Permit CT" Q OF T'GARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00504
Ai � DEVELOPMENT SERVICES DATE ISSUED: 8/13/99
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112AC -02100
SITE ADDRESS: 14915 SW 72ND AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT : 047 JURISDICTION: TIG
Project Description: First branch circuit
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: SIGNAUPANEL:
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: 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:
CHAMBERLAIN -HUSSA PROPERTIES PHOENIX ELECTRIC CO
18755 SW TETON 7379 SW TECH CENTER DR.
TUALATIN, OR 97062 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 8/13/99 $37.50 99- 317656 Elect'l Final
5PCT BON 8/13/99 $2.63 99- 317656
ORG1NAL
Total $40.13
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.
Permit Signature: �" ,/ �
g (974 �iG�t� - v�' IR�tXQG Issued By: � MAjkair
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: 01,A 11 DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
AUG -12 -99 THU 01:32 PM PHOENIX ELECTRIC CO FAX NO. 15036843611 P. 02
CITY OF TIGARD Electrical Permit Application' Recd By
13125 SW HALL BLVD. Date Recd _ 13
:TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit# El i'l -.
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Number of Inspections per permit allowed
Name of Development
Name (or name of business) b. _ , s. '_ Service included: Items Cost Sum 1
Address -- c.:- .. v • V.-Q.- 4a. Residential - per unit
� 1000 sq. II. or less 5 117.75 4
City /State /Zi •II .. Each additional 500 sq_ ft. or
portion thereof $ 26.25 1
Commerciag .. Residential El Limited Energy $ 60.00
�l,� 10 r 1. r? � �` 0.0.--\,... \ C cA Each Manufd Home or Modular
a. ontractor installation only: w
y: Dwelling Service or Feeder $ 72.75 2
(Prior to permit Issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT • ata base). , - Installation, alteration, or relocation
Electrical Contractor ` v.�. f �' c. CO) 200 amps or less $ 64.25 2
/�,, �� N � 201 amps to 400 amps $ 85.50 _ 2
Address 1' 401 amps to 600 amps $ 128.50 2
Cj V , t,N.c )_ State (1 f'� _Zip r) a 601 amps to 1000 amps 5 192.50 2
*tom
Phone N (1 3 (.000 Over 1000 amps or volts 5 363.75 2
Job No. 1 ( '' - S1 Reconnect only 5 53.50 2
Elec. Cont. Lice. No. at( - )R _ Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. I Exp.Date Installation. alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less 5 53.50 2
201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n / i % -� Over 600 amps to 1000 volts,
see °b" above.
License No. Li O� ,Exp.Date 4d. Branch Circuits
Phone No. (A �S - ?� � t- ) New. alteration or extension per panel
e) The tee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit - t---- _ $ 37.50 j7_ S? 71 !
Each additional branch circuit $ 5,35
The installation is being made on property I own which is not 4c. Miscellaneous
intended for sale, lease or rent, (Service or feeder not included)
Each pump or irrigation circle . $ 42,75
Owners Signature _ Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
panel, alteration or extension $ 60.00
3. Plan Review section (if required) :* Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. bf. Each additional Inspection over
4 or more residential units In one structure the allowable in any of the above
Per inspection $ 50.00
- Service and feeder 225 amps or more Per hour $ 50.00
System over 600 volts nominal In Plant 5 59,00
Classified area or structure Containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: 2
5a. Enter total of above fees 5 __7 -,
* Submit 2 sets of plans with application where any of the above apply. ,/u Surcharge (.05 X total fees) $
Not required for temporary construction services. Subtotal $
5b. Enter 25% or line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR '1
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS R.Trust Account # ,5`p Dsi-40( /�
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 4 /0. /
is \ds is \forms \cicclric.dec
- CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
8��3�gq
BUP
� Date Requested AM PM BLD
t
Location � - I - I 1 S . 1 `4 f / e Suite / MEC
Contact Person 1-06 Ph ( D V� - .mac ,Oe) PLM
Contractor Ph SWR Q
BUILDING Tenant/Owner ELC i 1 1 ou soy
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab Crawl Drain Inspection Notes: a,,5 _/U f--( r p .�
T J SIT
Post & Beam `211 MA I R Y f
Ext Sheath /Shear J
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall /42.
Sprinkler /2.- b V /2 Q A . / on nom ep
Fire S rinkler
Fire Alarm ( f L - 44 6 A
Susp'd Ceiling CS
Roof
Misc:
Final
PASS PART FAIL
PLUMBING 2 o g'i 14c' N Ct VC v L
Post & Beam
Under Slab
Top Out 1-0.12
Water Service Ue. C' QS 0 4 a 0
Sanitary Sewer J'
Rain Drains
Final
PASS PART FAIL kl\/
MECHANICAL r LcJD 1��' ,le S'
Post & Beam
Rough In
Gas Line
Smoke Dampers l , - , _ w i 11 _ ► 4
Final
PASS PART FAIL 3 ha v i
rs Cori i n Q (J •
Service / �V X eZ 1i - A th;?/ S -
Rough s
b
UG /Sla T h / / 0 /Q
/ f 1 p
b / S C /YG'Ul P �' Shp l he Ca [� � �
Low Voltage Aoki S O p A O _ 9
Fire Alarm I1G1�1 cY G2 f'YI / s •
S Farb 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 Inspector %__•_ Ext
Final
PASS PART FAIL DO 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 / - 1 I IS 7 2A-6( Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner I Alw A /< ELC 1 g -[ G�
9 --ODsOti
Retaining Wall ELR
Footing - - -- -- -
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH SGN
Crawl Drain NO INSPECTION(s) IN FILE
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 EXPIRED 2 � L
P ASS PART FAIL
PLUMBING l 17 "
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
PA___PART FAIL
g rr -E vI C . T1 E 25k_O
Rough In
UG /Slab
Low Voltage
Fire Alarm
- ASS 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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date a / /d Inspectov— "
��7/ ",vim- /� C . Ext
Other I
Final
PASS PART FAIL DO NOT REMOVE this inspection record from th fob site.