Permit CITY O 1 T' G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000-00507
le DEVELOPMENT SERVICES DATE ISSUED: 8/25/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 114AB -03000
SITE ADDRESS: 16415 SW 93RD AVE
SUBDIVISION: KNEELAND ESTATES ZONING: R -4.5
BLOCK: LOT : 017 JURISDICTION: TIG
Proiect Description: Installation of one branch circuit for new a/c unit.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 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: 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:
MANGHELLI, DONALD L AND PHOENIX ELECTRIC CO
BARBARA A 7379 SW TECH CENTER DR.
16415 SW 93RD AVE TIGARD, OR 97223
TIGARD, OR 97224
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT CTR 8/25/00 $37.50 2720000000( Elect'l Final
5PCT CTR 8/25/00 $3.00 2720000000(
Total $40.50
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 -1987.
PERMITTEE'S SIGNATURE D `'_ ISSUED BY:
l
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. ELE 'N' DATE:
LICENSE NO: 1 70 3
Call 639 -4175 by 7:00pm for an inspection the next business day
AUG -23 -00 WED 03:28 PM PHOENIX ELECTRIC CO FAX NO, 15036843611 P, 02/02
CITY OF TIGARD • • Plan C ck At
yeas SW HALL BLVD. Electrical Permit Application
Recd O
• TIGARD OR 97223 Date Recd &
Date to P,E,
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit if E1 t
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Addre s: 4. Complete Fee Schedule Below:
Name of Development 1 Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum 1
Address "11 Y • _ 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City /State /Zip a v.c.SNA _ (' ).- Each additional 500 sq. ft. or
portion thereof 5 26,75 1
Commercial Resides ' • Limited Energy $ 60.00
w�� CC r Each Manufd Home or Modular
2a. Contrac ins tallation o Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b, Services or Feeders
information for COT = . to base). . Installation, alteration, or relocation
Electrical Contractor _.• NA . _ _ _ 1,A, AIM amps or less $ 64.25 r
1i A 2
Address � *. 201 amps to 400 amps $ 85.50 2
rr 401 amps to 600 amps $ 128.50 _ 2
City _� - Sta Zip 601 amps to '1000 amps $ 192.50 ^� 2
Phon - _ Over 1000 amps or volts $ 363.75 2
Job No_ _ =' Reconnect only $ 53.50 2
Elec. Cont. Lice, No. Lam- Exp.Date 4c. Temporary Services or Feeders
OR State GCB Reg, No. " " xp,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
Signature of Supr. Elec'n r? .....r 401 amps to 600 amps , $ 100.00 2
Over 600 amps to '1000 volls,
see "b" above.
License No. L/ o S Exp.Date 4d. Branch Circuits
Phone No. ,. , -ems P
Now, 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.
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
w
panel, alteration or extension $ 60.00
3. Plan Review section (if required):* �
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
Service and feeder 225 amps or more Per Inspection $ 50.00
Per hour $ 50.00
_ ___ _System over 600 volts nominal In Plant 5 59.00
Classified area or structure containing special occupancy as - " r
described in N.E.C. Chapter 5 5, Fees: �J l
5a. Enter total of above fees $ 3 5 `J
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (,08 X total fees) $ ,fftj
Not required for temporary construction services. Subtotal $ '1114151b )
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) 5 / .
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 ti L / //, 1
AT ANY TIME AFTER WORK IS COMMENCED. oral balance Due $ ` v
i:\dsis \forms \cicctric.doc
•
CITY OF TIGARD BUILDING INSPECTION DIVISION • • MST •
24- HourinspOction Line: 639 -4175 Business Line: 639 -4171.
BUP
Date Requested 9 AM PM BLD
Location / (( /5 St✓ 93 Suite MEC
Contact Person - . Ph w4" 34e- PLM
Contractor > Ph SWR
BUILDING . °rr° Tenant/Owner ELC 2c 0 0$b 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
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
ce
•
Rough In
UG /Slab
Low Voltage
F - Alarm
• ASS - ART FAIL
SI
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ) Please call fo reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
` C k .
•
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By 11 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final �— i - c.Tt1
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing I Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
4 Inspection Description Date Passed By
Drywall nailing
Post/beam mechanical
Suspended ceiling Gas line
•
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
F. SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils I Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC ELR MEC, SIT PERMITS
CI TY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00507
VP DEVEL i OPMENT rPERMI9723 T
' ) 639 -4171 DATE ISSUED: 08/25/2000
-- 13125 SW PARCEL: 2S114AB -03000
SITE ADDRESS: 16415 SW 93RD AVE
SUBDIVISION: KNEELAND ESTATES ZONING: R-4.5
BLOCK: LOT : 017 JURISDICTION: TIG
Project Description: Installation of one branch circuit for new a/c unit.
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: 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: 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:
MANGHELLI, DONALD L AND PHOENIX ELECTRIC CO
BARBARA A 7379 SW TECH CENTER DR.
16415 SW 93RD AVE TIGARD, OR 97223
TIGARD, OR 97224
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Elect] Service
PRMT CTR 08/25/200 $37.50 2720000000 Elect'l Final
5PCT CTR 08/25/200 $3.00 2720000000
Total $40.50
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 -1987.
PERMITTEE'S 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: O
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELECN: DATE: O
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
.i 1'
9/12/00 Activities for Case #: ELC2O00 -00507
10:50:37 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCA001 Application received 8/23/00 DEB FAXD No Hold DEB 8/24/00
ELCA003 Permit created 8/24/00 DEB DONE No Hold DEB 8/24/00 %i
ELCA400 Ready to issue 8/24/00 DEB DONE No Hold DEB 8/24/00
ELCA730 Elect'I Service No Hold DEB 8/24/00
ELCA799 Elect'I Final No Hold DEB 8/24/00
ELCA500 (F) Issue permit 8/25/00 DEB DONE No Hold BLD 8/25/00
ELCA510 (F) Reprint permit 9/11/00 ZZZ DONE No Hold ZZZ 9/11/00
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