Permit CITY OF TI GA R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00195
,14 DEVELOPMENT SERVICES DATE ISSUED: 04/24/2000
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104AC 00800
SITE ADDRESS: 12999 SW 132ND AVE
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install 1 service /feeder 200 amps or less in existing commercial building.
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: . 1 W /SERVICE OR FEEDER: 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:
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Owner: Contractor:
TIGARD WATER DISTRICT PHOENIX ELECTRIC CO
8841 SW COMMERCIAL 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
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Phone: Phone: 684 - 3600
Reg #: LIC 00052288
SUP 4140S
ELE 3 ORIGINAL
• 4 -24
FEES Required Inspections
Type By Date • Amount Receipt Elect'I Service
PRMT KJP 04/24/200C $64.25 0001650 Elect'l Final
5PCT KJP 04/24/200C $5.14 0001650
Total $69.39
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 'rest 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N:- DATE:
LICENSE NO: Yi yO
Call 639 -4175 by 7:00pm for an inspection the next business day
APR -20 -00 THU 04:30 PM PHOENIX ELECTRIC CO FAX N0, 15036843611 P. 02
gITY. GF TIGARD ' Plan Check # _
Electrical Permit Application Recd By
13125 SW HALL BLVD. Date Rec'd
• TIGARD OR 97223 Date to P.E.
Phone (503) 6394171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit - C 2 --oe -3 0 i
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
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1, Job Address: V 4. Complete Fee Schedule Below:
Name of Development \<
\.t ht. 9 a, ■ . ' Number of Inspections per permit allowed
Name (or name of business) CL'- b \ i , i Service included: Items Cost Sum
Address es ; (..t) I "- -,-)"°A ba. Residential - per unit
1000 sq. ft. or less 5 117.75 4
City /State /Zip = 5 Each additional 500 sq, ft, or • portion thereof 5 26.25 1
Limit Energy 5 60.00
mmerci Residential �
; r , �� "�� Each Manufd Home or Modular
2 wS Dwelling Service or Feeder 5 72.75 2
. C ontfactor in tah ion only:
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders n
Information for COT d.ta'base). Installation, alteration, or relocation , • c 200 amps or lass 1 $ 84.25 d 2
Electrical Contract.- .''.e n .� 201 amps to 400 amps $ 85.50 2
1
Address 1 . 'u- `.z„ . e l 401 amps to 600 amps $ 128,50 2
City \ k , ct, , �, � ( State C� Zip 1 - -3 601 amps to 1000 amps $ 192.50 • _ 2
Phone No („QkU - -? C t) , _ Over 1000 amps qr volts 5 363.75 2
Reconnect only $ 53.50 2
Job No. , --()%51) -\ \'�
Elec. Cont. Lice. No. - WIC Exp.Date IQ Al 0 dc. Temporary Services or Feeders
OR State CCB Reg, No. 5. ? .Bxp.Date 1)0;510 I Installation, alteration, or relocation 53.50 2
COT Business Tax or Metro No, ' Exp.Date 200 amps or lass § •
201 amps to 400 amps $ 80,25 2
C .-- 401 amps to 600 amps $ 107.00 2
Signature of Supr, Elec'n 0 - Over 600 amps to 1000 volts,
I see "b" above.
License No. r-ity _Exp.Date Jut 0 1 b 1 4d. Branch Circuits
Phone No. " 0 ( New, alteration or extension per panel
• a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Each branch circuit $ 5.35 2
Print Owner's Name b) The fee for branch circuits
Address - - without purchase of service
City State Zip or feeder fee.
First branch circuit _ $ 37.50
Phone No, _ Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4c. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or Irrigation circle $ 42.75
Each sign or outline lighting _ $ 42.75
Owner's Signature Signal circuit(s) or a limited energy
panel, alteration or extension $ 60.00
3, Plan Review section (if required):* Minor Labels (10) 5 107.00
Please check appropriate item and enter fee in section 58. 4f. Each additional inspection over
the allowable In any of the above
4 or more residential units in one structure Per Inspection $ 50.00
Service and feeder 225 amps or more Per hour _ $ 50.00
System over 600 volts nominal In Plant _ $ 59,00
Classified area or structure containing special occupancy as Jam. Fees:
described in N.E.C. Chapter 5
Enter total of above fees $ , •
* Submit 2 sets of plans with application where any of the above apply. 3' a. ste, Surcharge (,05 X total fees) S -
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 5
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Trust Account # 9?'
'
AT ANY TIME AFTER WORK IS COMMENCED, Total balance Due $ @
i.' \d .iw \roans \lrc1ric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requeste �"� �i s D AM PM BLD
Location / 9� / Z - Suite MEC
Contact Person Ph S79 - 7/9/ PLM
Contractor SG Ph SWR
BUILDING ; _ ; . Tenant/Owner P(74 c(9-(X-S • ELC „2000 06 /9
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 -�- C2
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
P FAI L
ECTRICAI T
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
A$ 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
Other Date • ' Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.