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Permit
�� CITY OF TIGARD ELECTRICAL PERMIT • PERMIT #: ELC1999 -00661 f DEVELOPMENT SERVIC DAT I SSUED: 11/04/1999 '-- I " 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB-00100 SITE ADDRESS: 10255 SW 90TH AVE SUBDIVISION: TOWN OF METZGER ZONING: R -4.5 • BLOCK: LOT : 005 JURISDICTION: TIG Proiect Description: Install (1) 200 amp or less Service /Feeder and (1) signal circuit/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+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL: • Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: TIGARD - TUALATIN SCHOOL DIST ATLAS ELECTRICAL CONTRACTORS 13137 SW PACIFIC HWY 4403 SE ROETHE RD TIGARD, OR 97224 MILWAUKIE, OR 97267 • Phone: Phone: 659 -2212 • Reg #: SUP 2581S ORIGINAL LIC 00001532 • ELE 3 -2C . • FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT KJP 11/04/199 $107.00 99- 319533 Elect'I Final 5PCT KJP 11/04/199 $8.56 99- 319533 • Total $115.56 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. PERMITTEE'S SIGNATURE ISSUED BY: X 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 f� SS�TALLA TION ONLY SIGNATURE OF SUPR. ELEC'N: (, CGVL�t� -� • DATE: i / //?,' LICENSE NO: / 32--' Call 639 -4175 by 7:00pm for an inspection the next business day . Community Development ELECTRICAL PERMIT APPLICATION A '61 9-1- 13125 SW Hall Blvd. % ,��oj Tigard, OR 97223 Planck/Rec. # ��" � +1'^ I'i p� v �� ���� N Phone 503 639 -4171 ��' Permit # £LC (l 0O( j CIT FAX GARD FAX (503) 684 -7297 Date Issued TDD No. (503) 684-2772 Issued b Inspection (503) 639 -4175 . 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Metzger Elementary Number of Inspections per permit allowed Address 10255 SW 90th Avenue Service included: Items Cost(ea) Sum City /State/Zip Tigard, Oregon 97223 4a. Residential - per unit 4 1000 sq. ft. or less $110.00 - Each additional 500 sq. ft. or Name (or name of business) Metzger Elementary portion thereof $25.00 1 Commercial © Residential ❑ Limited Energy $25.00 - Each Manuf'd Home or Modular 2 Dwelling Service or Feeder $68.00 - 2a. Contractor installation only: 4b. Services or Feeders Installation, alteration, or relocation � ' Z5 2 Electrical Contractor Atlas Electrical Contractors 200 amps or less 1 $60.00 2 Address 4403 SE Roethe Road 201 amps to 400 amps $80.00 2 Mi lwaukie St ate OR Zip 9 7267 401 amps to 600 amps $120.00 2 City P sot amps to 1000 amps $180.00 2 Phone No. 659 -2212 Over 1000 amps or volts $340.00 2 Contractor's License No. 3 -2c loll ii-on Reconnect only $50.00 Contractor's Board Reg. No. 517 4 / /?4.16.1 4c. Temporary Services or Feeders _ I alteration, or relocation 2 , Signature of Supr. Elec'n . 1 4 . :yam__ 200 amps or less $50.00 2 License No. Phone No. 6 9 -2212 201 amps to 400 amps $75.00 2 / f 401 amps to 600 amps $100.00 f01 0l I Over 600 amps to 1000 volts 2b. For owner i st nations: see If above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per panel Address a) The fee for branch circuits with purchase of service or feeder fee. 2 City State Zip Each branch circuit $5.00 Phone No. b) The tee for branch circuits without The installation is being made on property I own which is purchase of service or feeder fee. 2 First branch circuit $35.00 2 not intended for sale, lease or rent. Each additional branch circuit $5.00 Owner's Signature . 4e. Miscellaneous (Service or feeder not included) • 2 3. Plan Review section (if required): Each pump or irrigation cirda $40.00 2 - Each sign or outline lighting $40.00 Signal circuit(s) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension 1 $40.00 $.4:00 X2. 4 or more residential units in one structure Minor Labels (10) $100.00 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N.E.C. Chapter 5 Per inspection $35.00 - Per hour $55.00 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: • NOTICE 5a. Enter total of above fees $ 1- 66:60' /0 ,00 5% Surcharge (.05 X total fees) $ 3 PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter ta l of line A for $ 19� II 5.5 AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan Review if required (Sec.3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ Balance Due $ 108:00 11 S. Sk wad\wmdmm.wnAv CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 HA-71(19 BUP Date Requested HA-7 t -/ AM PM BLD Location /O S� ' �{,) q 0 Suite MEC Contact Person At(& get . Ph (2S /- )-alb. PLM Contractor Ph SWR BUILDING Tenant/Owner r -Z l e" � S C:K -frU I ELC �f 6 0 Retaining Wall f ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Slab Inspection Notes: th _Leal/kr SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing : � / _ • ��_ L ; S Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Lop A Final PASS PART FAIL 4 41 _ 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 FAIL ECECTRICAL Rough Rough n UG /Slab Low Voltage Fire Alar d e r • - T 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 f Other Date 1 I (/ — Inspector /// / J_ 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 /(I (?'( Q G i AM PM BLD Location / D› SO C Suite MEC Contact Person ` +(& EI.e V L CJ Ph & 5 a - )' PLM Contractor Ph SWR BUILDING Tenant/Owner t 2/ delii - • ELC 145 - (0 4 ( 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 �/' (, q( — /('. - 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 s ELECTRICAL Service Rough In UG /Slab, Low Voltage Fi — larm ,e0 ART FAIL • � /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 ii / a — q 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 (I lJ (' / c� AM PM BLD Location itgEr 16,,155 Suite MEC Contact Person 4 L— L e .C� Ph 4 'S 4 I ' L PLM . Contractor - Ph SWR BUILDING Tenant/Owner LL Zr_ ��/Yt� e'"i ELC 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 EICAL ( Rough In UG /Slab Low Voltage Fir • nal PAS ART FAIL ITE Ba ill /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: s pect no access ADA / 6 Approach /Sidewalk Other Date -- Ins •o 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 Lin 39-4171 3 � � //-2.—, BUP L9O - lob Date Requested / 1 AM PM ■ A BL. 1,0P _ .004/3 Location / 0 i (CS 96. Sul MEC Contact Person • .DY fr Ph QY J « / PLM Contractor Ph SWR UILD! Tenant/Owner giir2 6.: ®i lII (• . E C \ 06(Q.43 / Retaining Wall Zt,- lj'ELC t"\ `1 `� - ©U to LQ Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: ff rr,, Slab Post & Beam SIT \ `"6[ - 6 0 0 6 �1 Ext Sheath /Shear Int Sheath /Shear ' ` (� q � � ] /� Framing 1,� d� J U l (,- \ -- 6__A---t Insulation r - 1� �� �� / , C Drywall Nailing VCA NT 1 l �i\ rD Fire Sprinkler ( ls /\ �`► -�`,v f1f\ rte`- v-� 05 `C Fire Sprinkler Fire Alarm " Y� _ 1 ©( 3 ( 4 C�. C `a Susp'd Ceiling (` J S J —^ Roof (, 4 v 42.�,/• , / _ () Misc: _ � �"�✓ �.t - l.�x ciriD PASS PART FAI • i `� r r _ i .,i -- - _ , - - r . '41,, . _ rte. ' . ' - o < -- PLUMBING Post & Beam � (CT? �.J�.1 -' Under Slab / 1,,,.y') 4 - 1 T tCkC) - 0-0 ( 4 J u - u--) Top Out % 4-c_ �' L1/\ 5 V' L k �`- Water Service Sanitary Sewer Rain Drains -' Final _ PASS PART FAI A l , �- 4.- MECHANICAL \ -e ms \ t' �0 t� " 1'M `` Post &Beam ,! �• - - � • Rough In / 1 _ O _A_,IA./� 7J -A..�m [��l `-e ✓ Gas D �; Smoke e Dampers i , ► i 0" d - ✓J 1 . Final - _ - � - PASS PART FAIL ,kr . ems �/, ` ' . . ELECTRICAL / � ^ Service -] L �� c.-� V� ck �- ' V Rough In ` � UG /Slab l t Q/) . c �L� CA'). l� r t� � c✓v V 1 L V \ c Ar () ?, Ji\ 4 1 �. Fire Alarm ` � � �-'�� � � � �- C./L., C tiL '� t b -� 1_ PASS PART FAIL ? , i l'CJ`' SITE Z7`klir { ' S acktill ry Sew � C I � c �, „,,, • Sanita Sewer k l, � L Storm Drain [ VAkA pectic) 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 9 Approach /Sidewalk ` '? Other Date \ 0 /1 1 1C1 Inspector V (/� Ext Final PASS PART FAIL !D DO NOT is ins \e t� ion recorc rom the job ii e. � . N �- ►^- vt-)-e--! , 1_,..e-t\- , .52_