Permit ,
CITY OF T ELECTRICAL PERMIT
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,U�7.,�� PERMIT #: ELC97 -0719
DEVELOPMENT SERVICES DATE ISSUED: 10/30/97
'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 1 S 136PD- -04000
SITE ADDRESS...:11533 SW PACIFIC HWY
SUBDIVISION -VILLA RIDGE ZONING:C -f,
BLOCK • LOT :007 JURISDICTION: TIG
Proj ect De scr i pt ion : Install ten (10) branch circuits to an existing commercial
building.
- -- 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 • 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/O SRVC OR FDR.: 1 PER HOUR • 0
401 - 600 amp 0 EA ADD'L BRNCH CIRC: 9 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.:
Own a v : - _ _ - -- - - - -- -- - - -- FEES - - - - - - -- -
BENIFICIAL REAL ESTATE type amount by date recpt
11533 SW PACIFIC HWY PRMT $ 80.00 GEO 10/30/97 97- 300523
TIGARD OR 97223 5PCT $ 4.00 GEO 10/30/97 97- 300523
Phone #:
Contractor: -- - - - - -- ------- - - - - -- --
NEW TECH ELECTRIC $ 84.00 TOTAL
1400 NE 48TH AVE
--- - - - - -. REQUIRED INSPECTIONS - - - - --
HILLSBORO OR 97124 Ceiling Cover Underground Cove
Phone it: 648 -1900 Wall Cover Elect'I Service
Reg it.. : 000418
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: Issued By: I / '� ____
- -- ---------- - - -• -- - -OWNER INSTALLATION ONLY---- ------------------- - -...- - - - --
h The installation is being made on property I on which is not intended for
• sale, lease, or rent.
. OWNER'S SIGNATURE: __ DATE:
-------------- -- ----- - -- CONTRACTOR INSTALLATION ONLY------------------------
SIGNATURE OF SUPR. ELEC' N : c' -hi DATE: /d
LICENSE NO: 35 S
+ + +-1 + + ++ + + + + +-F + + + + ++ + +-F ++ + + + + + + ++ ++++++++ + + + + + + + + + + + + + + + + + + + + +- t- -I -+ +-f + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++-++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + ++ + + + + + + + + +44+
CITY.OFTIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Rec'd By
Date Rec'd
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DSST�
Inspection (503) 639 -4175 Print or Type Permit # yr_ ,e q
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development // j1 �? Number of Inspections per permit allowed
Name (or name of business�`7kir '.G Dal gliak Service included: Items Cost Sum
Address 15..33 56) (p&fl C., Ala 4 S Residential o per unit $110.00 4
City /State /Zip Ti X06 Each additional 500 sq. ft. or
Commercial Residential 1=1 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 = I urren II eris ( s) 4b. Services or Feeders
Electrical Contractor O. C/‘1 re ri Installation, alteration, or relocation
Addre s / 14 . - y: � 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City /A. '_ ii s State 0, Zip 9' 124 401 amps to 600 amps $120.00 2
Phone No. L!: /COO 601 amps to 1000 amps $180.00 2
Job No. /4)4' it Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. ,° e Q /ec/G Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No.. 4 /1r4'68 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Me No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 5 vrt IP. 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 3) 1 Exp.Date /CD I - qg see "b" above.
Phone No. ;� - Pk
ti 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. F � /�
First branch circuit l $35.00 �� v O 2
The installation is being made on property I own which is not Each additional branch circuit Tr $5.00 S+.S.O 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:
SS 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 #
/�
$ S!
Total balance Due C�
I: \DSTS\ELC96.APP Rev 9/96
9
1 ( Akt d al,eiwi
CITY OF TIGARD B INSPECTION DIVI 06-0/Dta
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 2 (- l , A.M. P.M. MST:
l
Location: l (S J S-b() BUP:
Tenant: 13e1Jen CA At.- mil - T1 Suite: Bldg: MEC:
Contractor: Phone: G PLM:
Owner. �� Phone: l WO -741 - 5 - 37S ELC:9 ! -0 7 / 7
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL 7 ELECTR SITE
Site Post/Beam Post/Beam Post/Beam ve[ emce Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved CApprovedd Approved
Appr /Sdwlk Not Approved Not Approved Not Approved oved Not Approved
FINAL FINAL FINAL ( FINAL FINAL
/ //YFf L P/9-- ss' —
il
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: / / ex
) — ? ! Page of