Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00304
"OA DEVELOPMENT SERVICES DATE ISSUED: 6/7/00
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S113AA -00800
SITE ADDRESS: 16460 SW 72ND AVE B -06
SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: I -L
BLOCK: LOT : OOD JURISDICTION: TIG
Project Description: Install two (2) branch circuits
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: SIGNAL /PANEL:
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: 1 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:
PACIFIC REALTY ASSOCIATES PHOENIX ELECTRIC CO
15350 SW SEQUOIA PKWY #300 -WMI 7379 SW TECH CENTER DR.
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT GEO 6/7/00 $42.85 0002460 Elect'I Final
5PCT GEO 6/7/00 $3.42 0002460
Total $46.27
ORGNAL
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.
PERMITTEE'S SIGNATURE ISSUED BY: 4 , 9
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: l ' - 7 - e
LICENSE NO: 4
Call 639 -4175 by 7:OOpm for an inspection the next business day
NI,123- 4, 08'25 1111 PHOENIX ELECTRIC CO FAX N0, 15036843611 P. 02/02
�
CITY OF T CARD Electrical Permit Application Plan Check#
1'3 25 MALL BLVD. O Rec'd By
Date Rec'd
TIGARD OR 97223 � pate to P.E.
Phone (503) 639 -4171, x304 OO
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # kee i'?bCo oo Ny
Fax (503) 5 -1960 Me/ Incomplete or illegible will not be accepted Caned
F/ •`yrt` r YY
1. Job Address: `` 4. Complete Fee Schedule Below:
Name of Developmentt0.vA, -,e‘Q"---5ar- Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum C
Address At d-U 00 gf 4 ) d4 p 4a. Residential - per unit
City /State /Zip r� e �_„ 9 " loco sq. ft. or less $ 117.75 _ 4
�V• Each additional 500 sq. ft. or
�•-� portion thereof $ 26.25 1
Commercial Residential El Limited Energy $ 60.00 _
2a. Contractor installation
,, C�.r � - f No f Each Man9 Service or Feeder Modular
$ 72.75 2
O h y:
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
Information for CO : • K base). Installation, alteration, or relocation
Electrical Contracted . L. L . ....�- . ) 200 amps or less 5- 64.25 2
Address ,1-5 ° cr( .4.) .1, �s� u• �\ 201 amps to 400 amps $ 85.50 2
City State Zi �
7 �. 1 401 amps to 600 amps 5 128.50 2
y a e p . 601 amps to 1000 amps $ 192.50 2
Phone No .1SL( ,�a 00 Over 1000 amps or volts 5 363.75 2
Job No. U - •,3 Reconnect only 5 53.50 2
Elec. Cont. Lice. No. ' • ' Exp.Date _ 4c. Temporary Services or Feeders
OR State CCB Reg. No. 2' . Exp.Date Installation. alteration. or relocation
COT Business Tax or Metro No. r ' Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n ,./ �-„ 401 amps to 600 amps $ 107,00 2
c
.% - Over 600 amps to 1000 volts,
License No
KfQS Exp.Date sou "b" above.
Phone No. l D . it e) O . 4d. Branch Circuits
New, alleralion.or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee,
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or loader foo.
Phone No. First branch circuit ( $ 37.50 Si ,51)
Each additional branch circuit I • $ 5.35 .5 6 s
The installation is being made on property 1 own which is not 4o. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation cirde $ 42.75 _
Owner's Signature _ Each sign or outline lighting $ 42.75
Signal circuit(s) or a rimitod energy
if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in suction 513. 4f. Each additional inspection over
4 or more residential units In one structure the allowable in any of the above
Par inspection 5 50,00
Service and feeder 225 amps or more Per hour $ 50.00
,_System over 600 volts nominal In Plant $ 59.00 -
Classified area or structure containing special occupancy es -
described in N.E.C. Chapter 5 , 5. Fees:
a. Enter total of above fees - 5
4 ' Submit 2 sets of plans with application where any of the above apply. WED W. Surcharge (.05 X total fees) $ ^ IthA!
Not required for temporary construction services. Subtotal $ ''
5b. Enter 25% of fine 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
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS rust Account # s�•r} C
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ V6-09
I: \fists \forms \c l uclrie.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested CP / 1 ct/Oa AM PM BLD
Location 1 Le —! CPU 1 Z/k4 Suite A MEC
Contact Person 510.616 Ph ce-1-36,00 PLM •
Contractor Ph SWR
BUILDING Tenant/Owner • • - _ - L
ELC 2.
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain S �..4--" SGN
Crawl Drain Inspection Notes: _
Slab
u-�'� SIT
Post & Beam
Ext Sheath /Shear //
Int
Sheath/Shear
Framing � [ n i t (U l� /� a.CX / /1 �4 Wei
Insulation o r,� yCJ! l�> Q
Drywall Nailing C. `�,51�'��C/I V
Firewall V
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING 0
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
PASS PART FAIL-
E T cUAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4
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 �
Other Date ' ` / Inspector Ext
Final
PASS PART FAIL • e NOT REMOVE this inspection record from the job site.