Permit A 0 _ CITY OF TIGARD ELECTRICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98 -0172
-1 I 13125 SW HaII Blvd., Tigard, OR 97223 503 639 -4171 DATE ISSUED: 04 / 08198
PARCEL: 1S136DB -00500
SITE ADDRESS... :11619 SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTION: TIG
Project Description : Installation of 200 asps or less service to cosuercial TI.
- -- 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 • 1 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
GRAHAM ELECTRIC CO type amount by date recpt
PO BOX 4725 PRMT $ 60.00 DLH 04/08/98 98- 304772
PORTLAND OR 97208 5PCT $ 3.00 DLH 04/08/98 98- 304772
Phone #:
Contractor:
GRAHAM ELECTRIC CO $ 63.00 TOTAL
PO BOX 4725
REQUIRED INSPECTIONS
PORTLAND OR 87208 Ceiling Cover Elect'1 Service
Phone #: Wall Cover Elect'l Final
Reg #..: 000001
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- 801 -8010 through OAR 952441 -1987. You say obtain a copy
of these rules or direct questions to OUNC by calling (583)246 -1987.
Permittee Signature: "1Ii Issued By: /(0547,./d-C__
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' 9 9 OWNEER' S SIGNATURE 07V e NATURE : �7 fJ ■9 —�✓ O� DATE
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: "VT/} DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++
CITYO'FTIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By .a Z-/f
TIGARD OR 97223 Date Rec'd ,7479 *
i Date to P.E.
Phone (503) 639 -4171, x304 Print or T @ i I ' Date to DST
Inspection (503) 639 -4175 Incomplete or illegible w not be accepted Permit # 4 9P-0/7.2..._,
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of inspections per permit allowed
Name (or name of business) /' A, Z A T 1. Ja ff (E5 ► . Service included: Items Cost Sum
Address i/ / 4-i 1 S->� Ac.., r I C 14 Residential - per unit .
1000 sq. ft. or less $110.00 4
City/State/Zip : &,A/E , Each additional 500 sq. ft. or
Commercial K Residential 1=1 portion 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 urrent licenses) �+ 4b. Services or Feeders
Electrical Contractor. �±.4r/./A1c.1`dl /d se %, Lo. Installation, alteration, or relocation gyp/
Address o l� a 7�,� 200 amps or less / $60.00 4 h . / 2
'� 201 amps to 400 amps $80.00 2
City �ss.QXpl €. vs V State 40,e-- Zip *7 ?4' 401 amps to 600 amps $120.00 2
Phone No. 2 2... 2' -/ dZ/ 601 amps to 1000 amps $180.00 2
Job No. O Z- Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. Pi.- S C._ Exp.Date to -/ - 9 g --- ✓ Reconnect only $50.00 2
OR State CCB Reg. No. 192_ Exp.Date //- /2. "II' SI/ 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date - Installation, alteration, or relocation
200 amps or less $50.00 2
�� i 201 amps to 400 amps $75.00 2
Signature of Supr. E R� / /., i _J, / ,.J 1 i!'' 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No /13 - 5 Exp.Date /4e - $ $ see "b" above.
Phone Nc. __2 -p S' /
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 circ $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 $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: g/ Not required for temporary construction services. 5a. Enter total of above fees $ by.
5% Surcharge (.05 X total fees) $ 3
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 ID TIME AFTER WORK IS COMMENCED. Trust Account # 63,
Total balance Due $
1: \DSTS\ELC96.APP Rev 9/96
6/16/99 Activities for Case #: ELC98 -00172 •
2:05:57 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received • 4/8/98 DLH RECD DLH 4/8/98
ELCC003 Permit created 4/8/98 DLH DONE DLH 4/8/98
ELCC700 Ceiling Cover DLH 4/8/98
ELCC720 Wall Cover DLH 4/8/98
ELCC730 Elect'I Service DLH 4/8/98 •
ELCC799 Elect, Final • NOTE JT 1/13/99 1/13/99 inspection request
• (research) sent to Chuck
ELCC500 (F)Issue permit 4/8/98 DLH DONE DLH 4/8/98
ELCC920 Miscellaneous action 2/2/99 CD FAIL CD 2/2/99 spoke with mel at Graham
electric, he will search records
& reschedule.
ELCC799 Elect! Final 2/4/99 CD PASS CD 2/4/99 pane change
ELCC800 Case Finaled 2/4/99 VLN 2/4/99
•
•
•
- Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location / 1 (o ( � �,GZu Suite MEC
•
Contact Person Ph PLM
Contractor / .n.c f4-a Ph _222- 1324 / SWR
BUILDING Tenant/Owner La , /,. �/ , �� !�
Retaining Wall AO ELR
Footing Access:
Foundation l l [, FPS
Ftg Drain Re_e_e SGN
Slab
Crawl Drain Inspection Notes: _ A � J
SIT
Post & Beam
Ext Sheath /Shear
Ina Framing /Shear
Fra V � /
ming / "I 1,
Drywall on J
Drywall Nailing -VC
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final J �
PASS PART FAIL _ T g?
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
PAR FAIL
( ECTR
Sew
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
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 /I
Other Date 07 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.