Permit CITY OF TIGARD
ELECTRICAL PERMIT
P ERMIT #: ELC2000 -00051
DATE ISSUED: 02/18/2000
1pi l j �. D EVELOPMENT SERVICES
� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113AB -00800
SITE ADDRESS: 16135 SW 74TH AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical - new building
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: 3 W /SERVICE OR FEEDER: 50 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: 1 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: X CLASS AREA/SPEC OCC:
Owner: Contractor:
JOHN DUNCAN ELECTRO -WIRE INC
7060 SW PALMER WAY 18857 SE SUNNYSIDE RD
BEAVERTON, OR 97007 BORING, OR 97009 -9222 •
Phone: Phone: 658 -8136
4
Reg #: ELE 26 -667C Or1GINA I
LIC 00067879
SUP 0002717S
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT BON 02/02/200C $588.75 00- 321585 Wall Cover
PLCK BON 02/021200C $147.19 00- 321585 Underground Cover
5PCT BON 02/021200C $47.10 00- 321585 Elect'I Service
Elect'I Final
Total $783.04
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 OUNC at (503)
246 -1 "987. //
PERMITTEE'S SIGNATURE x id ISSUED BY: y, ,,
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
l ‘y,L___
SIGNATURE OF SUPR. ELEC'N: )i� 54L � .P DATE: a.A/0
LICENSE NO: -2 7 / - 7 S
CaII 639 -4175 by 7:OOpm for an inspection the next business clay
CITY OF TIGARD Plan Ch >. 0 / C
13125 SW HALL BLVD. Electrical Permit Application
Rec'd ,, 4,
Date Rec'd pq - 5 -0(9
TIGARD OR 97223 Date to P.E. ,z g - 2��
Phone (503) 639-4171, x304 - .1,.. 7 -i's
Date to DST ff -+�
Inspection (503) 639 -4175 Print of Type Permit # Fa-ZL 9 -6 l
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called Z `
1. Job Address: p 4. Complete Fee Schedule Below:
Name of Development lDONICAlk BO I t-D /1 6- Number of Inspections per permit allowed •
Name (or name of business) Service included: Items Cost Sum l'
Address i691 - 3b stki ---ir� � f Laut v/t ) 4a. Residential - per unit
City/State/Zip t d 0 Z 2! 1000 sq. ft. or less $ 117.75 4
ty p Each additional 500 sq. ft. or
`.. portion thereof $ 26.75 1
Commerci 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 J 9 .5
information for COT data b se) Installation, alteration, or relocation
Electrical Contractor • - Lty 14x2,, t.+i -e--) 200 amps or less 3 $ 64.25 2
Address "(5 g t . l_. , * • 201 amps to 400 amps $ 85.50 2
Ci State d.� Zip o' 7�� q 401 amps to 600 amps ( $ 128.50 fi Z$ , 56 2
ty / 601 amps to 1000 amps $ 192.50 2
Phone No. t, slr- 51 3 Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. - 24 ( C-, 1 Exp.Date 117- 1 '10 4c. Temporary Services or Feeders
OR State CCB Reg. No. (0 7 Exp.Date 10- I 2-- •t01i'd 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
Signature of Sur. Elec'n,L 1../ 401 amps to 600 amps $ 100.00 2
g Supr. Over 600 amps to 1000 volts,
see "b" above.
License No. 2 I 1 '7S Exp.Date /a /o ) 701
Phone No. (, 5g - g 1 31 Nio b 11 5 3 rf -1 3 9 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 $ 5.35 2./y/' 1 S 0 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
if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 100.00
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
X 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: t cL j
5a. Enter total of above fees $ 5 1.15
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 1 - 41110
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for /
NOTICE Plan Review if required (Sec. 3) $ 1 ∎ 1
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 S/
is \dsts \forms \e l ectri c. doc
i I
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (0/ AM PM BLD
Location 1 LP ! ?' 7 LP& A Suite MEC
Contact Person 001/ Ph PLM
Contractor G f - 9, (LE O Ph 3(J7- 6"2-(o g SWR
BUILDING . Tenant/Owner ELC ZOC(7 ODD; ( ('
Retaining Wall ELd `V
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
Spr [�' ' �(✓ V
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
4
1 -ough
UG /Slab
Low Voltage
Fire Alarm
o- 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 Date Inspector Ext
Other
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 /� AM PM BLD
Location ( 6 1 T S �- j Suite p MEC
Contact Person Ph CP 50 ' g 3,6 PLM
Contractor Ph S 3 - / 3 % S SWR
BUILDING Tenant/Owner ELC .2 - y -S
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
'`�
Slab r C– 2_ 0� L ��� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing ZiiarLi
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
�E!tE�TFZTC7�k - y—
rvice„>
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
SS 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: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date v ` Ara Inspector /� - �r Ext
Other
Final
PASS PART FAIL DO NOT ` EMOTE 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
Z2 Z)
Date Requested 9- AM PM BLD
Location / (0 / 3S 7 L / Suite MEC
Contact Person Ph COs g� 3(0 PLM
Contractor ,1�Ph SWR 1
BUILDING 11�
Tenant/Owner ' ml klq -- l X56 ELC WOO ()COS 1
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 A - • 1 C b
Post & Beam
Under Slab
Top Out
Water Service [/ •
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL /
MECHANICAL ,� (� /„ l SIS •
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
CTR
TN
UG /Slab
Low Voltage
Fire Alarm
FinaI7.
PASS FAIL
SITE
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
ADA [ ] Please call for reinspection RE: 7 /3[ ] Unable to inspect no access
A roach /Sidewalk
PP Date Z ^ g d C/ Inspector ✓ /�i ��� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION'DIVISION MST •
'24- Hoerr- Inspection Line: 639 -4175 Business Line: 639 -4171 BUP
Date Requested < G z " AM PM BLD
Location / ' 5 (3 l 7 G/ �'-e Suite MEC
Contact Person / Ph PLM
Contractor Ph SWR
BUILDING � � �� � � Tenant/Owner
ELC tau 0 v 0 - 5- 7
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 — 4 vlS-
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
PAS PA T FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm •
RT FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before ne pection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
Approach/Sidewalk Date JZ D 0 Inspector 41 Ext
Other
•
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.