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Permit
- CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00387 ' II SW i DEVELOPMENT SERVICES 639 -4171 ACES' DATE ISSUED: 08/06/2001 , PARCEL: 2S 110CA -00200 SITE ADDRESS: 15080 SW 116TH AVE LAUNDRY SUBDIVISION: KING CITY ZONING: ? BLOCK: LOT : JURISDICTION: KIN Project Description: JOB #298 Remove water heater from dedicated meter and reconnect to building meter. 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: WESTON INVESTMENT CO GEORGE + SONS ELECTRIC CORP 2154 NE BROADWAY PO BOX 339 PORTLAND, OR 97232 CLACKAMAS, OR 97015 Phone: Phone: 654 -8634 Reg #: LIC 35600 ELE 3 -117C SUP 3185S FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 08/06/2001 $46.85 2720010000( Wall Cover Elect'I Final SPOT CTR 08/06/2001 $3.75 2720010000( Total $50.60 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 -6699 or 1 -800- 332 -2344. _ 49 ,, 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: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N• J'l .11 -0-a DATE: LICENSE NO: 11 .- S Call 639 -4175 by 7:00pm for an inspection the next business day • ,Fi trical Permit Application Datereceived: Z2 Permit no.:© ., / - 3' . it j . . ' City of Tigard RECBVED Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd Tigard UK 97223 Date issued: ri Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 JUL 3 0 206; Case file no.: Payment type: Land use approval: COMMtttutry DEVELOPMENT TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial al Multi family ❑ Tenant improvement ❑ New construction a Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: /C0990 .5 f/‘ - A V Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: (Block: (Subdivision: fci.'vG Cry/p7s / / J Project name: I Description and location of work on premises: ,e I'+o t; E. 4o `/ waTr J- „der F a vte Estimated date of completion/inspection: Ucd'ca led meie cCMvl e.1- i-o . (. N wt - - CONTRACTOR APPLICATION ' - -.''., FEE SCIIEDU.E Job no: 029 / e ) Fee Max Business name: Ce m r-' . Scry . c71 m _ Description Qty. (ea) Total no. insp , / Ca � New residential - shtgle or multi-family per Address: Po 84,x 33 S dwelling unit. Includes attached garage. City: C L k,vts 'State: Oyz I ZIP: `�70/ r Service included: Phone: S' V 8. 43 +f/ I Fax: KS E -mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: 35600 Elec. bus. lic. no: 3 //7-C, Limited energy, residential 2 City /m o lic. n : � te tea` 2 b f�� Limited energy, non- residential 2 l �'� Each manufactured home or modular dwelling Signature of supervising electrician (required) Date '. -'2b_ / Service and/or feeder 2 Sup. elect. name (print): Cam ,( ,s o.y' License no: /.., ,r— S Services or feeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): L o s . G , ih 201 amps to 400 amp 2 g address: , , V ,V q /3 (1 , /� y 401 amps to 600 amps 2 Mailin address' O YK 601 amps to 1000 amps 2 City: ) D 2( I State:OR I ZIP: 7 72 /a. Over 1000 amps or volts 2 Phone:, y- (Fax: I E -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, orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: 'State: 'ZIP: B. Fee for branch circuits without purchase �// r Phone: Fax: E-mail: of service or feeder fee, first branch circuit: / T G ` S 2 Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps- commercial Cl Health-care facility Each pump or irrigation circle 2 ❑ Service over 320 amps - rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories Cl Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection 1 1 1 Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other p Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 54/ -5 ❑ Visa ❑ 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‘ 7 S TOTAL $ so Name of cardholder as shown on credit card Expires accepted as complete. $ Cardholder signature Amount 440 -4615 (6J00/COM) Electrical Permit Fees: Limited Energy Fees: . r A 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 n 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 Garage Door Opener Dwelling Service or Feeder $90.90 2 El Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 n Vacuum Systems 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 � 601 amps to 1000 amps $240.60 2 I I 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, n see "b" above. Audio and Stereo Systems Branch Circuits n Boiler Controls New, alteration or extension per panel a) The fee for branch circuits � with purchase of service or l l 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 Fire Alarm Installation or feeder fee. First branch circuit $46.85 f � I Each additional branch circuit $6.65 I I HVAC Miscellaneous 0 Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 n Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable in any of the above Nurse Calls Per inspection $62.50 Per hour $62.50 In Plant $73.75 n Outdoor Landscape Lighting Fees: [] Protective Signaling Enter total of above fees $ 1 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 $ i:\dsts \forms\elc- fees.doc 10/09/00 07/30/2001 15:12 5036393771 CITY OF KING CITY PAGE 02 61411 KING CITY 15300 S.W. 116th Avenue, King City. Oregon 97224.2693 Phone; (503) 639.4082 • FAX (503) 639.3771 • • Notice To Contractors Working In King City Due to an intergovernmental agreement with the City of Tigard, many.bui:Iding related permits for projects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will . collect all fees and fax the application to the City of Tigard. 'City of Tigard staff wiIl then create the permit, issue the permit, and perform inspections. Please indicate on the permit application • whether you would like the Tigard staff to call you when the permit is ready for issuance or • whether you prefer it to be mailed without any notification. Any incomplete or illegible application will be returned to King City -staff for correction and no processinz will occur until a complete, legible application is received. • If your permit application DOES REQUIRE PLAN REVIEW,. this form must be signed •by a • King Cite staff person. King City staff will simply sign this form indicating land use approval. Tee this signed form to the •City of Tigard Development Services Counter located at 1312■ SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are . available at 639 -4171 Ext.,304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. • The City of King City hereby authorizes applicant to pursue permits at the City of Tigard • Building Department for the following project: . % ,;/ ,:per „•, �, ,� located at: /%5 / /(a fh 0� • • Dine City Representative ' 6- r,6 DSTS $7 o0c CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 n/ - BUP Date Requested l0 AM PM BLD Location s g G /(C, 44 Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 7 / b03g 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 rl � ^ Drywall Nailing "` e( e'er `� c°CO 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 ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm M 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 l 0-0 p Approach /Sidewalk Other / Date Inspector aaii Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.