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Permit
CITY OF T ELECTRICAL PERMIT ..1 4 1 DEVELOPMENT SERVI DATE IssUEDL 8/98 PARCEL: 2S1O4AC -00800 SITE ADDRESS...:12999 SW 132ND AVE SUBDIVISION - ZONING:R-4.5 BLOCK LOT - JURISDICTION: TIG Project Description : Installation /alteration or relocation of one (1) 200APp and three (3) 402111M service /feeders and five (5) branch circuits for a pump station. - -- RESIDENTIAL UNIT - - -- ----TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS....: 0 0 — 200 amp ° 0 PUMP /IRRIGATION • 0 EACH ADD'L 500SF...: 0 201 — 400 amp ° 0 SIGN /OUT LINE LTG..: 0 LIMITED ENERGY : 0 401 — 600 amp.......: 0 SIGNAL /PANEL ° 0 MANE. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0 - - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- - 0 — 200 amp ° 1 W /SERVICE OR FEEDER: 5 PER INSPECTION ° 0 201 — 400 amp - 3 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 CITY OF TIGARD type amount by date recpt 13125 SW MALL BLVD PRMT $ 325.00 GEO 04/27/98 98- 305284 TIGARD OR 97223 SPCT $ 16.25 GEO 04/27/98 98- 305284 Phone #: Contractor: PHOENIX ELECTRIC CO $ 341.25 TOTAL 7379 SW TECH DR. REQUIRED INSPECTIONS TIGARD OR 97223 Elect'1 Service Phone #: 684 -3600 Elect'1 Final Reg #..: 000522 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- %1- %10 through OAR 952- 001 -1987. You may obtain a copy of these rules or direct questions to OIAdC by calling (503)246 -1987. I Permittee Signature: Issued By° jam._ 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 �r SIGNATURE OF SUPR. ELEC' N: d' DATE: LICENSE NO: /N - +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + ++ + + + + + + + + + + + + + + + + + + + + + +4•+ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + +•+• + + + + ++ CITY OF TIGARD RECEIV El ect r ical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By TIGARD OR 97223 APR 2 :1999 Date Rec'd I Date to P.E. Phone (503) 639 -4171, x304 COMMUNITY DEVELO ?MEfd) Date to DST Inspection (503) 639 -4175 Print or Type Permit # Ufa �f � /y Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development ( � V-t - ,. 1A. Number of Inspections per permit allowed 1 Name (or name of business), R�7 _ Service included: Items Cost Sum (� � .,.��/ 4a. Residential - per unit /�� Address �� l 1000 sq. ft. or less p $110.00 4 City /State /Zip ,1 C \. `l ( � 1 Each additional 500 sq. ft. or Commercial Residential ❑ portion thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: © (Attach copy II current licenses) 4b. Services or Feeders Electrical Contractor �� \fix i, Q--e , ( tallation, alteration, or relocation A SS G C Sl.. 1 1� o an (..��,._ I 200 amps or less $60.00 2 s� Jr) Jty 201 amps to 400 amps _3_ $80.00 2 C3 City \\ , State I(__ Zip ' .4 401 amps to 600 amps $120.00 2 Phone No. (p3 1- L T) \ 601 amps to 1000 amps $180.00 2 Job No. '730 ` Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. .-l) ") Exp.Date OR State CCB Reg. No. ,�l->* Exp.Date 4c. Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 Or 201 amps to 400 amps $75.00 2 Signature of Supr. Elec n /ai 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No Exp.Date see "b" above. Phone Nc. i 1:WIMI 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. i Address Each branch circuit . $5.00 �0 2 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 System over 600 volts nominal Per inspection $35.00 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 required for temporary construction services. 5a. Enter total of above fees $ f . v 5% Surcharge (.05 X total fees) $ s+T"+ it* NOTICE • Subtotal $ -1i1) L 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 7 . 1 € 0. $ Total balance Due / r5- I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION (ao yJ i7 MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP I G - 1 7'r 33 Date Requested t q 1 ^e d AM PM BLD Location � 2_ ! 1 - 132_ / ri l� Suite MEC Contact Person � 0 � Ph A ' 3600 PLM Contractor `f"r� Ph SWR BUILDING e ; Tenant/Owner ELC qer - O;* 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 Service 'Rough In UG /Slab Low Voltage Fi - AI. m 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 - 1 Inspector Ext Final PASS PART FAIL DO - NOT REMOVE this inspection record from the job site.