Permit CITY OF TIGARD ELECTRICAL PERMIT
•
kpy A DEVELOPMENT SERVICES PERMIT #: ELC97 -0627
13125 SW Hall BIvd., Tigard, OR97223 (503)639.4171 DATE ISSUED: 09/26/97
PARCEL: 2S1O1DD -01000
SITE ADDRESS...:13965 SW 72 ST
SUBDIVISION ZONING:
BLOCK • LOT • JURISDICTION: TIG
Project Description : Add first branch circuit to existing commercial tenant
occpy.
- -- 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
AUTO BATTERY ELECTRIC type amount by date recpt
13651 SW AMBLER ROAD PRMT $ 35.00 GEO 09/26/97 97- 299587
CLACKAMAS OR 97015 5PCT $ 1.75 GEO 09/26/97 97- 299587
Phone #:
Contractor:
$ 36.75 TOTAL
REQUIRED INSPECTIONS
Ceiling Cover Underground Cove
Phone #: Wall Cover Elect'l Service
Reg #..:
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 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 801-8818 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling ( )246 -1987.
Permittee Signature: Issued By:
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 SUP R. ELEC' N : DATE: 7//99
LICENSE NO: '7 MC 5
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
C A4q -41 75 by f,_Qu71 r m fnr An i nap r +inn mmAH rl +hp ref hi,ci npcc H y
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
' ~ SEN 19 -97 FRI 01:25 PM PHOENIX ELECTRIC FAX NO, 503 684 3611 P. 02/02
- CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Phone (503) 639 -4171, x304 Date to P.E.
Inspection (503) 639 -4175 Print or Type Date to DST
Incomplete or illegible will not be accepted
Permit q-7- 06,2- Fax (503) 684 -7297 P 9 p
Called ,
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
1
Name (or name of busines * \i t�
m / f , tL Service included: Items Cost Sum
Address 1'3q'lc5 Su.,� 1 4a. Residential - per unit
City /State/Tip JL t \A (: - cj� ��3 10 00 sq. ft.
or tens 5110.00 4
l Each additions! 500 sq. ft. or
Commercial Residential ❑ portion thereof 525.00 - 1
limited Energy 525.00
-
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder 568.00 2
(Attach copy `s tl current licert 4b. Services or Feeders
•
Electrical Contracto .. !�.. 3. • , , fly A.
Installation, alteration, or relocation
Address ) ' ' �' e , „ 200 amps or less 56
� 2
City `LL1. 2 Vk State CAL _ Zp i7 a'.l' 4 40 0 1 amp to
600 amps
$80.00 2
Phone No. t c. LC - 3l O 0 (_0 � O -n srY■ � 601 amps to 1000 a amps
sic .00 - 2
- Job No. ..-)f._ r C) • Over 1000 amps or volts $340.0o 2 - Reconnect only 2
Bec. Cont. Lice. No. �. Exp.Date 10 '7 y $SO.00 2
OR State CCB Reg. No. • Exp.Date 1 9 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date 4 37 Installation, alteration, or relocation
200 amps or less $50,00
Signature of Supt. Elecin 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. / OS Exp.Date see "b" above.
Phone No. " ' a
4d. Branch Circuits
N ew, alteration or extension per panel
2b. For owner installations:
a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address - Each branch circuit 55.00 2
City State 7jp b) The fee for branch circuits
without purchase of •
Phone No. service or feeder fee.
First branch circuit j S
$35.00 1. C ` ,n . 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 _ 2
intended for sale. lease or rent.
4e. Miscellaneous
Owner's Signature (Service or feeder not included)
Each pump or irrigation circle 540.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
per, alteration or extension $40.00 2
-
Please check appropriate item and enter fee in section 5B. Minor Labels (to) sloo.00
4 or more residential units in one structure 41. 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 535.00
Classified area or structure containing special occupancy Per hour $56.00
as described in N.E.C. Chapter 5 In Plant 555.00
' Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary consmuction services. 5a. Enter total of above fees $ €'
5% Surcharge (.05 X total fees) $
NOTICE - Subtotal $ .,t a J.
5b. Enter 25% of fine Sa for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review)! r ui (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK ubtolal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. Trust Account # :, �.� ' �^ .
Total balance Due
$
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 1 Z - f 3--- ci 7 A.M. P.M. MST:
Location: 1 S9 6 5 5 iN -- 1 -- 1D- . r o / BUP:
Tenant / l� � Suitte: Bldg: MEC:
Contractor. 9�' / i$t 1(1 Phone: ( t - .6 nn PLM:
Owner Phone: ELC: J 7 - 06 7-7
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL LECTRIC SITE
Site Post/Beam Post/Beam Post/Beam Cover /e Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approv:. Approved
Appr /Sdwlk Not Approved Not Approved Not Approved r• u .. ved Not Approved
FINAL FINAL FINAL AL FINAL
l//1/�9 4 — i S
r -_-------
cm,
•
0 Call for reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
/
Inspector: reinspection
Date: / -/ F 9" 2 Page of
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
� 1 l� BUP
Received L0 Date - Requested AM PM BUP
Location � I(b 5LL) Suite MEC
Contact Person 8( A- 51 'In.S LAG Ph ( 573 )5" 9 710 PLM
Contractor Ph ( ) SWR / _
BUILDING Tenant/Owner ELC � 4
r 7 1 3
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
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
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
ICE_C;RICAJI
Servic
Rough -In Y
UG/Slab V1^
Low Voltag
Fir: Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
-
Please call for reinspection RE: Unable to inspect — no access
Aire Supply Line 4' # ( t np E
ADA Approach/Sidewalk Date Inspector (F�c!
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
0p Soi V
n TUALATIN VALLEY FIRE & RESCUE
�JP `6 AND
BEAVERTON FIRE DEPARTMENT
FIRE MARSHALS OFFICE
4- & R S� (503) 526 -2469 POSTED:
OCCUPANT F
CONTRACTOR BLDG. PERMIT d�
PROJECT NAME 1 /5 PLAN REVIEW 0
LOCATION 1 3 ( (� 5 jJ 7 (� ) ,.o"" �
JURISDICTION: 1= Be. 2= Du. 3= P.C' 5= Tu. 6= Sh, 7= Wi. 8= CC 9= WC 0= MC
COVER ( F NA SPECIAL FOLLOW -UP /REINSPECTION ATTEMPTED FINAL
O Framing El Separation Walls 0 Sprinkler System
0 Shaft 0 Fire Dampers (Overhead /Underground)
O Alarm System 0 Hood•Extng Systems 0 Conference
O Spray Booth 0 Ceiling Cover 0 - Other
( 7. \
` -�
Date: ((J J Inspector: 6.4 � G'�' f )
(
1 '