Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00598
_A ''' I, DEVELOPMENT SERVICES DATE ISSUED: 10/24/00
� 'i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S114AC -00700
SITE ADDRESS: 17005 SW 92ND AVE
SUBDIVISION: COOK PARK ZONING: R -4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one (1) branch circuit.
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:
TIGARD, CITY OF TEAM ELECTRIC CO
13125 SW HALL 9400 SE CLACKAMAS RD
TIGARD, OR 97223 CLACKAMAS, OR 97015
Phone: Phone: 557 -7180
Reg #: LIC 004733
SUP 1819S
ELE 3 -225C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT CTR 10/24/00 $46.85 2720000000( Elect'I Final
5PCT CTR 10/24/00 $3.75 2720000000(
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 -1987. n
PERMITTEE'S SIGNATURE /� 77, — �� L�� ISSUED BY: l �
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
e
Iii Iii !Ill '111' I , ! \t. .,1!:1 . I'!t,ti t :l 1'1 (H. •f IG\i JUu
r:. � � '' '- '
Flectr•icaI Permit Application '
— -- - - -- ��_ Dale received: /d //7/� Permit nu.: Elm' 20ap `ODS9,'
�' City o I igai'(I A 6G ProjccU:tppl. {{ Expire date:
(7t';;,17),,zard Addt.':;. SW I lall I�J
11\. tt :artl. UII P Dale issued: liy: Receipt no.:
fax • 1 50,;) it)�l- 19h0 0 w ��0 Case filers.: Payment type:
Lati'I It.Ce ippr val: - -- 0
0
r ,
t f iiA v 4� t : , k :. � } 4', ,4'ili 4r- 2i ?f PA QTY E.011. PERMIT � `� .: [ 1 y �6 Yd i 4 p
Ls _ r .. > % i .. ,.
-• 4 - _ ..x t` : :. t 'r sas, \ ; , f,'47 ,J „ r , ?,' •
t .:] i C. 2_ famtl\ Ow ....‘11i= nr :IL Ce ssnl'. A Commercial/industrial U Multi- family U Tenant imp overman
I Li ,N;rty (: rI .rrtic :ion J Addition/alteration/replacement U Oilier - CI Partial l
r , r.' i . ^? 1 g a" stir r - s s;e t
rt r v ' 41}�y,,,, -,{ xt r 1 3.t t t lJOB SITE INFORMA_ TION --.:,:t7'..".. 1 r
a,, TZ'r , = Y 1l ,l.,i, r r � f:s, . S' t r 3� r X.
1 ) ad ticss. .� t
110 -
----- - -- - SCE I Z _ C ___ . ____._..__�_- Bldg. no.: Suite no Tax Wrap /tax lot/account n, r. - -_
L, o: I hl� I Sululis i iot .
I'rolecl name: -1 i)c,,,npticin and Incatton of w ork on premises: -- 1
� Estimated date of Ci;n,l !:'11,9r/(i1;l
` „,s='=1'1="..'7,.=- ` ' y, ' . qa . #' t ItNl .:.._ OR APPLIC 'IO)ri,, ... : FEF;'SCHEDLLE . ° g { s F ;
k ..s .
! .101) 1141. ^ , , :.. . .�. .Fi. :'t;•
J Ol Fee Max
ltusincss ram': - �
Descript Qty. (ea.) Total no. insp
��” •- ` u New residential -single or multi - family per
r Address: C � - . _ dwelling mrit Includes attached garage.
fH.'jty: i __ -. -__ Stab•• 71 , C (� Ser•viceincluded:
( I'hrntc: -1 Q J S 5-7-S21•j J, I. tttail_ I000sy.fLOr �_ 4 —
Ilay:
COI It rn?.: Elec. . hu :. lie. no: % � 7 Each additional 500 sq ft or portion thereof
j - -- -- - - -- -- s"' ^J`� • I.imitcdenergyrresidential 2
I C_IIyhitClrit Ii[•. tie' : g 275 - /0� O/ Limited energy. non- residential - 2
1,c �_- Each manufactured bonne or rnodular dwelling
i �tgnarure cf cups - viisl e a :!c_:
r nc i t (iC 1111re_d )__ - Dare /0- ■OC) . . Service and/or feeder 2
c.;,.,,,. leer tt 1 1 `' Services or feeders- installation.
f Mu�Q \ �,t, 4'Qr 44 License m '-1 1 10
t i n f alteration or relocation:
,:.•,11,;.::,.•4.:73?.: ,1 r�� , no PFient O%Nri ,
'... -n.:_ _ : -,_.?z >... ,: __4 00 arms or less 2
Name (ptilil). 201 amps to 400 amps
- - -- - 40 I amps to 600 amps 2
I \•failinlr address: --
-- -- - ---- -- -- - - -- — ' r;01 snips to 10(1(1 amps 2
C: Slate: ZIP: Over 1000 amps or volts 2
r-
- I'h one: F ax: L -mail: Recum\ectunly I
- -
--
O \viler insta!iuttnn: 'I h• itioall;ttintf "is being made on properly I own Temporaryservicesorfeedern-
%vch is nt tntcnticd (••r S;t1 , lease. rent. or according to installation, alteration, hj
2011 am s or less 2
t')1 ?1 4_17 ..15:'S..17 '). h '•, 701. p _.
201 amps to 400 amps -^ 2
t t\xnu s sit n lint Date: 401 to 600 snips 2
Iyr `. . r ; . i vz . ) : ' i•'y� ,J ' ..' �t . OiNt,G _, c -.. , „... r . �...,, Branch circuits- nen,:lteration. 1
or extension per panel:
---------------- .- ..-- --- __ --------- - - -.__ A. Fee for branch circuits with purchase of
,'\ddt` ss • _ _ _ _ _ _ service or feeder fee, each branch circuit 2
City: - i I State: LIP: B. Fee for branch circuits without purchase
t ! - -' - -- of service ur feeder fee. first branch circuit: 2
I'honc Fax I mil - - -� --
. wr . Each additional hranch circuit:
' 4I a ' `Ia ∎'iiitt�ci -i ii1 lt>hat ........ I ' , ( ) -- - _ti * * I �� lise. Seniceorfecder,notincluded :
.I Service o .ver 2'S.i :; : - ; UI{eatri:.imefacility Each pump or irrigation circle 2
J S,•.r- ;iec o _2,_Uau.ps.l of i,C'C U Ih,r,t 1 Each sign or outline lighting 2 —
family )'.v. lli :, J nuilJint over I u,ODU square feet feuror I Signal circuit(s) or a limited energy panel.
- 155e rn ti' :er 6t1') \l`!ts 11. mere ress ri? ill units iii one structure I alters Lion, or extension` 2
Lujlshng over I :110.; ...in e' U Feeders. 41111 :nup.s or more . Description: _
t •J Occupant load es',:t 5 pei, rt U N1,,nut.,ctutcd structures or RV park Fach additional inspection over the allowable in any of t_ he above: -
i '-.1 Lgressilightine plan U Other: Per inspection --
Submit -__ _ _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
• � N: , ,! t ; irJ�: • caI! ju;icd :en••n 1. pave inf - Permit fee $ -- - - - - - -
:Ili lifri, icti `n: ,1J t ^, i Icy ,, -�
Notice: phis permit application
_I \ iOa U Ni.:=t.•;('arl expires if a i.emiit is not obtained Plan review (at ";'o)
( earl nuq,tsr - ___ - -- ... -- __ - I _ State surcharge ( 8 within 180 days after it has been (8%) .... $
-
�/lt�
Epic P P TOTAL $ 50
Nam:. i f : m•11;,.j,!.9 ;, _ --- _ _.__ <'; -; •:n rndi
1 err r ca4) accC ted as com lete.
—
: S
i Car,!h,JJc, ■ a..n al , \___ __.__.._ .-_ - _e i fg0 1 P e 4-10-1615 16.CreCO\4.
I0 Iu 011 v11i. i i . I vA 2ti3 :,II,,,, 1' t: I 11 lll• 'I I G.1Itl) LLJ ut "'
Electrical Permit. Fees: Limited Energy Fees:
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 I Check Type of Work Involved
Residential - per unit
1000 so. ft or less 514j I5 ___ 4 I l Audio and Stereo Systems
Each aticttinnal ;>CiC so. II
portion the'e:c•' _ S. ,1 0 1
n Burglar Alarm
Limited Energ $7J CUt)
Each Mane(' H)ino 1. :1
S90 9u 2 Garage Door Opener'
f ?welling Ser'�, ice 0" Fee:: __ -- �
Services or Fnedr_re n Heating, Ventilation and Air Conditioning System"
In;t4Hatinn, alteration or r.;l. :a'i. :v,
200 amps or less $80.30 2
201 amps to 0i ,,,,tl s _ - -_ - $100.85 _ -- -- 2 Vacuum Systems
- 101 amps to 600 mp= $160 8.1 2
<:
GUI amps l0 1 VI'.J rrh: ; ZQtt 5C; 2 ❑ Other
- -
Ov 1000 am, ^5. or vc'i•O — 5454.1.;.5 2
Reconnect only -- $60.85 2
Temporary Servir.es or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Ir.:aaltaton, altel;tio" or r- ,ncahr,n Fee for each system $75.00
200 amps or iesc ___ — S6C s5 2 (SEE OAR 918 - 260 -260)
201 amps to 400 a:np _ S100.30 2
401 amps In 600 a•np> — 8133.75 2 Check Type of Work Involved:
Over Goo amps to , 05( -0k, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑
New. alteration so e.t000.,, t,e, panel Boiler Controls
a) The fee ror branch ci
with purchase ofscrorec. or l l Clock Systems
feeder fee.
Each branch ;;ir;. li; --
56.65 2 ❑ Data Telecommunication Installation
b) The fee ter l: rar. a l_
without purc; ;o of;;Qr.irc I
�� Fire Alarm Installation
Or feeder lr n,
rnh c 4 � • .
First bra_ , li0 - asG 8`, l
Es, i, add'linnol , hr:an'; , miri , !t St' HVAC
Miscellaneous I I Instrumentation
(Service or feeder not rru.hlccd)
50■0 pump or irri atir.n t :i•r.'r;m $53.40 10 Each sign Cr cutl li;lhir g $53 40 _- - Intercom and Paging Systems
Signal cucuit(s) or a limited corn;
panel, alteration or exiC,u _ $75.00 n Landscape Irrigation Control*
Minor Labels (10) —. $12500 `
Each additional inspection over l l Medical
the allowable in any of We above
For inspection 562.50 ❑ Nurse Calls
P sr hour S52 50
In Piant 973.75 U Outdoor Landscape Lighting
Fees: „ l l Protective Signaling
Enter total of above fees S 44/2 Other ' State Surcharge S —
13",,;13",,;:, 3 x .86 __—
V Number of Systems
25°1, Plan Review Fee
(
See "Plan Re. vie.. sect on S No licenses are required. Licenses are required for all other installations
front of apps »canon
Fees:
Total Balance Due $ 50,, 60
Enter total of above fees `D.— _____— .___-_..
j ❑ Trust Account - __ - 8% State Surcharge $`
Total Balance Due $_�
t : "dsrs \forms'ete- fces.oiuc lit o') 11(I
•
CITY OF TIGARD BUILDING INSPECTION DIVISION \ 0n
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 3
BUP
Date Requested //•- / 8-0 AM PM
BLD
Location / � ofl� �->�� �,�/� Suite MEC
Contact Person I L Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC , - 9oY9ff
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: �K �',2
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler :r
Fire Alarm
Susp'd Ceiling
Roof
c&
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
S FAIL •
ELECTRI
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fi
PART FAIL
SITE
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 // - D D Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
, Date Requested 7/) 3� AM PM BLD
Location / 7G 05 5A) 9Z / "? Suite MEC
Contact Person Ph 53 7 - 45 y PLM
Contractor
7L--1161".°1-1- Ph 2/ ED SWR
BUILDING Tenant/Owner ELC v ) 5'lp
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
PAS RT FAIL •
LECTRICAL
Service
Rough In
UG /Slab
Low Voltage
F' a Alarm
Final •
ASS PART AI
SITE
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 Date • .
D a
Other • Inspector Ext
Final
PASS PART FAIL D • NO REMOVE this inspection record from the job site.
BUP -.Building Permit ELC - Electrical Permit
Ins "•pection Description Date Passed By I Inspection Description Date Pasted 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 /1_ / - y
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 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 4 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
BUP - Fire Protection System Permit
4 Inspection Description Date Passed By
Y 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
4 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 ®F TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC2000 -00598
*- .14 DEVELOPMENT SERVICES DATE ISSUED: 10/24/00
+L " 1 3 125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 25114AC =00700
SITE ADDRESS: 17005 SW 92ND AVE
SUBDIVISION: COOK PARK ZONING: R -4.5
BLOCK: • LOT : JURISDICTION: TIG
Project Description: Installation of one (1) branch circuit.
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:
TIGARD, CITY OF TEAM ELECTRIC CO
13125 SW HALL 9400 SE CLACKAMAS RD
TIGARD, OR 97223 CLACKAMAS, OR 97015
Phone: Phone: 557 -7180
Reg #: LIC 004733
SUP 1819S
ELE 3 -225C
FEES Required Inspections
Type By Date Amount Receipt
Elect's Service
PRMT CTR 10/24/00 $46.85 2720000000( Elect'l Final
5PCT CTR 10/24/00 $3.75 2720000000(
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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.
PERMITTEE'S SIGNATURE d . - , p - 7 0 / ) ‘ / . . � ( _ A , 7 ‹ 4 7 , 4.6 . ISSUED B Y : / c 6 , 7 - ) , uI . O
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:
1/ 4 1
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
Ihi
LICENSE NO: A
Call 639 -4175 by 7:00pm for an inspection the next business day
ogi