Permit ELECTRICAL PERMIT
CITY OF T I GARD DATE PERMIT I ISSUED: 03 18/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 19136 DB -02603
SITE ADDRESS—: 11612 SW PACIFIC HWY
SUBDIVISION • ZONING:C -G
BLOCK • LOT
Project Description: Tigard Park N Ride LIGHTING
Tigard Cinema accesss driveway.
- -- 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 /F EEDER - --- -- - • -. --- BRANCH CIRCUITS----- -- -ADD' L INSPECTIONS--
0 - 200 amp......: 1 W /SERVICE OR FEEDER: 6 PER INSPECTION.....: 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 - • 600 amp...... : 0 EA ADD' I_ BRNCH C I RC : 0 I N PLANT........... : 0
601 - 1000 amp - 0 - -- _ - - - -- PLAN REVIEW SECTION -- - - - --
1000+ amp /volt.....: 0 > =4 RES UNITS........: > 600 VOLT NOMINAL.. :
Reconnect on 1 y : 0 SVC /FDR > = 225 AMPS..: CLASS AREA/ SPEC OCC. :
Owner: --------- - - - - -- --------- - - -. -- .._. -- - .------- ---- • - - ---- - - -_.. - ... _..... ... - _._.. FEES - -- - - -- --- ..__- - - - - --
RICK KINDS TRI MET type amount by date recpt
710 NE HOLLADAY ST PRMT $ 90.00 J*H 03/18/96 96- 277091
SPCT $ 4.50 J• H 03/18/96 96- 277091
PORTLAND OR 97232
Phone #: 239- -2100
Contract or:
H & H ELECTRIC $ 94.50 TOTAL
REQUIRED INSPECTIONS - - - - - --
BEAVERTON OR 97005 Elect' 1 Service
Phone #:
R 4$. .
This permit is issued subject to the regulations contained in the _ }� - elk1/ l./ / �' E L, C-
J 9
Ti and Municipal Code, State of Ore. Specialty Codes and all other Permitt'/ee Si nature
9 Pa � P Y 9
applicable laws. All work will be done in accordance with -
•
approved plans. This permit will expire if work is not started
w
dkill--------
ithin 18@ days of issaance, or if work is suspended for more
than 180 days. sued By
---------------------------OWNER _ I NS T ALLAT I I A ONLY - - -
The installation is being made on property I own which is not intended for
sale, ].ease, or rent.
OWNER'S SIGNATURE: DATE:
- -_ -- .-- ---- --- - - - - -- CONTRACTOR INSTALLATION ONLY - -- - -- • ---------------
SIGNATURE OF SUP R. ELEC' N : DATE:
LICENSE NO :
Call for inspection -. 639 -4175
o ,w a Qg �
Community Development ELECTRICAL PERM
1 3125 SW Hall Blvd. �C
Tig a rd, OR 97223 Pl #
Y �. t Permit # E L G cis- 03k4 Y
0 �,�f '% -
',.� � I Phone (503) 63 -4171 Date Issued �� R 1
CITY OF TIGARD FAX (503) 684 -7297 Issued by
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Tigard Park & Ride Number of Inspections per permit allowed
Address Tigard Cinema Access Driveway Service included: Items Cost(ea) Sum
City /State/Zip Tigard OR 4a. Residential - per unit 4
1000 sq. It. or less $110.00
Name (or name of business) Tri -Mel ► Kim Knox Each additional 500 sq. ft.or
portion thereof $25.00 1
-
Commercial Residential ❑ Limited Energy $25.00 - Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: i4 t_ f%I
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor To be set t_ d 200 amps or less 1 $60.00 60.00 2
Address ii-i 3 �}y► 201 amps to 400 amps $80.00 2
City State 672, . , Zi 91005 401 amps to 600 amps $120.00 2 -
r 601 amps to 1000 amps $180.00 2
Phone No c; ` /(n a Over loon amps or vone $340.00 2
Contractor's License No. 0 00 -� Z / ! Reconnect only $50.00
Contractor's Board Reg. No. 3 F ae7� /0 n r 6 4c. Temporary Services or Feeders
k
LL ^, Installation, alteration, or relocation 2
Signature of Supr. Elec'n * 200 amps or less $50.00 2
License No. Phone No. 201 amps to 400 amps $75.00 2 - 401 amps to 600 amps $100.00
-
Over 600 amps to 1000 volts
2b. For owner installations: see •b• above.
4d. Branch Circuits
Print Owner's Name it i -Met /David Ca lver New, alteration or extension per panel
Address 710 NE Holladay a) The fee for branch circuits with
City Portland State OR Zip 9 7 2 3 2 purchase of service or feeder lee. CIO. 0D 2
Each branch circuit $5.00 C7
Phone No. 239-6716 Kim Knox b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, ease or rent. First branch circuit $35.00 2
Each additional branch circuit $
Owner's Signature - 4e. Miscellaneous /14. te0' m. 9 �
(Service or feeder not included p IA) V21 / / ✓Y/4 M-
3 Plan Review section (if required): Each pump or irrigation circle 20.00 , u 2
Each sign or outline lighting $40.0
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension .$40.00
-
4 or more residential units in one structure Mi nor Labels (10) $100.00
0A Service and feeder 225 amps or more
S ystem over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
`��' as described in N.E.C. Chapter 5 Per inspection $35.00 - Per hour $55.00
-
In Plant $55.00
Submit 2 sets of plans with application where any of the above -
apply. Not required for temporary construction services.
5. Fees:
NOTICE 5a. Enter total of above fees $ '90•0
5% Surcharge (.05 X total fees) $ 9J /f
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account #
Balance Due $ q 4/ , 5'Y
wo,d ssd. Wc. ,m.app
I
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
RECEIVED
TRH_ MAY b 1996 PERMIT NOTICE MET FR' � � 996
MAY 1 7 1996
H & H ELECTRIC
PO BOX 30868
PORTLAND OR 97230
Electrical Signature Form • ti • :_. • - _
Permit # ELC95 -0342
Date Issued.: 05/14/96
Parcel 1S136DB -02603
Site Address: 11612 SW PACIFIC HWY
Subdivision.:
Block Lot:
Zoning C -
Remarks:
Tigard Park N Ride LIGHTING
-Tigard Cinema accesss driveway.
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
TRI MET H & H ELECTRIC
ATTN: RICK KINDIG PO BOX 30868
710 NE HOLLADAY ST
PORTLAND OR 97232 PORTLAND OR 97230
Phone #: 239 -2100 Phone #: FAX 253 -0466
Reg #. . 50449
•
X ,� L ••••
. z S . atur of 'S pervi ng Electrician
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639 -4171, ext. #310
ACTLVE Grp Smry Edit Prcl Name Actn Cond Log -note Fee Doc Tag Misc Xit
Edit /view information in active case screen
OaPLUMBING PERMITaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
o :PLM95 -0221: PROJECT:TRI -MET PARK -N -RIDE : STATUS:R : UPD:03/15/96: :J *H: °
o PERMITTEE:TRI -MET (KIM KNOX) PRIM..:SIT95 -0030: °
o SITE ADDRESS:11612 SW PACIFIC HWY °
uaDESCRIPTION OF PROJECT (1) aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa?
o 210 space Tri -Met Park & Ride facility with storm drain system, assessment °
o made in SIT95 -0030. °
uaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaac
o CLASS OF WORK..:NEW: GARBAGE DISPOSALS • 0: MOBILE HOME SPACES.: 0: °
o TYPE OF USE •OTR WASHING MACH • 0: BACKFLOW PREVNTRS..: 0: °
o OCCUPANCY GRP..:B2 FLOOR DRAINS • 0: TRAPS • 0: °
o STORIES • 0: WATER HEATERS • 0: CATCH BASINS • 5: 0
o FIXTURES LAUNDRY TRAYS • 0: SF RAIN DRAINS • 0: 0
o SINKS • 0: URINALS • 0: GREASE TRAPS • 0: °
o LAVATORIES • 0: OTHER FIXTURES • 0: 0
o TUB /SHOWERS • 0: SEWER LINE (ft) 0: °
o WATER CLOSETS..: 0: WATER LINE (ft) 0: °
o DISHWASHERS • 0: RAIN DRAIN (ft) • 940: °
o NOTES:PER ENGINEERING: CALL FOR SURFACE WATER CONTROL SYSTEM INSPECTIONS 0
o (3):FOR CATCH BASINS AND PLUMBING TO DETENTION POND. °
aaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaai
•
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation 410:1,
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: '7 ! °� ( ' A.M. P.M. Entry:
Address: / / (o / Z p
Tenant: Ste: MST: If BUP:
� ' H MEC:
EC :
PLM:
ELC: Z 0 3'
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
-411 //51 \ c
t �
Inspector: ��� C — 1 i Date:
X APPROVED DISAPPROVED /CALL FOR REINSP. 4F CO
P'Pr
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cove ,t121 FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: (Q ( 2_(.o L C I le A.M. P.M. Entry:
Address: / 1 Co /
Tenant: 6 1 f , Ste: MST:
�^ BUP:
Con /Own: tT 'F R Ti 1 MEC:
PLM:
ELC: /SG3e./ ?�
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: f Fe210 I ( CF 1 / 46.14 46.14 � 6 I
/f
1rn.
r
Inspector: '/ cz• _ Date: ,�� "7"
X APPROVED DISAPPROVED /CALL FOR REINSP. CF CO
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