Permit C I Tl� OF F T I G A R® ELECTRICAL PERMIT
PE RMIT #: ELC1999 -00545 •
� , � _ . , DEVELOPME SERVICES DATE ISSUED: 10/21/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AC 01200
SITE ADDRESS: 14865 SW 74TH AVE '`'`' R I G � 11 � I. ZONING: I -P
SUBDIVISION: FANNO CREEK ACRE TRACTS V
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Electrical shell
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: 18 W /SERVICE OR FEEDER: 90 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: 1 > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: X CLASS AREA/SPEC OCC:
Owner: Contractor:
KHNS'DEVELOPMENT . BEAR ELECTRIC
26262 S MERIDIAN ROAD P 0 BOX 389
AURORA, OR 97002 DONALD, OR 97020
Phone: Phone: 503 - 678 -1355
Reg #: LIC 20919
ELE 24 -107C
SUP 3162 -S
•
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT DEB 10/21/99 $2,001.75 99- 319239 Wall Cover
PLCK DEB 10/21/99 $500.44 99- 319239 Underground Cover
5PCT DEB 10/21/99 $160.14 99- 319239 Elect'l Service
Elect'I Final
Total $2,662.33
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 - • -• within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow r. -s adopted by th - •regon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obt- n copies of these rules o • irect questions to OUNC at (503)
246 -1987. P , .
PERMITTEE'S SIGNATURE IS , UED BY: It
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: , Ad.P ..4 r / I i n N--1 DATE:
LICENSE NO: 5(6
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application , Chec ' ' n�
13125 SW HALL BLVD. Rec'd By o'
TIGARD 97223 Date Rec'd
��L
Date to P.E. 1'1 -/
Phone (503) 639 -4171, x304 Print or Type Date to DST /O " - 9?
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted
Permit # �(°Il-DOS y S
Fax (503) 598 -1960 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development -; •1.:iier41sariirjrzwat ,fr Number of Inspections per permit allowed
Name (or name of business) Ai �LGD /4-/C--- Service included: Items Cost Sum
Address j .6 S 5. i-A-i - • 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip '� � 0 ] U Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial Residential ❑ Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
(Attach copy of all current licenses) Installation, alteration or locati
Electrical Contractor 8E42 El E IG 1 Nc 200 amps or lesd /W $60.00 / DSO 2
Address PO py>lc 3 ec1 201 amps to 400 a ps $80.00 2
City won p LD State 02 Zip 4 1 - 10D - c,, 401 amps to 600 amps $120.o0 2
Phone No. 5 GI 6. t 35s 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 340 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. a (61 r, Exp.Date l 0 - o I - Oo
OR State CCB Reg. No. c.) I9 Exp.Date e 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 305 Exp.Date 01-01 -00 Installation, alteration, or r location
200 amps or less , $50.00 2
C 201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n a_C 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. ?/ G 1. Exp.Date tt/2(902 see "b" above.
Phone No. A ' -/S. S.s." 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.
Each branch circuit $5.00 450 2
Address b) The fee for branch circuits /
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
Each additional branch circuit $5.00 , 2
The installation is being made on property I own which is not
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle .6 $40.00 2
Each sign or outline lighting - $40.00 2
3. Plan Review section (if required):*
Please_ check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
,4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection f $35.00
System over 600 volts nominal Per hour $55.00
Classified area or structure containing special occupancy In Plant $55.00
, as described in N.E.C. Chapter 5
_ 5. Fees: D
* Submit 2 sets of plans with application where any of the above apply. 5a. Enter total of above fees $ / 0
Not required for temporary construction services. 5% Surcharge (.05 X total fees) $
Subtotal $
NOTICE 5b. Enter 25% of line 5a for
Plan Review if required (Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ❑ Trust Account #
TIME AFTER WORK IS COMMENCED. Total balance Due $
I: \DST \ELEC98.DOC REV 4/98
CITY OF TIGARD BUILDING INSPECTION DIVISION- MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested LiI,S'0 AM PM BLD
Location " t S 7 v 1 "� , k ' '. Suite MEC
Contact Person 6e0A -- Ph 69 PLM
Contractor Ph SWR /�
BUILDING Tenant/Owner ELC 1 g 1 /�' 1- tD 5 ci S
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam 2,� b 2,C /^�
Ext Sheath /Shear (�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
tCTRICAt
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
i
S ART FAIL
t1TE
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 ti L%�) Inspector /I Ext
"��
Other
Final
PASS PART FAIL O N T 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
BUP
Date Requested �f AM PM BLD
Location / 1 1g6' £L) 7 Suite MEC
Contact Person 6W/ I C Ph & 7 K / 3 S PLM
Contractor Ph pp // �� SWR
BUILDING Tenant/Owner eept j (' (CS &4 S- /'G , I ELC / 9 -CAS .--
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain spection N to SGN
Slab 1 ( 41 i (-0 / 30, / 4 el 0 SIT
Post & Beam
Ext Sheath /Shear 4? ► a ..1-`4 0
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall ,r --"
• Fire Sprinkler
Fire Alarm _ n •
Susp'd Ceiling s .(41# / t ' i/
Roof
Misc: �I i Z O / Z 4 z.,4160 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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire !arm
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 r inspection RE: [ ] Unable to inspect - no access
ADA 4ef
Approach /Sidewalk
Date p (,l InS ector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.