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Permit
7N CITY OF TI GARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00479 '^ 4 11 1- DEVELOPMENT SERVICES DATE ISSUED: 9/27/01 Al, --.. 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 2 S 112 D C -01400 SITE ADDRESS: 15865 SW 74TH AVE 110 SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P BLOCK: LOT : 004 JURISDICTION: TIG Project Description: Installation of service /feed for seconary panel (lighting & recept.) 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: 2 WISERVICE OR FEEDER: 35 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: PACIFIC AMERICAN PROPERTY EXCH INFINITY ELECTRIC LLC PACIFIC SANTA FE CORP 23322 NE RAWSON RD 17700 SW UPPER BOONES FERRY RD BRUSH PRAIRIE, WA 98606 PORTLAND, OR 97224 Phone: Phone: 503 - 242 -2517 Reg #: LIC 36288 ELE 37 -669C FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT CTR 9/27/01 $393.35 2720010000( Wall Cover Elect'1 Service 5PCT CTR 9/27/01 $31.47 2720010000( Elect'I Final Total $424.82 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 copies of these rules or direct questions to Permit Signature: Issued By: �� 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: C NTRACTOR STALLATION ONLY SIGNATURE OF SUPR. ELEC'N: - /� ` rte DATE: LICENSE NO: , ,7269 g? Call 639 -4175 by 7:OOpm for an inspection the next business day i ;., y \ I, u 2 )00 / -00 33f-- Electrical Permit Applic : , . • .7 Date r eceived: 7 p i Per no.: _, �� / �� ' '4yh,. City of Tigard Project/appl. no Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9 Date issued: By: i • Receiptno.: Phone: (503) 639 -4171 • Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE' OF .PERMIT .... 0 1 & 2 family dwelling or accessory WI 0 Multi - family ,(9' Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: J 6S /ifs 5 j) 7.r7I1 4-y Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: !Block: 'Subdivision: Project name: 13gJti'A+2 Swo tiq.7 - neS I Description and location of work on premises: 0)0 n .. lig 0 (u 2o0 ,}- Estimated date of completion/inspection: Pt'd'" S ' t ,v-t Lt 6.. #/4 t ce ( r - ' •".: CONTRACTOR APPLICATION `, ''„ ., . - ' . '`FEE „SCHEDULE . Job no: Fee Max Business name: ..I 'Jr 'J ia V' (.� g i' . _- C Description Qty. (ea.) Total no. insp � A Nev residential - single or multi - family per Address: ,2 3 21 Z IV E / j /9- (, . 0 ,M A p , dwelling unit. Includes attached garage. City: /3rt)s t', e O ' rf-4 State: (j. ZIP: ?A/4,06 6 ' Service included: Phone: 503 AO y (j Fax: 1E-mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: 6a 3 's Elec. bus. lic. no: '37 &‘9 Limited energy, residential 2 City /m ro lic. no.: �j /d / E,>9 fj f 03 / % / /o ff Limited energy, non- residential 2 1 ccc /Jl, D e r , a ,6-Q f Each manufactured home or modular dwelling Sign e- of supervising electrician (required) Date / /p/ Q/ Service and/or feeder 2 Sup. elect. name (print): , < is f' iz)/V License no: o2tf , g J 5 Ser orfeeders — installation, D �0 - alteration or relocation: - � 0 , 2 4 ` , - •,_ ` PROPERTY :OWNER - .' 200 amps or less 1 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: 'State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: 1E-mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits -new, alteration, b/ or extension per panel: ( CV Name: A. Fee for branch circuits with purchase of t n - Address: service or feeder fee, each branch circuit ). 2 City: 'State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: • Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc .(Serviceorfeedernotincluded): 0 Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1 &2 0 Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 0 System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories 0 Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: 0 Egress/lightingplan 0 Other: Per inspection Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 3 X 1 3 35 0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 3 /. q 7 Expires accepted as complete. TOTAL $ . "Z '/. 8 Z Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00 /COM) C. '•i . 1 ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: - • TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 I I Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 n Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 I I Garage Door Opener Services or Feeders In Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 r 201 amps to 400 amps $106.85 2 I I Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 1 1 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. n Audio and Stereo Systems Branch Circuits New, alteration or extension per panel n Boiler Controls a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n or feeder fee. Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 n HVAC Miscellaneous n Instrumentation (Service or feeder not included) . Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 n Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 In Landscape Irrigation Control Minor Labels (10) _ $125.00 Each additional inspection over n Medical • the allowable in any of the above Per inspection $62.50 n Nurse Calls Per hour $62.50 In Plant $73.75 n Outdoor Landscape Lighting Fees: n Protective Signaling Enter total of above fees $ n Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees $ • ❑ Trust Account # 8% State Surcharge $ • Total Balance Due $ All New Commercial Buildings require 2 sets of plans. is \dsts \forms \elc- fees.doc 08/30/01 CITY OF TIGARD BUILDING INSPECTION DIVISION r r MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP / Date Requested /6 7 / AM PM BLD Location /5 �vt 74" " Suite //O MEC Contact Person ' e.-0 Ph a 09 a' 7 PLM Contractor "; /- /.r1Tj"z Ph SWR BUILDING Tenant/Owner SK ELC ,7 t / • p Retaining Wall ELR Footing " Access Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: p6_,-- Slab SIT Post & Beam Ext Sheath /Shear , a 6i6i0/44 t� (. � � i csli k-l` Int Sheath /Shear Framing Insulation 1 /� (� / �i Drywall Nailing iS`-/S J'`5r9 /2` Egr/7 ' 1 7) �4- l 2d ( 't Firewall 6 L Fire Sprinkler 5 1' , �5 f� pO&S c) ` 9 t' .✓-- . Fire Alarm Susp'd Ceiling Roof / V /J / — y Misc: Final PASS PART FAIL y y / / / A III PLUMBING � : 7 D 1 / -! Post & Beam Under Slab / Top Out /�' Water Service t ' fl , I ,f'� is F P7 `�= ri �d Sanitary Sewer / itJbTE3 / Rain Drains .( / �9 / S / �, tf f' (•i trig 7 -- Sp 4, �! - 4 0,- Final PASS PART FAIL �1 y y,- 1 - s Jam, P� • MECHANICAL _ , Post & Beam �� (� J , GasgLine V �— In c C■ 4r' V� tek.— / 1e F!/YISO^ L %GGt./- Smoke Dampers IX � Ir C S Of nr ^ f / * p Q,G � /�J Final / /J lD PASS PART FAIL /h � 2 '' L ! / ` c / r / / / , 7 R . �I s Service 1 f�GGti 6 � lesF S Ril' ( �� Pr-i� j "*s' Rough In UG /8 ab P rI,�/ g7 e //' -- u FA- A/ 7L Z" 4 Low Voltage . ��� U Fire Alarm Ce :ATOP , u PART FAIL ' . . � i./ _. 9 i,., . _ i Z. >>.. A l • I• Backfill /Grading /F 'iCc7/ "'��4 '?// ` 7, C� o 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 ///r, Inspector � © i 1 Ext Final � yc- PASS PART FAIL DO NOT REMOVE this inspection record from the job site.