Permit CITY OF TIGARD ELECTRICAL PERMIT
%�,,, DEVE LOPMENT SERVICES PERMIT #: ELC99 -0107
- �� 1v� 1
il DATE ISSUED: 02/22/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 26113AD -01900
SITE ADDRESS...:16640 SW 72ND AVE #B -10
SUBDIVISION -ROSEWOOD ACRE TRACTS ZONING:I —L •
BLOCK • LOT -009 JURISDICTION: TIG
Project Description : Install a 200 Abp service and 42 branch circuits.
- -- 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 • 1 W /SERVICE OR FEEDER: 42 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 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: FEES
PRECISION INTERCONNECT type amount by date recpt
16640 SW 72ND PRMT $ 270.00 GEO 02/22/99 99- 313118
TIGARD OR 97223 5PCT $ 13.50 GEO 02/22/99 99- 313118
Phone #:
Contractor:
STONER ELECTRIC $ 283.50 TOTAL
2701 SE 14TH
REQUIRED INSPECTIONS
PORTLAND OR 97202 Elect'l Service
Phone #: 233 -3631 Elect'l Final
Reg #..: 000448
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- 001 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5031246 -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 SUPR. ELEC'N: 6 elop DATE: A. - RR `el
LICENSE NO: 3g96-s
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
C ITY OF TIGARD RECEIVED Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 FEB 2 2 1999 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304
Date to DST �J
Inspection (503) 639 - IUNITV DEVELOPMENT Print or Type Permit #D Z -0 /6 q
Fax (503) 684 - 7297 Incomplete or illegible will not be accepted called •
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) PRE cowl �nr -raee �v� Service included: Items Cost Sum
Address 1(� 5(-4.) 7Z•.cp 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State/Zip / d44.1) , O 97Z2d Each additional 500 sq. ft. or
Commercial ® Residential El Limited 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 copy of all current licenses) 4b. Services or Feeders
Electrical Contractor s7a0-/E*' 1= ,-E bN• Installation, alteration, or relocation
200 amps or less __j__ $60.00 6� r 2
Address 2 - 72 . 0 1 Se /544g- 201 amps to 400 amps $80.00 2
City P R:-rz_,4 4p State o �' Zip 97 Z-'.- 401 amps to 600 amps $120.00 2
Phone No. 23 3 1 601 amps to 1000 amps $180.00 2
Job No. 3 4 ? - Over 1000 amps or volts - $340.0o 2
Elec. Cont. Lice. No. 2-6 z-z_ Exp.Date /o . /99 Reconnect only - $50.00 2
OR State CCB Reg. No. 446 Z3 Exp.Date 3 zo or. 4c. Temporary Services or Feeders
�
COT Business Tax or Metro No. 044 / (oExp.Date '/� 9' 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,
License No. 3V9 L5" Exp.Date "°/ see "b" above.
Phone No. X3 -363
4d. Branch Circuits
New, 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 42- $5.00 2,/0`-' 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 circuit $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: 27o
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ /3's a
NOTICE Subtotal $ X33 •Sa
5b. Enter 25% of line 5a for �_
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ .2-.0-3',52)
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ b33 __
Total balance Due
1: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 ° ) ' q 9 AM PM BLD
Location 1 10(040 .- 72 , )(la - Suite Pa' /i MEC
Contact Person & I / 1 4 ) !;,. Ph 3 F'fr7.,C ?a PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ea JA Slab '[ -4A SIT
Post & Beam
Ext Sheath/Shear
Int Framing hath /Shear e'�� I `"i'tt)2go r °T�
t�. M :.; n 2 No f
Insulation . �1�, 7 C � �.��
&L
Drywall Nailing �. - d- I I �, I W 2 °-? -r t �(,i9
Firewall f ,/vim d C L.l J i y CU Jca.
Fire Sprinkler d �-� t' C �i �� 1-, A 1 44-ED
Fire Alarm
Susp'd Ceiling � -� `'
Miscf l -SL Y .; q q' �o�1 t i Z53 ' i t //✓f�'GE - 0 L. 4-0
- cc )
Final
PASS PART FAIL
PLUMBING
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
LECTItTL'�CC>
Service
Rough In
UG /Slab
Low Voltage
Fire 4darm
�3�13
PASS 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 Inspector
Other _ P 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
Date Requested ( 4 AM PM BUP
//��,, BLD
Location 1 �.P 7 i � �%
� b
' Suite ',t' MEC
Contact Person Ph ) - 2,538 PLM
Contractor Ph SWR �
BUILDING n Owner pit C. ° iALe • ELC 1
Retaining Wall • ELt 11?- oczsO
Footing
Foundation Access:
FPS
Ftg Drain
Crawl Drain Inspection Notes: ' SGT
Slab 'l ffrlyr SIT
Post & Beam
Ext Sheath /Shear >! Lt 98 (� -7�-•-
Int Sheath/Shear �
Framing 6 C 6 7 l — OQ1O
Insulation
Drywall Nailing L - ! Z c)Ai it & ? — 0021
Firewall
Fire Sprinkler �L�D"t.� �faa 1
Fire Alarm . • ,, / _ .
Susp'd Ceiling L�J �iC !g g AfLe
Roof
Misc:
Final
PASS PART FAIL
PLUMBING > 00P/ 1 7 4 (t, C) , sp �.
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
(€LECT IC
Se ice
Rough In
UG /Slab
Low Voltage
Fire Alarm
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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other ther D ate / - � 9�/ Inspector � Ext _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.