Permit ELECTRICAL PERMIT
PERMIT #: ELC1999 -00383
. �i��, DEVELOPMENT SERVICES DATE ISSUED: 6/25/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134CC
SITE ADDRESS: 12325 SW KATHERINE ST
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: Service or feeder less than 200 amps
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: 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:
TIGARD TUALATIN SCHOOL DIST 23 PHOENIX ELECTRIC CO
13137 SW PACIFIC HWY 7379 SW TECH CENTER DR.
TIGARD, OR 97223 TIGARD, OR 97223
Phone: • Phone: 684 - 3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES
Type By Date Amount Receipt Required Inspections
PRMT BON 6/25/99 $64.25 99- 316409 Elect'I Service
Elect'I Final
5PCT BON 6/25/99 $3.21 99- 316409
Total $67.46 o R I GI N A L
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 ma ob copies of these rules or direct questions to OUNC at (503)
246 - 1987.
Permit Signature: L am- . `T Issued By: eriAC� (v"ajo-r
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: (7 Ic C 'o DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
JU: 1 -99 THU 10:41 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P, 02/02
Application Plan Check A
18125 SW HALL BLVD.
CITY OF TIGARD REC�iVE® Electrical Permit App Recd By
Date Rec'd
Date to P.E.
TIGARD OR 97223 JUN 2 4 1999 Date to DST_
Phone (503) 639 4171, x304 P rint or Type Permitl'� �
Inspection (503) 63g•U�In UEVEL�FnMco�plete or illegible will not b accepted
Fax (503) 684 -7297 Called
4, Complete Fee Sc Below:
1. Job Address: _
__,----1 / ( I-1 o0I S - Number of Inspections per permit allowed 111 Name of Developmen ,1? r\ i I it
��.
Name (or name of business) i q Residential -per unit
S?- $110.00 4
c�. i ` �.�,�1 [ t 4- c - 1000 sq. tt. or less
Address a f C t - Each additional 500 sq. ft, or 1
portion thereof $25.00 ------ CitylState /Zip i �� Li Energy $25.00
Commercial Residential Lt Each Manut'd Home or Modular 2
\ ` \ - a OD 0 f 0 t/ I C1C-u u(C t`. Dwelling Service a Feeder
$68.00 r--
� , c . � Irv..
4 b, Services or Feeders
2a, Contractor test l en t ion only: Inst alteration, or relocation � � 2
(attach copy. •f •11 current lieons , 200 aion, alteration,
less
(' - ti �� �' $60.00 2
-
Electrical • tr.. t• z 201 amps to 400 amps
---- - $120.00 2
d � Zip_ }��. 401 amps to 600 amps 12 ----- 2
Cih/ ° �O State d 601 amps to 1000 amps $0.00 $180.00r 2
7 Over 1000 amps or volts $50.00 -- 2
Phone Reconnect only
Job Elec. C _ 0 Exp.Date
OR Cont. Lice. Reg. o -- ' " Exp-Date�� 4c. Temporary $ervices or Feeders
. N O, - Installation, alteration, or relocation 2
OR State CCB Reg Exp -D - or Tes 00 2
COT Business Tax or Metro No. Cn 200 amps $50
$75.00 201 amps to 400 amps $100.00 2
��` 401 amps to 600 amps
Signature of Supr. Elec'n / _ Over 600 amps to 1000 volts,
sea "b" above.
Exp.Date
License No. �. G � L 4d. Branch Circuits
Phone No. MOW New, alteration or extension per panel
a) The lee for branch circuits with
2b. For owner installations: purchase of service or
feeder fee, $5,00 2
Each branch circuit
Print Owner's Name b) The lee for branch circuits
Address without purc of �� ��
State ZI without or feeder foe. 2
City �=
First branc circuit $5.00 2
Phone No• Each additional branch circuit
The installation is being made on property I own which is not
•
4e. MI5cr:llaneous •
intended for sale, lease or rent. (Service or feeder not included) $40.00 __ �_ 2
Each pump or irrigation circle $40.00 2
Owner's SignatUre Each sign or outline lighting
3. Plan Revrew.section (if required):* Signal panel, rat or a limited energy $40.00 2
pea c eult()o or
or extension $100.00
Minor Labels (10)
Please check appropriate item and enter fee in section 5B. units 4t. Each additional inspec over
4 or more residential units in one structure the allowable in any of the above $35.00 -
Service end feeder 225 amps or more Per inspection $55.00 r
System over eao volts nominal Per hour $ 55.00
Classified area or structure containing special occupancy In Plant
as described In N.E.C. Chapter 5
5. Fees:
* Submit 2 sets of plans with application where any of the above apply. 5a. Enter total of above lees $
Not required for temporary construction services. 5% Surcharge (.05 X total tees) $
Subtotal
O�1 TICE 5b. Enter 25% of line 5e for $ -
Plan Review if renuirer! (Sec.3)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS S/y�tot rf ��
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK � � , ITrust Account_ #�-- �d� •
TIME AFTER WORK I COMMENCED. A pERIOD OF 190- DAYS.AT -A__. -- _._
-- - -- - - S
Total balance Due
t,ncrc,Fi cna Art nos 5195 _,,,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /' �� 5 5 If) 412 ' F Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BOIL' DING` Tenant/Owner '5(4 A i -'477- ELC /4V/ 003 -
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 ° : R
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL° 'fr
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
.G7RICwA `:
Rough In -
UG/Slab
Low Voltage
. Fire : arm
PASS " 'ART FAIL ►��
V"
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 Date /3 L Inspect �iil Ad E -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.