Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00349
ter^ DEVELOPMENT SERVICES DATE ISSUED: 6/14/99
I l i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S136CA -01700
SITE ADDRESS: 11645 SW PACIFIC HWY
SUBDIVISION: ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of a temp 200AMP service /feeder.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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 +amps -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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: • 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:
•
KEN WATTS
•
11645 SW PACIFICE HWY
•
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRMT GEO 6/14/99 $53.50 99- 316104 Elect'l Final
5PCT GEO 6/14/99 $2.68 99- 316104
Total $56.18 ORIGINAL
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 952001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Permit Signature: Issued By: %�
OWNER INSTALLATION ONLY
The installation is being made on property I.own which is not inte ded for sale, lease, or rent.
OWNER'S SIGNATURE: -� - %�/LL DATE: fo — / 9 — 9
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
•
CITY OF TIGARD Electrical Permit Application Plan Check#
131 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type Permit #l
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: - 4. Complete Fee Schedule Below: .
Name of Development !.( A) W ►1 Res:' cLoc.P Number of Inspections per permit allowed
Name (or name of business) n Service Included: Items Cost Sum 4,
Address / /G Y5 S rf� c F.1.- . 4a. Residential - per unit
City/State/Zip 1'I q� a o /_ 9722 3 1000 sq. ft. orless $ 117.75 4
<1 Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial ❑ Residential ca 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 data base). Installation, alteration, or relocation
Electrical Contractor 200 amps or less $ 64.25 2
Address 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City State Zip 601 amps to 1000 amps $ 192.50 2
Phone No. Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. Exp.Date Installation, alteration, or relocation 7ti
COT Business Tax or Metro No. Exp.Date • 200 amps or less I $ 53.50 A5 • 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
see "b" above.
License No. Exp.Date
Phone No. 4d. Branch Circuits
New, alteration.or extension per panel
a) The fee for branch circuits •
2b. For owner installations: with purchase of service or
�
- I) feeder fee.
Print Owner's Name kra rn 5 (4 )iA ! Each branch circuit $ 5.35 2
Address �f' �/r S E&.) p c: ; b) The fee for branch circuits
without purchase of service
City rr C re c - State Ole Zip `77z 2 3 or feeder fee.
Phone No. Uu e - r \ 7,f 1r - /93/ First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or nt. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signa 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) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
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: s
5a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) $ 2 , 6,2
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 # / p/
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 56 1 p
i:\dsts\forms\electric.doc •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested £ ' / ( -/9 AM PM BLD
Location I 1 i VI Pl Suite MEC
Contact Person Ph iS L -- Z :rn PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC ( q -' W3/1
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
Insulation
Drywall Nailing �._ /' " /mss _
Fire Sprinkler
Fire Sprinkler _
Fire Alarm
Susp'd Ceiling ; C4
Roof
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
S�RT FAIL
CTRICA )
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fi
PART FAIL
E
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
Other D CO ""7 * 9 9 ns P I ector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.