Permit CITY OF TIGARD ELECTRICAL PERMIT .-
_. 4,,,,1 , DEVELOPMENT SERVICES PERMIT #: ELC97 -0673
___'!J -�' '.. 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 1 ¢� / 14 / 97
PARCEL: 1S126DC -04800
SITE ADDRESS...:O9495 SW LOCUST ST #E
SUBDIVISION °LEHMANN ACRE TRACT ZONING:C —P
BLOCK • LOT •004 JURISDICTION: TIG
Project Description : Installation of 6 branch circuits.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS ° 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 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 • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 5 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
CLINICAL RESEARCH type amount by date recpt
9495 SW LOCUST PRMT $ 60.00 DRA 10/14/97 97- 300025
TIGARD OR 97223 5PCT $ 3.00 DRA 10/14/97 97- 300025
Phone #:
Contractor:
WILLAMETTE ELECTRIC INC $ 63.00 TOTAL
PO BOX 230547
REQUIRED INSPECTIONS
TIGARD OR 97281 Ceiling Cover Elect'l Service
Phone #: 624 -3631 Wall Cover Elect'l Final
Reg #..: 000750
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 -001 ough OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)24 - 198
Permittee Signature: ,1180 ."- +T /✓rY10. ��J Issued : k, 1
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 : aOQ �yY1 DATE: /0
LICENSE NO : 19 Us - 5
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
r n i 0
CITY OF TIGARD Electrical Permit Application kr Plan Chec
13125 SW HALL BLVD. . (A1 Rec'd B •
TIGARD OR 97223 4; 8tA P9 7 _ o 4 Date Rec'd 10 - 10 - 9 7
Phone (503) 639 -4171, x304 �/ , Date to P.E. ----
Print or Type V Date to DST -
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # 5LCy7 -06i1
Fax (503) 684 -7297 Called
1. Job Address: /� 4. Complete Fee Schedule Below:
Name of Development IJ W CI, ,v ; cJ eSecL c Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
I
Address ‘9 4 9 C S w Lot-us i dr L ` 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City/State /Zip f s 5 n-fI a Each 1-9 Z Z ? Each additional 500 sq. ft. or
Commercial ® Residential El Limited thereof $25.00 1
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 Li • it p A. a ft(' rt r err k ic /< C
Installation, alteration, or relocation
200 amps or less $60.00 2 -
Address P t /30 Y 7 36 4 4 7 - 201 amps to 400 amps $80.00 2
City ?i N i Ay) State 0.- Zip 97 2 Cr t 401 amps to 600 amps $120.00 2
Phone 6. 4 24 - IC? f 601 amps to 1000 amps $180.00 2
Job No. 2.6. c Over 1000 amps or volts - $340.00 2
Elec. Cont. Lice. No. St - ZS 3 c Exp.Date !0 -( --5 Reconnect onl $50.00 2
OR State CCB Reg. No. 7 TO C 5 Exp.Date T - (o - 95 4c. Temporary Services or Feeders
COT Business Tax or Metro No. i S'9 ce Exp.Date 14- I - `t (b Installation, alteration, or relocation
A 200 amps or less $50.00 2
Signature of Supr. Elec'n �;.._ 401 amps to 600 amps $100.00 2
-
-
$75.00
Over 600 amps to 1000 volts,
License No. l q co S - S Exp.Date /6 - I -9 see "b" above.
Phone No. I; 2 U - - kC. 71 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. /
°J-.
First branch circuit / $35.00 _ 2
The installation is being made on property I own which is not Each additional branch circuit .5 $5.00 Z 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 $40.00 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: 4o
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $ •
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
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 # 43a
Total balance Due $
1: \DSTS \ELC96.APP Rev 9/96
2 /10 /00 Activities for Case #: ELC97 -00673
4:17:11 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 APPlication received 10/10/97 DRA RECD DRA 10/14/97
ELCC003 Permit created 10/14/97 DRA PASS DRA 10/14/97 Delay in creating due to waiting
for suite addressing for building.
ELCC700 Ceiling Cover 11/18/97 MJR PASS MJR 11/18/97 electrical only approved low volt
• not approved
ELCC720 Wall Cover 10/29/97 BRP PASS J *H 11/9/97
ELCC799 Elect! Final 11/20/97 MJR FAIL MJR 11/20/97 corrections on low volt not
complete
ELCC500 (F)Issue permit 10/14/97 DRA PASS DRA 10/14/97
ELCA920 Miscellaneous action 1/24/00 JMT DONE No Hold JMT 1/24/00 inspection request (research)
sent to Hap 1/24/00
ELCC799 Elect'I Final 1/26/00 1/26/00 1/26/00 BRP PASS No Hold AKJ 1/26/00
ELCC800 Case Finaled 1/26/00 AKJ DONE No Hold AKJ. 1/26/00
•
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Page 1 of 1
OCT -10 -1997 15 01 JON R.JURGENS ARCHITECTS 503+690 +0913 P.02
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TOTAL P.02
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 / 26 /00 AM_.V____PM BLD
Location c v s ,[A Suite MEC
Contact Person WeVhei 4 Ph PLM
Contractor Ph SWR 22
BUILDING Tenant/Owner , _ � _ -C V • r + - E - 0069 7 J
Retaining Wall 41r
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
�/�/�
Post & Beam bl fn,^ C 0 p , `-'
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling �— / /
Roof J —/ r" , 4 ! L S .S Ple
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----EART FAIL •
•ELECTRICAE
Service
Rough In
UG /Slab
Low Voltage
F - • larm
141 PART FAIL
S
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 n
Approach /Sidewalk Date _ fp — v Ins Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.