Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00254
"AFS .l; DEVELOPMENT SERVICES DATE ISSUED: 4/27/99
Ai-
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111 CD -00300
SITE ADDRESS: 15670 SW 98TH AVE
SUBDIVISION: ALDERBROOK FARM ZONING: R -7
BLOCK: LOT : JURISDICTION: TIG
Project Description: Add a first branch circuit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 49 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:
TIGARD CHURCH OF GOD PHOENIX ELECTRIC CO
15670 SW 98TH AVENUE 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
5PCT DJL 4/27/99 $1.75 99- 314885 Elect'I Final
PRMT DJL 4/27/99 $35.00 99- 314885
Total $36.75
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.
Permit Signature: fj ,-, c / Issued By: 25/
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. ELEC'N: 0 77 6 r 1 19 i ( DATE: A)7 / 9 y
LICENSE NO: /
Call 639 -4175 by 7:00pm for an inspection the next business day
APR -27 -99 TUE 12:08 PM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 02/02
CITY'Ol TIGARD Electrical Permit Application Plan Check k
13125 SW HALL BLVD. Recd By
Date Rec'd
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Z nspection (503) 639-4175 Print or Type
Inspection Permit #f4- e�/f -- d5 "
ns (503) 684 -7297 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
•(. �
1
Name (or name of business) C � YC, -� Ct -7t)( Service included: Items Cost Sum
Address /,/,'/ U t) 1 4.k 4a. Residential - per unit
1000 sq. ft- or less $110,00 4
City/State /Zip- i , �.(ti.�'.K / . - q7 ) Each additional 500 sq. ft. or
i portion thereof $ 25 . 00 1
Commercial,' ` Residential El limited Energy $26.00 .
1` Each Manut'd Home or Modular
- v-_� ��, l,v \-6.J. t_NATE! gc- CU.)_1 A� iv c41c Dwelling Service or Feeder $65.00 . 2
2a. Contractor installation only: <-(,-~ -. 1
(Attach copy 1 current license) 4b. Services or Feeders
ElectricahC ontC ('t .,/ 2 \ .y11 � �C . (-!) Installation, alteration, or relocation
Address I -- .k7.4
i C I . t-.. r 200 am less 560.00 2
r�_ti =� <._i C- 201 amps s to 400 amps 360,00 2
City 1 ,r� c.4,_...., .' State ( \(. �' n - Zip, '1 )- 401 amps to 600 amps 5120.00 2
Phone N ,p S\4 - ",-,LQ (..1:-:, 601 amps to 1000 amps - 5160.00 2
Job No. - ;C,;)- - ) - '19 Over 1000 amps or volts $340.00 2
Reconnect only 550,00 2
Elec. Cant. Lice. No. C.. Exp.Date 10'P I - 1.
OR State CCB Reg. No. Sa' Exp.Date I 2 3 1 : 40. Temporary Services or Feeders
COT Business Tax or Metro No. ,e1.0 V ) Exp.Date Installation, alteration, or relocation
200 amps or less - 550.00 2
Si nature of Su pr. Elec'n 201 amps to 400 amps $75.00 2 -
g p 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. /-- Exp.Date see "b" above.
Phone No., (. n `a 1 .5 n r C) - 4d, Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The lee for branch circuits with
purchase of service or
Print Owner's Name feeder leo. 5
Each branch circuit 55,00 2
Address, b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. ,:--- � �� )
First branch circuit / $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5,00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not Included)
Owner's Signature _ Each pump or irrigation circle $40,00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate Item and enter fee In section 5B.
4 or more residential units In one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above $35.00
Systom over 600 volts nominal Per inspection
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
-
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: '
Not roquirad for temporary construction services. 5a. Enter total of above fees $ ' il
5% Surcharge (.05 X total lees) $
NOTICE Subtotal $
sb. Enter 25% of line 5a for /
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if renuired (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION OR WORK Subtotal n/� $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY rt 1 Trust Account # -� /7rj k' �`'('� . 25 - TIME AFTER WORK IS COMMENCED. �+ $
Total balance Due
1 \ocTs \F.l.C9r.AVV Rev Wee
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5- 5- 1 f - 9/ AM PM BLD
Location i 5C0 9 D ` 5 .' Suite MEC
Contact Person ��.a:•t,f /� Ph co / '3e.oD PLM
Contractor U Ph SWR
BUILDING Tenant/Owner ChM /1(M l Gnek_ ELC 999' O0 2..S
> - - �c�
4 1
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 7 � �
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final 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
C TRI
Service
Rou e h In
Low Voltage
F" e Alarm
rep
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 q
Other Date � / ! 7 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.