Permit • CIT 1 OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00233
,04, Atoolifer DEVELOPMENT SERVICES DATE ISSUED: 05/05/2000
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: Install 1 service /feeder 200amps or less.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 0 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:
Owner: Contractor:
TIGARD, CITY OF PHOENIX ELECTRIC CO
13125 SW HALL 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288 ORIGINAL
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT KJP 05/05/200C $64.25 0001972 Elect'I Final •
5PCT KJP 05/05/200C $5.14 0001972
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 o 'red 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: f% `f O S
Call 639 -4175 by 7:00pm for an inspection the next business day
MAY -05 - 00 FRI 02:04 PM PHOENIX ELECTRIC CO FAX NO. 15036843611 P. 02
Cl Y OF TIGARD Electrical Permit Application Plan Check # •
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd
Phone (503) 639 -4171, x304 Date to P.E.
Date to DST
Inspection (503) 639 -4175
Print of Type Permit #C Lr. a.c000- v;, 7-33
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Ct.!.1_ c "., S 1 J Number of Inspections per permit allowed
Name (or name of business) iJ3M, Service Included: Items Cost Sum Z
Address L 1 c"1 ) C �� ,� 4a. Residential -
perunit
City /State/Zip t1 9 a 1000 sq. R. or less $ 117.75 4
c � �' (� - - -i- I E ach additional 500 sq, ft. or
thereof
6,2
Commercial Residential El Limited portion Energy $ 620.00 5 1
t7
` -ftsJ'
AA. L , Each Manufd Home orModular
$
2a. Contractor installation only welling Service or Feuder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b_ Services or Feeders
information for COTda , base). Installation, alteration, or relocation )/ _
Electrical Contractor- _ - ,, ��`L. 1 200 amps or less I `s 64.25 t/0 7• a5 2
Address i '.1,_7•1_,,1 S -0_0 ti •.e -(,/ 1i 201 amps to 400 amps $ 85,50 2
city State �kZ , r} ��.� Zip (� 401 amps to 600 amps $ 128.50 2
,/ 601 amps to 1000 amps S 192.50 2
Phone tel n S tr ( \.) Over WOO amps or volts $ 363.75 2
Job No. }e 3 )— . Reconnect only - $ 53.50 _ 2
Elec. Cont. Lice. No. ' e -' C-- Exp.Date r - - 2- OO 4c. Temporary Services or Feeders
OR State CCB Reg. No. ,., `3' ..-i, / Exp.Date )41,3/103 /2U3I Installation, alteration. or relocation
COT Business Tax or Metro No. , pt/) Exp.Date _ 200 amps or less • $ 53,50 2
- 201 amps to 400 amps $ 80.25 - 2
Signature of Supr. Elec'n t e C 401 amps to 600 amp - $ 107.00 2
Ovor 600 amps to 1000 volts,
License No /4 Exp.Date 1°1 al (0 I see "b" above.
Phone No. _ Q ^ ��. 6/ 4d, Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase or service or
feedor foe.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State • Zip , or feeder foe,
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 $ 80,00
Minor Labels (10) $ 107.00
Please check appropriate item and enter fee In section 58, 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. Chapter 5 5. Fees: •
pa. Enter total of above foes $ C,e,
* Submit 2 sets of plans with application where any of the above apply. 8y/a Sao Surcharge (.0RX total fees) $ .
Not required for temporary construction services. Subtotal $ v
513. Enter 25% of line 5a for
NOTICE Plan Review if requited (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 FORA PERIOD OF 180 DAYS Trust Account # ,. •
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ __6_2d2
j ;\ ■1 is \! \electric. due
1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
�
Date Requested 1 / 00 AM PM BLD
Location ) ? Ob ' ( v � - -� 111 for Suite MEC
V
Contact Person ! Ph (64 -31ocZ PLM
Contractor Ph SWR
BUILDING Tenant/Owner eJY7e.-- 12 ELC `iorr)-002 R2
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain •==•2c "' SS P �-- �-c�°�
�I
Crawl Drain Inspection Notes: JJJf,,�� D�q SGN
Slab Iw �/( (�v I - 328 2- SIT
Post & Beam Q
Ext Sheath /Shear (AL( 1 0
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall et. It-7
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: -
Final
PASS PART FAIL f:;;Vg-''‘IC2-3 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 PA FAIL
LECTRIt
Service
Rough In
UG /Slab
Low Voltage
F' a Alar
Fi
P 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 (!/ Inspector Ext
Final
' PASS PART FAIL DO NOT REMOVE this inspection record from the job site.