Permit ,
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
,,,,,,,, , m�n� � n�u~��w omnn�o� w w~n�n m� o~~n�~� PERMIT #: ELC96-0699
,�� :'l 13125 SW Hall Blvd., Tigard, ������
— — =-- ` - ' DATE ISSUED: 10/30/96
PARCEL: 2S1 12DC-00100
SITE ADDRESS...: 15705 SW 72ND AVE
SUBDIVISION ' • SP TIGARD INDUSTRIAL PARK ZONING:I—L
BLOCK • LOT ^2
Project Description: PHASE 2 — Electrical services for Tenant improvement
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS
1000 SF OR LESS ^ 0 0 — 200 amp • 0 PUMP/IRRIGATION ^ 0
EACH ADD'L 500SF...: 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 • 2 W/SERVICE OR FEEDER: 0 PER INSPECTION : 0
201 — 400 amp ^ 2 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp ^ 1 EA ADD'L BRNCH CIRC: 64 IN PLANT • 0
601 — 1000 amp ^ 0 PLAN REVIEW SECTION
1000+ amp/volt : 3 >=4 RES UNITS ^ > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Owner: FEES
CAPITOL ELECTRIC type amount by date recpt
12810 NE AIRPORT WY PRMT $ 1740.00 JMH 10/30/96 96-285945
PLCK $ 435.00 JMH 10/30/96 96-285945
PORTLAND OR 97230 5PCT $ 87.00 JMH 10/30/96 96-285945
Phone #: 503-255-9488
Contractor:
CAPITOL ELECTRIC CO INC $ 2262.00 TOTAL
12810 NE AIRPORT WAY #1
REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Underground Cove
Phone #: 503-255-9488' � Wall Cover Elect'l Service
Reg #..: 48748
This permit is issued subject to the regulations contained in the trvi 01
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with .
approved plans. This permit will expire if work is not startod � / / ' / -
within 180 days of issuance, or if work is suspended for more � �//�'( ' �= ��J�^(~/L�� [ / .
than 10W days. I 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 SUPR. ELEC'N: DATE:
LICENSE NO: -
Call for inspection — 639-4175
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a Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
- Tigard, OR 97223 Permit # G9 6 -0(0 9
A '014 Date Issued 10-30 -7h
� � i -
Phone (503) 639 4171
'� FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
• f
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development f p / Si� S Number of Inspections per permit allowed
Address /.S .SSE • 7 2.,m, r • Service included: Items Cost(ea) Sum
City /State /Zip '7 f d./ - O 9 7ZZ1 •: . _4a.,esidential - per unit '
/ ! .. JC f' 1000 sq. ft. or less $110.00 _1_ 4
Name (or name of busines 1- 7 Each additional 500 sq. ft. or 2 *".. $23.00
r portion thereof
"Commercial i� Residential ❑ Limited Energy $25.00 1
Each Manuf'd Home or Modular
_ Dwelling Service or Feeder $66.00 2
. t`2a. Contractor installation only:
4b. Services or Feeders
' Electrical Contractor 49.1.e/ 9.1.6/ 44,4 1 Cr In 200 amps or l ss n, or relocation Z $60.00 1 z
0 2
o 4/1 Address /2fri i4•'kf 11.,,,,,, , 201 amps to 400 amps y $80.00 y A* 0 2
City pwe ir..id State a ZI 401 amps to 600 amps $120.00 j Q
ty �/ K P °!�� ® $1so.00 2
601 amps to 1000 amps
Phone No. 2*..5" --9iff Over 1000 amps or volts $340.00 / 0 4 0 2
• Job NO. 9 4 - (07,5 Reconnect only $50.00 2
contractor's license NO. Z liy` 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 42,7 ♦ . , / Installation, alteration, or relocation 2
` Signature of Supr. Elec'n /11 200 amps or less
License No. 2E`45 s Phone No. 2 51•748S 201 amps to 400 amps $50.00 2
/ 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane •
Address a) The fee for branch circuits with -
City State Zip purchase of service or feeder fee. 2
Each branch circuit $5.00 3 Z O
7 Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. z
First branch circuit $35.00
not intended for sale, lease or rent. Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) • 2
3. Plan Review section (if required): Each pump or Irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more, residential units in one structure Minor Labels (10) $100.00
Service and, feeder 225. amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure.. containing special'occupancy , r the allowable in any of the above
Per inspection 535.00
as described in N'.E.C. Chapter 5' ,. . • Per hour $55.00
' • - • In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ /7 y1
NOTICE 5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal • $ / f 2. � 7
5b. Enter 25% .41,1 -OW
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF -77g-
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) Li j $ --
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 2 2. 83 1 2
COMMENCED. wordtcamdendeo ❑ Trust Account #
pr..3pp
Balance Due $ 2 2. 17.3 7i'
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /' FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: ! c- `' /(
Date: l 7 A.M. P.M. Ent ,:
Address: l _ 0 I4
Tenant: / " Ste: MST:
" BUP:
Con /Own: L/ ' MEC:
PLM: n ,
ELC: `�
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
c _
Inspector: A 4 _ .. / , , / / . ! � / Date . 1-.1.. *
APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO
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