Permit CITY OF TI GAR® ELECTRICAL PERMIT
PERMIT #: ELC2000 -00133
I'll DEVELOPMENT SERVICES DATE ISSUED: 03/24/2000
ajli 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DC -01400
SITE ADDRESS: 15865 SW 74TH AVE 100
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT : 004 JURISDICTION: TIG
Project Description: Install two (2) 200 AMP service /feeders, 55 branch circuits and a signal circuit/limited energy panel.
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: 1 .
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: 55 • 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: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CREEKVIEW BUSINESS PARK LAND CURRENT ELECTRIC
JDS, LLC & PACIFIC SANTA FE PO BOX 19652
17700 SW UPPER BOONES FRY 100 PORTLAND, OR 97280
PORTLAND, OR 97224
Phone: Phone: 245 -5997
Reg #: SUP 3689S
LIC 00046994
ELE 26-471C
FEES Required Inspections
Type By Date Amount Receipt
.Ceiling Cover
PRMT GEO 03/24/200C $482.75 0000927 Wall Cover
5PCT GEO 03/24/200C $38.62 0000927 Underground Cover
Elect'I F
Total $521.37 Elect'I Final ORIGINAL
•
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 1,80 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 copies of these rules ordir questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY
OWNER INSTALLATION ONL
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: DATE: 3 - a
LICENSE NO: i
Call 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
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit #`Xoeo -
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) C- 4tnsL Service included: Items Cost Sum
Address 1 J G L) D 7 ittlA d I rS V a 4a. Residential - per unit
City /State /Zip t, l.J t _ 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commerciale 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 d
Electrical Contractor e C QLt..1C.A� 200 amps or less $ 64.25 I Z n 2
Address 6A0 ' &0"tr'� I c t.(2. Z 201 amps to 400 amps $ 85.50 2
City State &?._ Zip _q--a 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. y`Ly - U - ' `S t' 7 Over 1000 amps or volts $ 363.75 2
Job No i G f 5 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. g.6 `L-e r I.l. • Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. 4 4,(0I Q c Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec' ®....,., Over 600 amps to 1000 volts,
see "b" above.
License No. 3qS Exp.Date
Phone No. , 3.2X- - D s 9 7 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 SG
$ 5.35 a9 3S 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
Each additional branch circuit $ 5.35
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 1 $ 60.00 V): 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
Per inspection $ 50.00
Service and feeder 225 amps or more
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 $ a 7,5
* Submit 2 sets of plans with application where any of the above apply. 4 F/o Surcharge (.t35)( total fees) $ R, " a.. •_
Not required for temporary construction services. Subtotal '✓ $ ... /
5b. Enter 25% of line 5a for 7
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
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
�: :
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due Bolt �} o
i:\dsts\forms\electric.doc JP /' ✓ 7
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
y� BUP
Date i Requested 5/1 7 0 AM PM BLD
Location 1 S D (O S 7 9 Suite / 0 0 MEC
Contact Person LeCtf \ A-- Ph 2i S / 7 PLM
Contractor 0,urre„, Ph Si 1— cap? SWR
BUILDING Tenant/Owner ELC joco —CO / 33
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
=i0aiiing n - /
//k' 1 C- �
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
<ELECTRIC
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
•ART 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: j [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date ' /'2 Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.