Permit OF TIGARD ELECTRICAL PERMIT '4441
, °CITY
P ERMIT #: ELC2000 -00399
, DEVELOPMENT B r SERVICES ) 639 -4171 DATE ISSUED: 7/20/00
PARCEL: 2S112AC -01200
SITE ADDRESS: 14865 SW 74TH AVE 170
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT : 020 JURISDICTION: TIG
Proiect 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: SIGNALIPANEL:
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: 678 -1878 Phone: 503 - 678 -1355
Reg #: LIC 20919
ELE 24 -107C
SUP 3162 -S
FEES "Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 7/20/00 $117.75 0003845 Elect'I Final
5PCT DEB 7/20/00 $9.42 0003845
Total $127.17
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 - see :• • the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain ...pies of these r or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE IS ED BY: . 1 if,
r
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. EL ' N: ��C1C, /4-2./\., DATE:
LICENSE NO: zCog,
Call 639 -4175 by 7:OOpm for an inspection the next business day
CITY OF TIGARD Plan Chec • A
-�-' Electrical Permit Application Rec'd By
131'25 SW HALL BLVD. _ "/
TIGARD OR 97223 Date Rec'd i 0 -OCR
Date to P.E. x -------
Phone (503) 639 -4171, x304 Date to DST -'-----
Inspection (503) 639 -4175 Print of Type Permit # o` er 377
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
i ` Number of Inspections per permit allowed
Name of Development /-, Aitl U 4-u2E s �us,,vpss O,I,r ( P P Pe
Name (or name of business) Service included: Items Cost Sum sl'
Address /4 .S 5 G/ 7 L/ ,9/ & / 7th 4a. Residential - per unit
City/State /Zip 7/6,71/) 0/2 9 7Z Z 3 Each additional it o less $ 117.75 4
Each additionn al 500 sq. ft. or
portion thereof $ 26.25 1
Commercial, 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 C trac �.�c EI Ic. MAX, 200 amps or less $ 64.25 2
Address vo l.}a% 381 201 amps to 400 amps $ 85.50 2
/�
401 amps to 600 amps $ 128.50 2
City ociwo et, State et Zip 9 Jr) ZC) 601 amps to 1000 amps $ 192.50 2
Phone No. G. 7R -/' S Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. ay -107C. Exp.Date / 6 -01 - 00 . 4c. Temporary Services or Feeders
OR State CCB Reg. No. "2.09 / 9 Exp.Dateo2 - - Installation, alteration, or relocation
COT Business Tax or Metro No. ;3os 7 Exp.Date /--/- o/ 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n
Z
,1�-- 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. x /6.2 / 5 Exp.Date /0 - 0 l - 01 see "b" above.
Phone No. (, ?R - /3SS New, 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. 2 ."(1) Phone No. First branch circuit / $ 37.50 3
Each additional branch circuit /. $ 5.35 8 . 0 , 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
• 3. Plan Review section (if required):* panel, alteration or extension $ 60.00
Minor Labels bels (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
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (O total fees) $ Ji; � �
Not required for temporary construction services. Subtotal $
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 S
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ /?
i:\dsts\forms\electric.doc
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
// BUP
Date Requested / e AM PM BLD
, Location /1 c?& . 7'1 Suite /7 MEC
Contact Person Ph 937 9r7)
5r7, -- PLM
Contractor (f41 Ph SWR
BUILDING Tenant/Owner ELC ,'U7) –
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 i . _ - -
•
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
T• C —
4 � e
Rough In
UG /Slab
Low Voltage
{ Fii j re � Alarm
�• SS PART IL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reins tion fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ease call for reinspection RE: 5_,k. 7_[ n SID 7 71 [4 inspect - no access
ADA
Approach /Sidewalk
Other D yA4,4 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
j . .
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested UT I AM PM BUD
Location /' tc Suite / 7 � _ MEC
Contact Person Ph l3 9 1 ) 7 S � PLM
Contractor Ph SWR
BUILDING Tenant/Owner
ELC ?61' ^° Va9 �
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
PASS PART FAIL
X-tEe
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
ASS 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
Fire Supply Line [ ] Please call for reinspection RE: 1 -ble to inspect - no access
ADA
Approach /Sidewalk ,
Other Date ! Inspector t t
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
BUP
Date Requested ---/ I AM PM BLD
Location f ( 1 Y6') 5 h✓ 7q Suite / 7 0 MEC
Contact Person Ph �..3f —'3 7) ---- PLM
Contractor Ph SWR
BUILDING _ , Tenant/Owner ELC 9...et ° 00 3 ,
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain G -P &%6° 4 Z /1 e7 ( / / 0
Crawl Drain Inspection Notes: SGN .
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewal
Sp I
Fire 66...," Sprinkler . t� Gt.__
Fire Alarm
Susp'd Ceiling
Roof _
Misc:
Final _ C 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 T FAIL
ELECTRICAL
Rough In
UG /Slab
Low Voltage
Fire Alarm
F'
A 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 Date An Inspector E xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.