Permit i
• , CITY OF T ELECTRICAL PERMIT
4 DEVELOPMENT SERVICES PERMIT #: ELC98 -0701
DATE ISSUED: 12 / 03 / 98
�- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
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PARCEL: 2S102AD -02200
SITE ADDRESS— . :08900 SW BURNHAM ST
SUBDIVISION - BURNHAM TRACTS ZONING :CBD
BLOCK LOT...°..... .... :006 JURISDICTION: TIG
. Project Description: Installation of service and branch circuits.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 - 200 amp ° 0 PUMP /IRRIGATION ° 0
EACH ADD'L 500SF...: 0 201 - 400 amp—e....: 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY : 0 401 - 600 amp 0 SIGNAL /PANEL ° 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp......: 1 W /SERVICE OR FEEDER: 11' PER INSPECTION.....: 0
201 - 400 amp - 0 1st W/O SRVC OR FDR.: 0 PER HOUR - 0
401 - 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT ° 0
601 - 1000 amp 0 PLAN REVIEW SECTION
1000+ amp /volt.....: 0 > =4 RES UNITS........: ) 600 VOLT NOMINAL..:
Reconnect only ° 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: •• - - - -- FEES
NEXTEL type amount by date recpt
8900 SW BURNHAM PRMT $ 115.00 DLH 11/25/98 98- 311101
TIGARD OR 97223 5PCT $ 5.75 DLH 11/25/98 98- 311101
Phone #:
Contractor: -
OREGON PACIFIC ELECTRIC INC $' 120.75 TOTAL
PO BOX 3040
REQUIRED INSPECTIONS
CLACKAMAS OR 97015 Ceiling Cover Elect'1 Service .
Phone #: 656 -7232 Wall Cover Elect'1 Final
Reg #...: 128019
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules.are set forth in OAR 952-1.-10 through OAR 952-0017,A;7. You lay ob
of these rules or direct questions to OUNC by calliig (503) '. -1987.
Permittee Signature: A, Issued By: ,dahr,
40101114111111■ C:141„,
NIV
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 :00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
- 11/23/98 MON 15:14 FVEMINEOD.960 CITY OF TIGARD Ij002
CITY OF TIGARD PS
1312 SW HALL BLVD NOV U 199E1ectrical Permit Application Plan Check
Recd By - Lh`
TIGARD OR 97223 COMMUNITY DEVELOPMENT DateRee'd /�f
Phone (503) 639 -4171, x304 Date to P.E. -
Inspection (503) 639-4176 /` 7 Date to DST -
Print o f T y p e Permit # &7.._e- 9, -- 0 70/
Fax (503) 598 -196EI
Incomplete or Illegible will not be accepted Called S - 7 --- 1/ -- •� fzs�j
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development
Number ot illeirettkme per penile allowed
Name (or name of business) r J C aL-i I- Service included: Items Cost . Sum 4'
Address ( 4 0 S W I ca n. 14-A Vv . 4e. Residential - per unit
g►Y P A n to D 2 51 '12-3 1000 Each additional 500 sq. ti. or $ 110.00 4
Commercial r= thereof
Residential ❑ limited y $ 25.00 1
$ 26.00
Each Manufd Home or Modular
2a. Contractor installation only: Dweang Service or Feeder $ 68.00 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
Information for COT data base Installation, mermen, or relocation
Electrical Contractorb czec f r 4c1 t . t C. r I. - 3c. - C (L► C 200 amps or fess I $ 00.00 (O o 0 2
Addre e0 (3.0X 3 201 amps to 400 amps 3 80.00 -' 2
_ CAm AS State D 2 T.tP c 7 O ► 401 amps to 600 ernes 3 120.00 2
Phone No. S I '1 C7 601 amps to 1000 amps $ 140.00 2
Job No. aver 1006 or volts $ 340.00 2
Elec. cont. Lice. No. 3 - 43q e Reconnect only $ 80.00 2
Exp.Date t O O 1 9 ✓ 4c. Temporary Services or Feeders
OR State CCB Reg. No. i 2. 8 2. ' O lc( Exp_Date ' _ oo !/ Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.D 200 �s or lass
amps $ 50.00 2
2 D 1
Ll/ i l 1 .nom � $ 75.00 2
Signature of upr. 4: titr:s_ ..;,....1 i 401 amps to 600 amps $ 100.00 2
License 4z5' S �6� ate , votes,
Ex p. D ate ( I c g
Phone No. - 4d. Branch Circuits
e 6 ,1 � tier+7� inn u t New. alteration or extension per pane)
a) The tee for branch circuits 2b. For owner installations: A ve.o% with of service or
Pratt Owner's Name 9.3��. LAGA. / / /zs/i �' Each branch circuR I I $ 5.00 SS 00 2
Address b) The fee for branch circuits
without purchase et service
City State Zip to feeder lee
Phone No. First branch circuit $ 35.00
Each additional branch Gaut $ 5.00 •
The installation is being made on property I own which is not 4e. Miscellaneous .
intended for sate, lease or rent. (Service or feeder not included)
Each pump or ini
Owner's Signature Each sign or Guthrie lighting $ 40.00
Signal dreult(s) or a handed energy `TT
3. Plan Review section of required):* Minor Labe (loon or extension $ 100.00
Please check appropriate Item and enter fee in section 5B. 4t. 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 1 hour inspection $ 35.00
System over 600 volts nominal In Plant $ 55.0 55.00
Classified area or structure containing special as .
$
described In N.E.C. Chapter 5 S Fees:
* Submit 2 z of 6a. Enter total M above tees $ 1 I S''
i with appttu ten where any of the above apply. 5`X. Surcharge (.05 X total tees) $ S- -r s
Not required for temporary construction services. Subtotal $
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NOTICE 6b. Err 25% of fine 5a for
Plan Review i mgi a (Sec. 3) 5
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED SuDtot� $
IS NOT COMMENCED MINN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS 0 Trust Account*
AT ANY TIME AFTER WORK IS COMMENCED. Tel balance Due $ I "),0 s7 S •
cidststfaimsletecu ic.doc
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
�6 /( // 7 Date Requested 72 - f 7-9 � AM PM BLD
Location Ug� 08(An 7 ita/n J —
' i Suite p MEG
Contact Person : Ph _I PLM
Contractor OP-, /FfC ff C' Ph SWR
N 1
BUILDING Tenant/Owner � � W// ST o 070 /
Retaining Wall / 4i - /(./TY S /7ELR
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
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
Service
Rough Rough In
UG /Slab
Low Voltage
Fire Alarm
r ASS 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 �y
Other Date Inspector / %/.e — Ext _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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