Permit CITY OF T ELECTRICAL PERMIT
PERMIT #: ELC98 -0622
:W
i,i\ DEVELOPMENT SERVICES DATE ISSUED: 11/'19/98
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S1O1BD -00105
SITE ADDRESS...:128O5 SW 77TH PL
SUBDIVISION....: ZONING:I -L
BLOCK....... LOT JURISDICTION: TIG
Pro.j ect Description : New electrical
- -- RESIDENTIAL UNIT - - -- ----TEMP SRVC/FEEDERS--- MISCELLANEOUS
1000 SF OR LESS....: 0 0 - 200 amp - 0 PUMP /IRRIGATION : 0
EACH ADD' L 5OIZISF...: 0 201 - 400 amp.......: 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY . 0 401 - 600 amp.......: 0 SIGNAL /PANEL - 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp......: 2 W /SERVICE OR FEEDER: 26 PER INSPECTION - 0
201 - 400 amp - 0 1st W/O SRVC OR FDR.: 0 PER HOUR : 0
401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT - 0
601 - 1000 amp.....: 0 PLAN REVIEW SECTION
1000+ amp /volt.....: 0 > =4 RES UNITS........: ) 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC. :
Owner: FEES - - --
PACIFIC UTILITY type amount by date recpt
12805 SW 77TH PL PRMT $ 250.00 B 10/13/98 98- 309954
TIGARD OR 97223 SPCT $ 12.50 B 10/13/98 98- 309954
Phone #:
Contractor:
CAPITOL ELECTRIC CO INC $ 262.50 TOTAL
12810 NE AIRPORT WAY
UNIT 1 REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Elect'l Service
Phone #: 255 -9488 Wall Cover Elect'l Final
Reg #..: 048748
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: ..Z6.9"/L- Issued By 4 -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent. !
OWNER'S SIGNATURE: N/f DATE:
-. CONTRACTOR INSTALLATION ON Y --
SIGNATURE OF SUPR. ELEC'N: /9 -6 '9r70 DATE:
LICENSE NO
+++++++++++++++++++++++++++++++++++++++++++++•++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plan Check #
13125-.W HALL BLVD. ELECTRICAL PERMIT APPLICATION Recd By °N
TI OR 97223 DateRec'd 101 - 1 6
Phone (503) 639 -4171, X304 Date to P.E.
Inspection (503) 639 -4175 Date to DST /y rr,, /�}7
Fax (503) 684 -7297 PRINT OR TYPE Permit # `1 - �t1�''�/v
INCOMPLETE OR ILLEGIBLE WILL NOT BE ACCEPTED Called Am-,( - H net If
4
tg/`P
1. Job Address: 4. COMPLETE FEE SCHEDULE BELOW:
Name of Development Number of Inspection per permit allowed
Service Included: Items Cost Sum
Name (or name of business) PACIFIC UTILITY 4a. Residential - per unit
1000 sq. ft, or less $110.00 $0.00 4
Address 12805 SW 77TH AVE. Each Additional 500 sq. ft.
- - " --- or portion thefeof- $25.00 $0.00 1
City /State /Zip TIGARD, OR. 97223 Limited Energy $25.00 $0.00
CommercialX Residential Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 $0.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Service or Feeders
Electrical Contractor CAPITOL ELECTRIC CO., INC. Installation, alterations or relocation
ddress 12810 NE AIRPORT WAY 200 amps or less 2 $60.00 $120.00 2
City PORTLAND State OR Zip97230 -1029 201 amps to 400 amps $80.00 $0.00 2
Phone No. (503) 255 -9488 401 amps to 600 amps $120.00 $0.00 2
Job No. 98 -693 601 amps to 1000 amps $180.00 $0.00 2
Elec. Contr. Lic. No. 26 -496C Exp. Date 10 -1- 9r/ -✓ Over 1000 amps or volts $340.00 $0.00 2
OR State CCB Reg. No. 48748 Exp. Date 8 -22 -99 ✓ Reconnect only $50.00 $0.00 2
COT Business Tax or Metro No. 00004542 Exp. Date 10-1-98 -
/ 4c. Temporary Services or Feeders
Signature of Supr. Elec'n Installations, alterations or relocation
200 amps or less $50.00 $0.00 2
License No. 2865 S Exp. Date 10/1/01 - 201 amps to 400 amps $75.00 $0.00 2
Phone No. (503) 255 -9488 401 amps to 600 amps $100.00 $0.00 2
Over 600 amps to 1000 volts
see "b" above.
2b. For owner installations:
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
ddress a) The fee for branch circuits with
City State Zip purchase of service or feeder fee
Phone No. Each branch circuit 26 $5.00 $130.00 2
b) The fee for branch circuits without
he installation is being made on property I own which is not purchase of service or feeder fee.
intended for sale, lease or rent. First branch circuit $35.00 $0.00 2
Each add'nl branch circuit $5.00 $0.00 2
Owner's Signature
4e. Miscellaneous (Service or Feeder Not Included)
Each pump or irrigation circle $40.00 $0.00 2
3. Plan Review section (if required): * Each sign or outline lighting $40.00 $0.00 2
Signal circuit(s) or a limited energy
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00 $0.00 2
4 or more residential units in one structure Minor Labels (10) $100.00 $0.00
Service & feeder 225 amps or more
-- System over 600 volts nominal -- - - Af; -Each additional inspection over -
Classified area or structure containing special the allowable in any of the above
occupancy as described in N.E.C. Chapter 5. Per inspection $35.00 $0.00
Per hour $55.00 $0.00
* Submit 2 sets of plans with application where any of the above apply. In Plant $55.00 $0.00
Not required for temporary construction services.
5. Fees:
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS 5a. Enter total of above fees $ $250.00
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK 5% Surcharge (.05 X total fees) $ $12.50
IS SUSPENDED OR ABONDONED FOR A PERIOD OF 180 DAYS AT ANY Subtotal $ $262.50
TIME AFTER WORK IS COMMENCED. 5b. Enter 25% of line 5a. for
Plan Review if required (Sec. 3) $
Subtotal $ $262.50
Trust Account #
•
CITY OF TIGARD BUILDING INSPECTION DIVISION L` ,�? j
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MS �`'�� L1�
14 Y / Date , Requested�� lQ i5_V AM PM BLD
Location ` Cd 5 . - 1 7 - (1 �� Suite MEC
Contact Person Ph PLM
Contractor Ph z-55 - g4ge SWR
BUILDING . Tenant/Owner TAC4r t(✓ W} C I --0 d
Retaining Wall ELR
Footing
Access:
Foundation lI l,( l eA2 ( FPS
Ftg Drain fJ SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing e I� -C,
Firewall 47 7 Fire Sprinkler lz_y2.. c .' - ti.ft
Fire Alarm
Sus p'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
ELECTRICAL
Service
Rou h In
/Slab
Low oltage
Fire Alarm
Final
PASS PART 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date �D ` "� �P 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
q BUP
A • Date Requested ' / l - 4 - / 9 , / AM PM BLD
Location /ZRi)5 ��(st1 7 77' 1 igE Suite MEC •
Contact Person Ph PLM 1_ A a
Contractor 2 ( G Ph 255 94-?g SWR I�,�11,
BUILDING Tenant/Owner PA- / c/ c_ ti/ 1 4
Retaining Wall ELR
Footing Access /
Foundation ��� o'L �� (;.rl.�./ IN ��Ai�11v / //� / PPS
Ftg Drain SGN
Crawl Drain Inspe Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof / V C sG -
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
SASS —PAR FAIL
L J ECTRICAL 7 —
Service
Rough In
(QG /SIab1
Low Voltage
Fire Alarm
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA / G
Approach /Sidewalk Date / v ? — ` 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
/6(!/� , /� l - BUP
Date Requested �, - 90 o A PM BLD
Location _; 64d 77 l / -,3'" Suite MEC
Contact Person Q &66.14 iP ' Ph PLM
Contractor /« _ _ Ph �� SWR •
J
/ PA I Fi C - L t.T7 L-I ' C � — (. >�l�
BUILDING � � Tenant/Owner
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab M /441r 7 if pr✓n/1 � SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing - ..d — ,
.I_ `L� ✓� �
Firewall
Fire Sprinkler .,dG� /Le •�e �-f-o t Q iLs
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
I<RECTRICAL
Service
gh In
UG/ lab
Low Voltage
Fire Alarm
Final
PASS PART 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 1 //Z-/P,/ 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
//4 P,,.3/ Date Requested /fit /%'I AM PM BLD
Location lc.I6 $ / A ( ) - 77 -i fI Suite MEC
Contact Person Ph PLM
Contractor � 1�G Ph �,�5 ���� SWR
BUILDING Tenant/Owner k 0 T t ( r fi/ ELC
Retaining Wall / ELR
Footing Access:
Foundation / FPS
Ftg Drain / � C - f4 g SGN
Crawl Drain Inspection Notes:
Slab ,2 - -f- -2&' -te-- SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall Nailing on 9�
Drywal (�(,J
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
C_ ART FAIL
ELECTRICA>
Ser v'
ou ajGZ
UG7Slab
Low Voltage
Fire Alarm
Fin
AS} 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 / - . 1 - 9 Ins Ext
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 �3 AM PM BLD
r
Location / . ; ° ! tat � ` Suite . MEC
Contact Person Ph PLM
c
Contractor CQ�t..���c. Q Ph ?-5 3 � /( SWR
BUILDING Tenant/Owner ELC cif .e6 v?
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 ) ;:
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 ART—, FAIL
C CTRICAL
ice
Rough In
UG /Slab
Low Voltage
F' rm
AS 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 ,, ,1 9 Inspector ���i(���� s- Ext
Other '
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.