Loading...
Permit CITY OF TI G A R D ELECTRICAL PERMIT 14,4 , , iA DEVELOPMENT SERVICES PERMIT #: ELC97 -0699 '11. SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10 / 20 / 97 PARCEL: 15126DC -04800 SITE ADDRESS...:09495 SW LOCUST ST #E SUBDIVISION °LEHMANN ACRE TRACT ZONING:C —P BLOCK • LOT °004 JURISDICTION: TIG Project Description : Install signal circuits or a limited energy panel for a tenant occpy. - -- 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 • 0 SIGN /OUT LINE LTG..: 0 LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 1 MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0 - - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- - 0 — 200 amp : 0 W /SERVICE OR FEEDER: 0 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 PACIFIC NW CLINICAL RESEARCH type amount by date recpt 9495 SW LOCUST PRMT $ 40.00 GEO 10/20/97 97- 300211 TIGARD OR 97223 SPCT $ 2.00 GEO 10 /20/97 97- 300211 Phone #: Contractor: CHRISTENSON ELECTRIC INC $ 42.00 TOTAL 111 SW COLUMBIA STE 480 REQUIRED INSPECTIONS PORTLAND OR 97201 Ceiling Cover Underground Cove Phone #: 241 -4812 Wall Cover Elect'l Service Reg #..: 000004 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 -001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246 -1987. Permittee Signature: _f? / 0 Issued By: 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 : ( \ 49.7 • DATE: 2 LICENSE NO: 5rT 3' ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++ ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + ++ + + + + + + + + + + + + + + + + + + + + + + + + ++ I CITY OF TIGARD Electrical Permit Application Plan Check # 13125 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 or Type Permit it E44- q 29? Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development PACIFIC NW CLINICAL RESEARCH LAB Number of Inspections per permit allowed Name (or name of business) AS ABOVE Service included: Items Cost Sum Address 9495 SW LOCUST 4a. Residential - per unit TIGARD OR 1000 sq. ft. or less $110.00 4 City/State/Zip Each additional 500 sq. ft. or El Limited thereof $25.00 1 Commercial El Residential Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Services or Feeders Electrical Contractor CHRISTENSON ELECTRIC, INC. Installation, alteration, or relocation Address 111 S .w. COLUMBIA, SUITE 480 200 amps or less $60.00 2 - 201 amps to 400 amps $80.00 2 City PORTLAND State OR_ Zip 97201 - 5886 401 amps to 600 amps $120.00 2 Phone No. • 5R3 601 amps to 1000 amps $180.00 2 Job No. 509 - 4686 Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. 26 - 34C Exp.Date OR State CCB Reg. No. 00458 Exp.Date 4c. Temporary Services or Feeders COT Business Ta • etro No. 5746 Exp.Date Installation, alteration, or relocation 200 amps or less $50.00 2 201 amps to 400 amps $75.00 2 Signature of S o -�,_o_ _. i 7 . ILIA- 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. 873S Exp.Date see "b" above. Phone No. 501- 741 -4R1 7 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 2 - b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required):* Signal circuit(s) or a limited energy panel, alteration or extension 1 $40.00 /i O 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above - System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 - * Submit 2 sets of plans with application where any of the above apply. 5. Fees: 40. Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ 7 NOTICE • Subtotal $ 4_9 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ 42 . NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # Total balance Due $ 42. I: \DSTS \ELC96.APP Rev 9/96 2/10/00 Activities for Case #: ELC97 -00699 4:22:11 PM Assigned Hold Updated • Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 10/20/97 GEO RECD GEO 10/20/97 ELCC003 Permit created 10/20/97 • GEO PASS GEO 10/20/97 ELCC700 Ceiling Cover 10/20/97 11/18/97 MJR FAIL MJR 11/18/97 cables on ceiling c ELCC720 Wall Cover 10/20/97 GEO 10/20/97 • ELCC725 Underground Cover 10/20/97 • GEO 10/20/97 ELCC730 Elect'I Service • 10/20/97 GEO 10/20/97 ELCC799 Elect'I Final 10/20/97 1/26/00 BRP PASS AKJ 1/26/00 ELCC500 (F)Issue permit 10/20/97 GEO PASS GEO 10/20/97 ELCC700 Ceiling Cover 11/24/97 MJR FAIL MJR 11/24/97 already covered ELCA920 Miscellaneous action 1/24/00 JMT DONE No Hold JMT 1/24/00 inspection request (research) sent to Hap 1/24/00 ELCC800 Case Finaled 1/26/00 AKJ DONE No Hold • AKJ 1/26/00 • • • • • 1 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 /� BUP Date Requested � V0 AM�� PM BLD Location ,[A Suite MEC Contact Person 44v1 Ph PLM Contractor Ph SWR • BUILDING Tenant/Owner M 1 , 1Cik V G . - ' f E Retaining Wall 4 Footing Access: Foundation FPS Ftg Drain — SGN Crawl Drain Inspection Notes: , , Slab SIT Post & Beam 1 �/"`^ Ext Sheath /Shear i3 I\ a 0 I� / y Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 1/ 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 "Bas8---eART FAIL CTRICAr) Service Rough In UG /Slab Low Voltage F' - larm 05, 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 Other _... D (O 00 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.