 volts,
License Nc
L ,,,g Exp.Date see "b" above.
l
Phone Nr \-e _ �'L.0 . 4d. Branch Circuits
New alteration or extension per panel
The loo for branch circuits wilt)
2b. For owner installations: a t
purchase of service or
feeder fee. $5 2
Print Owner's Name Each branch circuit
Address - b) The fee for branch circuits
City Stater Zip without purchase of
service or feeder fee. ` $ Q. (Y._.) 2
Phone No. First branch circuit 1 2
Each additional branch circuit 55.00 �-
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 540.00 2
Owner's Signature Each sign or outline lighting 540.00 2
s) or a limited energy x40.00 2
3. Plan Review section (if required):* Signal circuit anel, alteration or extension
Minor Labels (10) 5100.00
Please check appropriate item and enter Tee In section 5B. ad
Each t. Escdidonal Inspection over
4 or more residential units in one structure 4 he ac ad le in any of the above
Service and feeder 225 amps or more Per inspection'
System over 600 volts nominal Per hour $55.00
Classified area or structure containing special occupancy In Plant $55.00
as described in N.E.C. Chapter 5
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: S•0yj 5a Enter total of above lees 5
Not required for temporary construction services. 5% Surcharge (.05 X total fees) $
• Subtotal $
NQTICE 5b. Enter 25% of line 5a for /
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED 1S Subtotal $ Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK (�)��
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Account #at�tS� • S $
TIME AFTER WORK IS COMMENCED. Total balance Due
o ,_, -- 50ffe
. ,
I:\D5TS\ELC96.P1'P Pm 0'96 _ -
I CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
�j q BUP
Date Requested l_ 3 � - 61 0 AM PM BLD
Location / q'/ 5 c-SeA 1 7 - P ] (t C 7 is - Suite MEC
Contact Person c J Ph PLM
Contractor .P E Ph 7 " J �o V C✓ S WR
BUILDING en Owner oz�,,(_ L C ��,05-26
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab -71/4 Alf �sz'l ABC / -.14 SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
D
/
rywall Nailing L - ____. ��1. -aL t_ r. -
Firewall
Fire Sprinkler _XL�.&.+� —
Fire Alarm
Susp'd Ceiling
Roof
Misc: _
Final Q
PASS PART FAIL -l�4l -*x�
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
FAIL
ECTRIC
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
r i i ) 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 Y4 Inspector Ext
Other
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.