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Permit CITY O TIGARD ELECTRICAL PERMIT P ERMIT #: ELC2000 -00400 i DEVELOPMENT SERVICES DATE ISSUED: 7/20/00 � "� 1 3125 SW Hall. Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AC-01200 SITE ADDRESS: 14865 SW 74TH AVE 160 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P BLOCK: LOT : 020 JURISDICTION: TIG Project Description: Installation of 16 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: 15 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 -1070 SUP 3162 -S FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 7/20/00 $117.75 0003845 Elect'l Final 5PCT DEB 7/20/00 $9.42 0003845 Total $127.17 • 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 copie • ese r _s ordirect questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE A- j�/ ISSU D BY: p WNER INSTALLATION ONL' The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: `` nn CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: JO PP / 0 (4-1"— • DATE: LICENSE NO: `]' cP 9-/ Call 639 -4175 by 7:OOpm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Ch 1al 25`SW HALL BLVD. Rec'd B. .` _ gj Date Rec'd -1'� TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST ,------ Inspection (503) 639 -4175 Print of Type Permit # -00 Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development reNNG Ac/2E 5 0vsi vsss r#1 Number of Inspections per permit allowed Name (or name of business) /� Service included: Items Cost Sum 4 ' Address /'�c�GS - 5GcJ 7 ¥ A ll &- J" / ( 0 4a. Residential - per unit City /State /Zip /707? D v4 5' 722-.3 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial Et* 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 base). Installation, alteration, or relocation Electrical Corn��t ,B PoR giec7yam c 11..-L 200 amps or less $ 64.25 2 Addres PO erne 389 201 amps to 400 amps $ 85.50 2 City Uou,�,>? ra , State ©12 Zip 917010 601 amps to 1 00 amps $ 128.50 2 601 amps to 1000 amps $ 192.50 2 Phone No. 678- /3 Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. o 24 - `n7 L Exp.Date /0 - 0) - 0 0 4c. Temporary Services or Feeders OR State CCB Reg. No. _ a(' 9/ / Exp.Date 2-420-02. Installation, alteration, or relocation COT Business Tax or Metro No. .3C,,' 7 Exp.Date / - / -o/ 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n E 401 " /�(� amps to 600 amps $ 107.00 2 V Over 600 amps to 1000 volts, License No. ‘a,21 ...S Exp.Date /6-01-6( see "b" above. Phone No. E 78 - / s:5- 4d. Branch Circuits 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 City State Zip or feeder fee. Phone No. First branch circuit / $ 37.50 37•s0 Each additional branch circuit / ,5' $ 5.35 Fro, .2_,s- The installation is being made on property I own which is not 4e. Miscellaneous 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 * panel, alteration or extension $ 60.00 3. Plan Review section (if required): Minor Labels (10) $ 107.00 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 $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ 11 7. 7S j7 * Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (-135 total fees) $ ___41/_:7 °S Not required for temporary construction services. Subtotal s r 0 i $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 41aFt- IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 47./7 i:\dsts\forms\electric.doc "CITY OF TIGARD BUILDING INSPECTION DIVISION - 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST.. BUP Date Requested � vl AM PM, BLD Location J'/ 8 63- -- 3cti 7V 1 Suite /4 MEC Contact Person Ph 73P—f PLM Contractor _�C/ -� ��,� Ph SWR BUILDING - Tenant/Owner ELC !/U - vv <100 Retaining Wall ELR Footing Access: r Foundation D l i FPS Ftg Drain �N SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall • Fire Sprinkler Fire Alarm Susp'd Ceiling c;;C.(4 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 4t e TDI A Service Rough In UG /Slab Low Voltage FirAlarm _ PART FAIL E 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 Approach /Sidewalk Other Date t Ins Ext Final PASS PART FAIL DO NO REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2"4- Hour,irlspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 73 — 1 AM PM BLD Location /40 (i) S' t.. 74/ t Suite /6'0 MEC Contact Person Ph f39 -9 ) 7 � PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 0,24 Z " v ' / 2 0 20 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam 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 P ASS A PART FAIL ` ___ R CAL Service Rough In UG /Slab Low Voltage Fire Alarm • - , - AS ' 'ART FAIL SIT 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 _ 3 47 Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site