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Permit
CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00433 4 DEVELOPMENT MENa Tigard, (503) 639 -4171 RVICES DATE ISSUED: 07/28/2000 SW PARCEL: 1S135AB-00100 SITE ADDRESS: 10255 SW 90TH AVE SUBDIVISION: TOWN OF METZGER ZONING: R -4.5 BLOCK: • LOT : 005 JURISDICTION: TIG Project Description: Installation of service /feeder and signal circuit or limited energy panel. 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: 1 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: ATLAS ELECTRICAL CONTRACTORS 4403 SE ROETHE RD MILWAUKIE, OR 97267 Phone: Phone: 659 -2212 Reg #: SUP 2581S LIC 00001532 • ELE 3 -2C FEES Required Inspections Type By Date Amount Receipt Elect'l Service PRMT DLH 07/28/200C $124.25 0004067 Elect'l Final 5PCT DLH 07/28/200C $9.94 0004067 • Total $134.19 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 a re 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 0-f ,f -f fi r, X04 ISSUED BY: ..1/9X4/ 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 CI,TY O'F TIGARD Electrical Permit Application Plan Check # 13125 SVv HALL BLVD. Rec'd By TIGARD OR 97223 RECEIVED Date Rec'd ( V Date to PE. Phone (503) 639 -4171, x304 � ection 503 639 -4175 2 4 2000 Date to DST Inspection ( ) Print of Type Permit # C�c2aao - 4 Fax (503) 598 -1960 Incomplete or illegible will not Wing Called called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Metzger Elementary Metz Elementar Number of Inspections per permit allowed Name (or name of business) Metzger Elementary Service included: Items Cost Sum Address 10255 SW 90th Avenue 4a. Residential - per unit City/State/Zip Tigard, Oregon 97223 - woo sq. ft. or less $ 117.75 4 ry p Each additional 500 sq. ft. or portion thereof $ 26.75 1 Commercial ® 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 Electrical Contractor Atlas Electrical Contractors, Inc 200 amps or less 1 $ 64.25 $64.25 2 Address 4403 SE Roethe , '':.: , ; ":.= . - -. , 201 amps to 400 amps $ 85.50 2 Milwaukie State OR Zip 97267 401 amps to 600 amps $ 128.50 2 City 601 amps to 1000 amps $ 192.50 2 Phone No. 659 -2212 Over 1000 amps or volts $ 363.75 2 Job No. 8013 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 3 -2C Exp.Date 10 /1 /00 4c. Temporary Services or Feeders OR State CCB Reg. No. 1532 Exp.Date 9/3/01 Installation, alteration, or relocation COT Business Tax or Metro No. 2432 Exp.Date 11 /1 /00 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, License No. 2581S Exp.Date see "b" above. Phone No. 659 - 2212 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 $ 5.35 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. / y /j�,, -1C , (Service or feeder not included) /� /Vl�// a..t.`' Each pump or irrigation circle $ 42.75 Owner's Signature 1 Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy 3. Plan Review section (if required):* Minor alteration or extension 1 $ 60.00 $60.00 nor Laa 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. Chapter 5 5. Fees: 5a. Enter total of above fees $ 124.25 * Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ 9.94 Not required for temporary construction services. Subtotal $ 134.19 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 # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 134.19 is \dsts \forms \el ectric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3 ) AM PM BLD Location / O Z 5-"c f 4" 9O Suite MEC 3 Contact Person Ph Cfl ZZI`Z/ PLM Contractor Ph SWR BUILDING - „ Tenant/Owner ELC 2-ou o . O ( C/33 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 ✓ / _ / I / Drywall Nailing h / r )? P t 4401 s-c- �1J ( e Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final � / P ASS PART FAIL r PLUMBING 4 13( Post & Beam Under Slab Top Out Water Service '6%/ Sanitary Sewer / ! Rain Drains c� Final PASS PART FAIL s MECHANICAL Post & Beam / f V Rough In 6\11 Gas Line Smoke Dampers Final \ .1 PASS PART FAIL ` --� LECTRICA - j Service Rough In UG /Slab Low Voltage Fire Alarm PASS 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 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 9/7 0" AM PM BLD Location ✓ Li do/ = Suite MEC Contact Person Ph PLM Contractor �/1' � Ph SWR / BUILDING.. ." Tenant/Owner (` 74 Z 6 i( iC � ji•P�,`l / ELC ©CD �- O , L33 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 `1iL _ J _ :v_. . 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 PA T FAIL E TRI c 1 In C UG/S G /Slab IC.GI Low Voltage Fire Alarm Fina • 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 ge /7 "19 Inspector /� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 6394175 Business Line: 639 -4171 MST BUP Date Requested r- "2 AM PM BLD Location /0 3 & fv Suite MEC Contact Person Ph G3.-f Zzf Z s PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Gel/ 33 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 OA Q e KQ I-4 _ tJ d 4 s S Fire Alarm Ceiling Roof Misc: ` ,411 Final l!'" PASS PART FAIL L`Ut PLUMBING VI I A Post & Beam Under Slab Top Out Service C'V Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final • yeec P RI FAIL ervice> - Rough In UG /Slab -& d `. Low Voltage yYbv -/ Fire Alarm Fi. - 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date a 7 7 DD Inspector ir - A 4eA " -------- Mxt Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.