Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00495
4. DEVELOPMENT SERVICES DATE ISSUED: 08/21/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110CD -07600
SITE ADDRESS: 15705 SW 116TH AVE
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Installation of 2 services /feeders and 40 branch circuits.
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: 2 W /SERVICE OR FEEDER: 40 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
TOBIAS INVESTMENT CO HAMER ELECTRIC INC
300 SE SPOKANE ST 126 INDUSTRIAL WAY
PORTLAND, OR 97202 LONGVIEW, WA 98632
Phone: Phone: 360- 636 -2227
Reg #: ELE 1135LMS
LIC 37 -144C
SUP 3479S
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT CTR 08/21/200C $342.50 2720000000( Wall Cover
5PCT CTR 08/21/200C $27.40 2720000000( Underground Cover
Elect'I Final
Total $369.90
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. "1
PERMITTEE'S SIGNATURE / ISSUED BY:
1
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: , . f Ce ceJ--t/' DATE:
LICENSE NO: 3( 7 / S
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Permit ApplivaCIVIE Plan c
13125 SW HALL BLVD. Recd :11E1 71 r i
TIGARD OR 97223 NOG 21 7:3°° Date to P.E. •
-o
Phone (503) 639-4171, x304 to oPlaOPMEN1 Date to DST
Inspection (503) 639 -4175 Print of Type c00 Permit # gte 02tYX' -'S
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development c'Ze:2 : 7le7' Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
Address /5705 56(1. / //p 72 iite 4a. Residential - per unit
City/State /Zip 6-1.6 �t. -�/ tie- 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.75 1
Commercial l 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
information for COT data base). Installation, alteration, or relocation 30
Electrical Contractor toe- 200 amps or less L- $ 64.25 / g ' 2
Address (2..GP 11.Q2,16T 12.1,4 Imo/ 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City j i/,L/E' '4'-* 360 / State WA- Zip 9 601 amps to 1000 amps $ 192.50 2
3c2
Phone No. ' -�v ,2 .2 7 Over 1000 amps or volts $ 363.75 2
Job No. � ` ire6 4 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 57 - /yt/C Exp.Date /B D/ - OD 4c. Temporary Services or Feeders
OR State CCB Reg. No. 3 S81 g Exp.Date D /-2S' -27/ Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
y 201 amps to 400 amps $ 80.25 2
' 401 amps to 600 amps $ 100.00 2
Signature of Supr. Elec'n . X0-wp. aZi.)
O Over 600 amps to 1000 volts,
•
License No. 5 Exp.Date /0 -06.0/ see "b" above.
Phone No. 36 - 6 36 - 722 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 A O $ 5.35 �! 9 # 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
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (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 $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. 50
Chapter 5 5. Fees:
p
5a. Enter total of above fees $ a '
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ _VAP
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
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 # PO
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 369 .
is \dsts \forms \elcctric.doc
CITY OF TIGARD BUILDING IN PECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • t•
BUP
Date Requested AM PM BLD
Location 4S7493 //V Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC - 70-0- 0 — BaVg4
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 ��n
Fire Sprinkler 1:://9.- dJ
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 FAIL
CT
Service
Rough In
UG /Slab
Low Voltage
F - Alarm
r ' AS PART FAIL
E
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date - Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
1
•
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By I 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 `l 2-
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing Ai Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing � Inspection Description Date Passed By
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
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
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 -4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000=00495
DEVELOPMEN ) 639 -4171 DATE ISSUED: 8/21/00
a 13125 SW Hall Blvd.,
PARCEL: 2S110CD -07600
SITE ADDRESS: 15705 SW 116TH AVE
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Installation of 2 services /feeders and 40 branch circuits.
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 HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: 40 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
TOBIAS INVESTMENT CO HAMER ELECTRIC INC
300 SE SPOKANE ST 126 INDUSTRIAL WAY
PORTLAND, OR 97202 LONGVIEW, WA 98632
Phone: Phone: 360 636 - 2227
Reg #: ELE 1135LMS
LIC 37 -144C
SUP 3479S
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT CTR 8/21/00 $342.50 2720000000 Wall Cover
5PCT CTR 8/21/00 $27.40 2720000000 Underground Cover
Elect'I Final
Total $369.90
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 r m.
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 o
Q
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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
8/22/00 Activities for Case #: ELC2O00 -00495
4:46:16 PM
Assigned Hold Updated
1 Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 8/21/00 MAIL RECD No Hold DLH 8/21/00
ELCC003 Permit created 8/21/00 DLH DONE No Hold DLH 8/21/00
v
ELCC700 Ceiling Cover No Hold DLH 8/21/00
ELCC720 Wall Cover No Hold DLH 8/21/00
,
ELCC725 Underground Cover No Hold DLH 8/21/00
ELCC799 Elect'I Final No Hold DLH 8/21/00
ELCC500 (F)Issue permit 8/21/00 DLH DONE No Hold DLH 8/21/00
ELCA510 (F) Reprint permit 8/22/00 ZZZ DONE No Hold 777 8/22/00
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