Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00159
0.1' DEVELOPMENT SERVICES DATE ISSUED: 04/06/2000
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S136AD-06400
SITE ADDRESS: 11440 SW PACIFIC HWY .
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI
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 +am -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: 2 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 BP SERVICE CO INC PREMIER ELECTRICAL CONTRACTORS
11440 SW PACIFIC HWY 115 NICHOLAS WAY
TIGARD, OR 97223 PO BOX 7010, BEAVERTON, OR 97
NEWBERG, OR 97132
Phone: Phone: 259 -1305
Reg #: LIC 001264
SUP 4427S
ELE 36 -79C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT BON 04/06/200C $48.20 0001222 Elect'l Final
5PCT BON 04/06/200C $3.86 0001222 ORIGINAL
Total $52.06
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 ordirect questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ` , ? /J/� ISSUED BY: v
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: /9 Gtrel C S 1Y1'` DATE:
LICENSE NO:
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 i3
Date Rec'd i..1,-(jr tide
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304
Date to DST
Inspection (503) 639 -4175 Print of Type Pemtit # at 2040 -ODI' /
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 business) 76 5 1 - eti1om Service included: Items Cost Sum NI•
Address j Li q 0 5. Co. ( ci 'C c. HWY 4a. Residential - per unit
6 vr� O P 1000 sq. ft. or less $ 117.75 4
Cit /State /Zip Ty
/ ( Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial I 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 da base). 1 Installation, alteration, or relocation
Electrical Contractor f t ;cv e
Ete., i co..tl Corm'- 4./CF 200 amps or less $ 64.25 2
Address Po, Bit. 113-2. 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City State 02 Zip q)/3.2_ 601 amps to 1000 amps $ 192.50 2
Phone No. ,537 -!3O '/ Over 1000 amps or volts $ 363.75 2
Job No. 3450 , / Reconnect only $ 53.50 2
Elec. Cont. Lice. No. , k - 7f . Exp.Date /2-o ( 4c. Temporary Services or Feeders
OR State CCB Reg. No. )Z-6 VG I Exp.Date /Z I Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
' n 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec
Over 600 amps to 1000 volts,
see "b" above.
License No. v /2-7,5 Exp.Date /D r7�/
Phone No. S ,��b1 4d. Branch Circuits
New, alteration,or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of servlce 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 tee.
Phone No. First branch circuit / $ 37.50 3), SO
Each additional branch circuit A( $ 5.35 /0 , 7 O
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
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 440-99
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over /CO .60
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 $ qLb • ZP
* Submit 2 sets of plans with application where any of the above apply. c rab ,59f, Surcharge (.85-X total fees) $ Co
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
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ J r
2
i:\dsts\forms\electric.doc
05/30/2000 Activities for Case #: ELC2000-001 59
9:45:14 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 04/06/2000 BON DONE No Hold BON 04/06/2000
ELCC003 Permit created 04/06/2000 BON DONE No Hold BON 04/06/2000
ELCC730 Elect'I Service No Hold BON 04/06/2000
ELCC799 Elect'I Final 04 /21/2000 CD PASS No Hold AKJ 04/24/2000
ELCC500 (F)Issue permit 04 /06/2000 BON DONE No Hold BON 04/06/2000
ELCC800 Case Finaled 04/24/2000 AKJ DONE No Hold AKJ 04/24/2000
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/, /� BUP
G
Date Requested 74/06 AM PM BLD
IIJ /
Location r I L LI b P4:6 Suite MEC
Contact Person Culp 0 Ph ZD J- nq RS PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
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 '
Drywall Nailing �� , r 4. S e4r �� .� �y�s ■ I
, �
rt
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling AP %/ ? il�� / ,ilSS r :44t1
Roof t ,//
Misc:
Final
PASS PART FAIL
PLUMBING 0-4.. -a -A. — / / 4.e-' 2
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains /pL/
Final
PASS PART FAIL
MECHANICAL
Post & Beam `` �✓
Rough In
Gas Line
Smoke Dampers
Final
P T FAIL
EL CTRICAL
Service
Rough In
UG /Slab
Low Volta s e
Fire Alary ,
AS / yam, FAIL
l 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
Other Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.