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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00652 c . �l� DEVELOPMENT SERVICES DATE ISSUED: 11/01/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101BD 00300 SITE ADDRESS: 08015 SW HUNZIKER ST SUBDIVISION: ZONING: I -L BLOCK: LOT : JURISDICTION: TIG Project Description: Add ten (10) branch circuits. 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: 9 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: E HOWARD LOSLI GUILD CONSTRUCTION BY PERFORMANCE CONSTRACTORS 7959 SW CIRRUS DR CHARLOTTE, NC 28127 . BEAVERTON,•OR 97008 Phone: Phone: 641 -4634 Reg #: LIC 109116 SUP 3868S ELE 26 -986C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DST 11/01/199E $85.65 99- 319458 Elect'l Final 5PCT DST 11/01/199E $6.85 99- 319458 • Total $92.50 ORIGINAL 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 SIGNATU' � SSUED BY: �� OWNER INSTALLATION ONL 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 CITY'OF TIGARD Electrical Permit Application Plan Check# -1312 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Rec'd Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type permit Ce't<Qgq 6 ✓0( Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of businesss 1 G� C�Ti�G�lt.1,G�{ Service included: Items Cost Sum 4 ' Address SD1� 04 4 )t4Z. - 4a. Residential - per unit City /State /Zip 4c e-42 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 26.25 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 ,/(j 7 12I4.1..I, 200 amps or less $ 64.25 2 Address 145 0-410- 0-tJs 1772-- 201 amps to 400 amps $ 85.50 2 city Ar1G -TOt� State c' - Zip g7oog 401 amps to 1000 amps $ 128.50 2 601 amps to 1000 amps $ 192.50 2 Phone No. (Otkl • 4 41 Over 1000 amps or volts $ 363.75 2 Job No. -(a. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. V.-lo • nor, ._ Exp.Date 4c. Temporary Services or Feeders OR State CCB Reg. No. l 01116. Exp.Date Installation, alteration, or relocation COT Business Tax or Me r• No. •f,••,,,, 200 amps or less $ 53.50 2 �" .,. Exp.Date 201 amps to 400 amps $ 80.25 2 401 amps to 600 amps $ 107.00 2 Signature of Supr. Elec' / Al L am. / Over 600 amps to 1000 volts, see "b" above. License No. , 29419+36 Exp.Date 4d. Branch Circuits Phone No. ` ' -t �p �' 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 , - 7 . Each additional branch circuit $ 5.35 4 • 1 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 . panel, a alteration or extension $ 60.00 3. Plan Review section (if required):* Minor Labels (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 described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ 5 V * Submit 2 sets of plans with application where any of the above apply. r Surcharge X total fees) $ - -t_ . Not required for temporary construction services. Subtotal $ 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 l WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ --- 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 /// 9 AM PM BLD • Location gars" 44X/Pt_Z eit./ Suite MEC Contact Person 40/ e (d Jd 6 LL v1CU Ph !p '74/ -'40 30 PLM • Contractor Ph SWR BUILDING • �` , ` ', ''; Tenant/Owner arS tA'YYL2/yieL - �i ELC (�1 9 -41747 - 5- 0/ — 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 �� -eck r0 r /-- �-- / � 7 / 101'0 /Q CI Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof / t 9 / — QS_s Misc: v 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 S A Rough In UG /S ab Low Voltage Fire / #.- 0 PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Csin Fire Supply atch Ba Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA L q Inspector Approach /Sidewalk Date/ A cs - L Ext Other Ii , f / i 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 -e,21- 00 AM PM BLD • Location 00/c HOf Z_/ / Suite MEC Contact Person _TO `) Ph 0269— 7 4- 9'O PLM Contractor Ph SWR BUILDING . . = Tenant/Owner /qqq — 00 6.2 Retaining Wall . 5C A)02000° 06c, ZS Footing Access: Foundation C f� -!R' FPS Ftg Drain Ol'i'A - / �'� C..i / �LC't�C e SGN Crawl Drain Inspe o ote Slab LIl c / SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing ,,0"°1 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Q 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 P FAIL Service Rough In UG /Slab Low Voltage Fir- Alarm • S PART FAIL AFT 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 �` O Ins ector _Ext Other Date p Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.