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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00505 r � ' � DEVELOPMENT SERVICES DATE ISSUED: 8/17/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) OR711G INA P ARCEL: 1S135AB-04500 SITE ADDRESS: 10250 SW GREENBURG RD 200 SUBDIVISION: LINCOLN BUILDING PP1991 -055 ZONING: C -P BLOCK: LOT : 001 JURISDICTION: TIG Project Description: Installation of two branch circuits. Job No. 62 -06057 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: 1 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: KNICKERBOCKER PROPERTIES INC CHRISTENSON ELECTRIC INC BY NORRIS BEGGS & SIMPSON 111 SW COLUMBIA 10300 SW GREENBURG RD STE 200 STE 480 PORTLAND, OR 97223 PORTLAND, OR 97201 Phone: Phone: 241 -4812 Reg #: LIC 000458 SUP 3289S PLM 2468S ELE 26 -34C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 8/16/99 $42.85 99- 317695 Elect'l Final 5PCT DEB 8/16/99 $3.00 99- 317695 Total $45.85 • 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 ' s ofr f these riles or direct questions to OUNC at (503) 246 -1987. Permit Signature: ' , Q 6- $ Issu d By: k si2. Q �;,, kaeCe2444),d4 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: e DATE: LICENSE NO: 673 Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF.TIGARD Electrical Permit Application Plan Check# , 13125 SW HALL BLVD. Rec'd By SfgraW . ' TIGARD OR 97223 RECEIVED Date Rec'd ir / /-99 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 AUG 111999 Print of Type Permit# ` LL t1 499 SDI Fax (503) 598 - 1960 COMMUNITY D!PfR or illegible will not be accepted Called 1. Job AddrEgi IS BEGGS SIMPSON PROPERTY MNGMI 4. Complete Fee Schedule Below: Name of Development LINCOLN BLDG Number of Inspections per permit allowed Name (or name of business) FOREST CITY TRADING Service included: Items Cost Sum Address 10250 SW GREENBURG RD SUITE 200 & \ 2 2 4a. Residential - per unit Ci /State /Zi TIGARD OR 1000 sq. ft. or less $ 117.75 4 ry p Each additional 500 sq. ft. or MALIBU PA FIC:GENERAL portion thereof $ 26.25 1 Commerci- it Residential ❑ Limited Energy $ 60.00 QUESTIONS? CONTACT ROSS CROSBY 245 -1965 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 CHRISTENSON ELECTRIC, INC. 200 amps or less $ 64.25 2 Address 111 SW COLUMBIA, SUITE 480 201 amps to 400 amps $ 85.50 2 City PORTLAND State OR Zip 97201 -5886 401 amps to 600 amps $ 128.50 2 ry P 601 amps to 1000 amps $ 192.50 2 Phone No. 503 241 -4812 Over 1000 amps or volts $ 363.75 2 Job No. 62 -06057 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 26 -34C Exp.Date 10/99 4c. Temporary Services or Feeders OR State CCB Reg. No. 458 Exp.Date 5/03 Installation, alteration, or relocation COT Business Tax or Metro No. 5246 Exp.Date 12/99 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 0 401 amps to 600 amps $ 107.00 2 Signature of S • - ...emm■•••■ C--k�: Over 600 amps to 1000 volts, License No. 873S Exp.Date 10 /01 see "b" above. Phone No. 503 241 -4812 40. 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 b) The fee for branch circuits Address without purchase of service City State Zip or feeder fee. Phone No. First branch circuit 1 $ 37.50 37.50 2 � Each additional branch circuit ` : / $ 5.35 4-6 ,5; 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 $ 60.00 Minor Labels bels (10) $ 107.00 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 5 described in N.E.C. Chapter 5 5. Fees: 5a. En er total of above fees $ b * Submit 2 sets of plans with application where any of the above apply. Surcharge'X total fees) 7% $ 3. ° Not required for temporary construction services. Subtotal $ 91,6-5 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 �/ f WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust Account # 7S AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due 6 - $ 434 o ^ i:\dsts\forms\electric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested i //7 99 AM PM BLD f � J Location O_ I � , uite 24 MEC Contact Person Q955 Ph PLM Contractor ( s��.•rs .l �iL-� Ph SWR BUILDING Tenant/Owner ,��f ELC /9 — ob , r 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 Wa'6' 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 SS PART FAIL ELECTRICAL Rough In UG /Slab Low Voltage Fire Alarm • PART FAIL r Backfill /Grading ti ✓ 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 Q Approach/Sidewalk Other C Inspector Itor Other Ext Final PASS PART FAIL ' 0 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 /1/3 AM PM - BLD Location (6 Suite CRO MEC Contact Person a Ph PLM Contractor ��Y 66/7 -4430 o) Ph 6-6 416 SWR BUILDING Tenant/Owner ELc 7 q 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 ELECTRICAL Service Rough In Low Voltage b Low V Fire Alarm ■ PASS FAIL S�17� 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 // 3 —P7 Other Inspector o.� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.