Permit CITY OF TI GA R D ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98 -0412
A 1-11-( DATE ISSUED: 07/22/98
- _!_n_ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S113AD -01800
SITE ADDRESS...:16650 SW 72ND AVE #B -12
SUBDIVISION •ROSEWOOD ACRE TRACTS ZONING:I -L
BLOCK • LOT •011 JURISDICTION: TIG
Project Description : Installation of 3 branch circuits. .3 ;old- `fc
- -- 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 • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION : 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 1 PER HOUR . 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 2 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
PACTRUST type amount by date recpt
15115 SW SEQUOIA PKWY, SUITE 200 PRMT $ 45.00 DEB 07/22/98 98- 307543
TIGARD OR 97224 5PCT $ 2.25 DEB 07/22/98 98- 307543
Phone #:
Contractor:
PHOENIX ELECTRIC CO $ 47.25 TOTAL
7379 SW TECH CENTER DR.
REQUIRED INSPECTIONS
TIGARD OR 97223 Ceiling Cover Elect'1 Service
Phone #: 684 -3600 Wall Cover Elect'1 Final
Reg #..: 000522
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 -8010 ••• . OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling ( '• )246 -1987.
Permittee Signature: A/. •'.. .4 , , %_.l 1 Issued = _ • 1,/,..d114./... ._
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: , L2 i i0-�u DATE: 7-AA-IV
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
JUL -21 -98 TUE 11:53 AM PHOENIX ELECTRIC CO FAX NO. 15036843611 P. 02/02
CITY OF TIGARD Electrical Permit Application Plan Check . -
• 13125 SW HALL BLVD. Rec'd By 411110MMAr
Date OR 97223 ate Recd 7 -- -
Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Dale to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # �C�C. Oc/I --
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of busine 'c �
( 1 }-1- C - _ � �r � Y� �; � ppe Servfce included: Items Cost Sum
Address \ 5 - D �"l . Li + 1 c* - _ 4a. Residential - per unit
\ loon sq. ft. or less $t 10.00 a
City /State/ P Y� C �lL_ ��'� Each additional 500 sq. II. or
Commerci< Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
`i " J) 4 � � Each Manuf'd Homo or Modular
K Dwolling Service or Feeder $68.00 2
2a. Contra for installation only:
(Attach copy ;4 current licenses) _f • 4b. Service@ or Feeders
Electrical Contracto �C. f�' uANN.r � Installation, alteration. or relocation
A. dress a - 5 61 - 0 - 1 1 � • ('t+ %N r l -a'� 200 amps or less $60.00 2 • 201 amps to 400 amps $80.00 2 -
City ■ State Ji I • 1� 401 amps to 600 amps $120.00 2
Phone Nb. - ( ) OL. v. 601 amps to 1000 amps - $180.00 2
Job No. / .�ERW tgae - Over 1000 amps or volts - $340.00 2
7 Reconnect only $50.00
Elec. Cont. Lice. No. - .i�.ii EYp7Date 2
OR State CCB Reg. No., 57.) e" Exp.Date 4c, Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, of relocation
200 amps or less $50.00 2
-
Signature of Supr. Elec'n ej3)------X 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr Exp.Date see "b" above.
Phone Nr o- •
-- - _ - - 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 circ $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder foe.
First branch circuit $35.00 •, 0- � 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 / 1'). ( 2
intended for sale, lease or rent. de, Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle 840.00 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 cheek appropriate Item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
-
Service and fender 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: a /r
Not required for temporary construction services. 5a. Enter total of above fees $ `f �� U O
•
5% Surcharge (.05 X total tees) $ ;
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review 11 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
TIME AFTER WORK IS COMMENCED. XTrust Account 415-$<‘1 141
Total balance Due $
11osT5\ELC9c OP RN 9190 / 3/91D
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
2- I C ? 33 Date Requested " c/-98-
- 9t - AM PM BLD
Location 1(, (c 3 C ) 11(_L' -- Una tC -C Suite 4J ' , .-- 1 MEC
Contact Person Ph ?4-/ -360o PLM
Contractor • Ph swR
BUILDING Tenant/Owner ELC Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Claw
Crawl Drain Inspection Notes: ( joy' 4ti1„L n'LL; - it c f2
SIT
Post & Beam U
Ext Sheath /Shear � ' 4 -itt`
Int Sheath/Shear
Framing 7
Insulation A-
Drywall Nailing / /Ii
Firewall / '--
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - e..A7L–/.41 -C1
Roof
Misc:
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
4 - ELECTRI.CAL, '
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
�<Fia
�V 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: [ 1 Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector .LGl_�l Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.