Permit z. r CITY OF TIGARD ELECTRICAL- PERMIT
PERMIT #• : E1_C98 -0552
, „NrA
DEVELOPMENT ME OR SERVICES DATE ISSUED: 09/17/9E3
.4.4 13125 PARCEL: 291 12DC -00100
SITE ADDRESS...:15705 SW 72ND AVE
SUBDIVISION.... :SOUTHERN PACIFIC TIGARD INDUST ZONING:I - -L
BLOCK........... LOT .............:002 JURISDICTION: TIG
Project Description: Alteration of electrical service.
- - -- RESIDENTIAL UNIT- .. - - -- -- -TEMP SRVC/FEEDERS---- .----«-- MISCELLANEOUS - - - - --
1000 SF OR LESS....: 0 0 - 200 amp.......: 0 PUMP /IRRIGATION....: 0
EACH ADD' L 501 NSF...: 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-I-amps -1000 volts.: 0 MINOR LABEL (10)...: 0
----- SERVICE /FEEDER - - - - • - - -- BRANCH CIRCUITS - -- -- --- -ADD'L INSPECTIONS---- --
0 -- 200 amp.:,,...: 8 W /SERVICE OR FEEDER: 36 PER INSPECTION.....: 0
201 - 400 amp......: 0 1st W/O SRVC OR FAR.: 0 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: ----- __ _.__._..- - .- ___ - --
PHOENIX ELECTRIC CO type amount by date recpt
7379 SW TECH CENTER DR PRMT $ 660.00 DLH 09/16/98 98- 309188
TIGARD OR 97223 5PCT $ 33.00 DLH 09/16/98 98- 309188
Phone #:
Contractor: --
PHOENIX ELECTRIC CO 3 693.00 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS - - - - --
TIGARD OR 97223 Ceiling Cover Elect'1 Service
Phone #: 684 -3600 Wall Cover Elect' I Final
Reg 44.. : 0uZ10522
This peruit 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 with approved plans. This persit will expire if work is not started within 180
days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0310 through OAR 952 -001 -1987. You aay obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: / Issued By:
------------ OWNER INSTALLATION ONLY- - - - - -- ---------------
installation is being wade on property I on which is nct intended for
sale, lease, or rent.
OWNER'S SIGNATURE: /(� /g- DATE:
_ -
CONTRACTOR INSTALLATION ONLY - -
SIGNATURE OF SUPR. ELEC' N: O7V /9 /'PG /(7/f-T7O// _ DATE:
LICENSE NO:
+ + + + + + + +- + + + + ++ - + ++++ +•i--I-++ + ++ i- + + + ++ + + + ++ + + ++ + ++ - + + + + + + + + + + +-c--f +++ + + +++ + ++ ;- + + ++ +
Call 639 -4175 by 7:00 p.m, for an inspection needed the next business day
+ + + + + + + + + ++ + ++ + + ++ + + + + +- + + + + + + + + + + ++ + + + ++ + + + + ++ + +-: + + + + + + + + + + + ++ + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical PermitkApplication Plan Check #
13125 SW HALL BLVD. Rec'd By . . t..ff
TIGARD OR 97223 ` '� 1998 Date Recd 9/ /V
/�- Date to P.E.
Phone (503) 639 -4171, x304 /i V Date to DST --- Inspection (503) 639 -4175 CPrin, t,qp Type ,:o Permit # &-Z Cy,P- OSso2.,
Fax (503) 684 -7297 Incomplete or illegible will not be accepted called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development \� \ ∎ \ k\ , C .1 Number of Inspections per permit allowed
Name (or name of business � Service included: Items Cost Sum
Address 1. .:01 ( a) r l '" 1-(2- 4a. Residential - per unit
\ 1000 sq. ft. or less $110.00 4
City /State /Zip v\ . Each additional 500 sq. ft. or
Commercial 4 Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
_ • . �.-
(Attach cop II current Ilcens =s) 4b. Services or Feeders
Electrical ontracto %A.. • � O UD 2
.� C , I alteration, or relocation
. . � $so.00
Address - ...% 200 amps or less
201 amps to 400 amps $80.00 2
City - ... �. - ` State t2
tee & Zip " . .. 401 amps to 600 amps $120.00 2
Phone - ta
- f f�.1 601 amps to 1000 amps $180.00 2
Job No. _ Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No e. Exp.Date o / `/a' Reconnect only $50.00 2
OR State CCB Reg. No. Exp.Date -2 ag 9 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
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 $100.00 2
Over 600 amps to 1000 volts,
/0/91 License No d Exp.Date � see "b" above.
Phone Nr ,' ' " a o
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The tee for branch circuits with
purchase of service or
Print Owner's Name feeder fee. 3 -- / gO Q0
Address Each branch circuit $5.00 l l 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circ $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ • ,
5% Surcharge (.05 X total fees) $ MAW/ NOTICE Subtotal $
5b. Enter 25% of line 5a for /
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY / q,p
TIME AFTER WORK IS COMMENCED. El Trust Account # 409..1 UO
Total balance Due $
I:\DSTS\ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
�, / D
f,5 Date Requested [ /-.� - l ( AM PM BLD
Location 452:65 SW 7A rid . afro Suite ' / MEC
Contact P 7 45' ta- Phi -e 46 Ph a 7 J(1� PLM
Contractor '", Ph SWR
BUILDING Tenant/Owner \je:Zu _ ELC ?it G
`05.g.
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 PA - T FAIL
Under Slab
Top Out
Water Service
Sanitary Sewer
'4 Drains
latI
AS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P T FAIL
LECTRICAL
Service
Rough In
UG /Slab
Low Voltage
arm
Final
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 reinsp-ctio RE: [ ] Unable to inspect - no access
ADA p T�9 / •
Approach/Sidewalk Date ' = Inspector 6 Ext
Other �`�'�
Final
PASS. PART FAIL DO NOT REMOVE this inspection record from the job site.