Permit CITY ®F TIGARD
PERMIT #: ELC2001 -00165
- 13125 , !'it -
DEV w O B MEN Tigard, 3) 639 -4171 DATE ISSUED: 3/26/01
PARCEL: 2S1 12AC -01200
SITE ADDRESS: 14865 SW 74TH AVE 270
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Installation of 15 branch circuits for new tenant.
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: 14 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:
KNHS DEVELOPMENT CO BEAR ELECTRIC
26262 S MERIDIAN RD 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 CTR 3/26/01 $139.95 2720010000( Wall Cover •
5PCT CTR 3/26/01 $11.20 2720010000( Elect'I Final
•
Total $151.15
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 -bythe Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obta copies of these r lu es,ordirect questi• s to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE KAd7 I SUED BY: � � el .����
/ 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 IN TALLATION ONLY
SIGNATURE OF SUP . ELEC'N: �� // %� 'AS DATE:
LICENSE NO: /,'E9/
Cali 639 -4175 by 7:OOpm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check#
13125-SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Phone (503) 639 -4171, x304 Date to P.E.
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # F /Z!J V /io /op'
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development FANpo 04e.R0"5" 4 c PON ( Number of Inspections per permit allowed
Name (or name of business) tars-r' pi ILL.'S 0A7 co t,vc- Service included: Items Cost Sum 4 '
Address ferirC S S 0 7 '4 tJ s" ®Z ?C 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City/State /Zip 7 (. 4-A D ? V 2 ' Each additional 500 sq. ft. or
p� portion thereof $ 26.5 1
Commercial Yom` Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data ba ). - Installation, alteration, or relocation
Electrical Co tractor 'Cep_ 1��� �P� 200 amps or less $ 64.25 2
am p
Addrew HO IgAC ,3 rcl 201 amps to 400 amps $ 85.50 2
Cit al State OR Zip 9 70 7_,C) 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. ,S 3 - G 7 F ---- / 3SS Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No., `-/ -10 L Exp.Date / 0 - 0 / - o / 4c. Temporary Services or Feeders
OR State CCB Reg. No. 2 O, / Exp.Date 2 -Zo- 0 Z. Installation, alteration, or relocation
COT Business Tax or Metro No. 3 (ms' 7 Exp.Date / - / - °"t 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
2
/,,//(--- 401 amps to 600 amps $ 107.00
Signature of Supr. Elec'n fit Over 600 amps to 1000 volts,
!� G see "b" above.
License No. 6 2 . /S Exp.Date / 0 - / - v '2_,, 4d. Branch Circuits
Phone No. Ei ?8 / 35-S-- New, alteration,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 J� $5' 4, ��
City State Zip or feeder fee. Y
Phone No. First branch circuit i $
' Each additional branch circuit / l_/ $ ,r?rs5
The installation is being made on property I own which is not 4e. Miscellaneous 6 . • is
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
• 3. Plan Review section (if required):* panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 1A7--99
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over i�'OD
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as c� p5
described in N.E.C. Chapter 5 5. Fees: /.6
5a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. 0-0jy&% Surcharge (.05 X total fees) $
Not required for temporary construction services. °` Subtotal • o r $ //,.2,0
5b. Enter 25% of line 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 c /S
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # /�J . �,
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 1 I mi l.
is \ds is \forms \e l e c tri c. d o c
yiC /) /'
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -lour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
'/ Date Requested .5 - Z/ AM PM BLD
Location / - t “e .S'-✓ 7 ( '1 -" Suite MEC
Contact Person Ph 7f / 3s S PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC /��i��G s�
Retaining Wall ELR
Footing Access: J /, A
Foundation - ��L i / ;� / FPS
Ftg Drain v SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam /
Ext Sheath /Shear v ' / th
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling / 1? JC.
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Final Drains
a
Final
PASS PART FAIL
!MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL �
�E;t:9�CTRTZAf�
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
SS
P RT 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 Date 0 ( Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.