Permit • CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00188
1 DEVELOPMENT r o
SERVICES 639 -4171 ACES DATE ISSUED: 04/19/2000
— 13125 SW Hall
PARCEL: 1S136DA-00800
SITE ADDRESS: 11540 SW PACIFIC HWY
SUBDIVISION: FRUITLAND ACRES ZONING: C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Install a 200 AMP service /feeder and five (5) branch circuits.
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 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 5 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:
HIGH HAT CHRISTENSON ELECTRIC INC
11530 SW PACIFIC HWY 111 SW COLUMBIA
TIGARD, OR 97223 STE 480
PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
• PLM 2468S •
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
5PCT GEO 04/19/200C $7.28 0001546 Wall Cover
PRMT GEO 04/19/200C $91.00 0001546 Underground Cover
Elect'l Service
ORIGINAL
Total $98,28 Elect'l Final
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 or direct questions to I UNC at (503)
246 -1987. /
PERMITTEE'S SIGNATUR �� --- ISSUED BY:
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: DATE: /2
LICENSE NO: Sr 3 3 -5 c�'/ �
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check #
4,13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 • Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304
(503) 639 -4175
Date it DST
Inspection
( Print of Type Permit #F-Gd R00 -
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below: •
Name of Development SECURITY Number of Inspections per permit allowed
Name (or name of business) BABCO SECURITY Service included: Items Cost Sum •I'
Address 11540 SW PACIFIC HWY 4a. Residential - per unit
City /StateRtp TIGARD 1000 sq. f . or less $ 117.75 4
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial a Residential ❑ Limited Energy • $ 60.00
QUESTIONS? CONTACT HARRY MCCLANE 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. • • r Feeders
. information for COT data base). Instal . 1 . eration, or relocation
Electrical Contractor CHRISTENSON ELECTRIC, INC. • 200ampsorless 1 $ 64.25 64.25 2
Address 111 SW COLUMBIA, SUITE 480 201 amps to 400 amps $ 85.50 2
City PORTLAND State OR Zi 7201 -5886 401 amps to 600 amps $ 128.50 2
601 amps to 1000 amps $ 192.50 2
Phone No. 503 241 - 4812 Over 1000 amps or volts $ 363.75 2
Job No. 65 - 11295 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 26 -34C Exp.Date 10 /00 .4c. Temporary Services or Feeders
OR State CCB Reg. No. 458 Exp.Da / - 5/ ' 3 Installation, alteration, or relocation
COT Business Tax or Metro No. ,,A; 6 / .D - e 12/00 200 amps or less $ 53.50 2
:OAF amps to 400 amps $ 80.25 2
401 amps to 600 amps $ 107.00 2
Signature of Sup ... Over 600 amps to 1000 volts,
License No. b 2 3 Exp.Da e 10/01 see "b "above.
i
Phone No. 503 241 -4812 4d. Branch Circuits
4/19/00 New, alteration.or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
• feeder fee.
Print Owner's Name Each branch circuit 5 $ 5.35 26.75 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. 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 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) $ 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:
5a. Enter total of above fees $ 91.
* Submit 2 sets of plans with application where any of the above apply. W. Surcharge (0$X total fees) $ 7.28
Not required for temporary construction services. Subtotal $ 98.28
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 98.28
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 $ 98.28
//
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 S ( S/bO AM PM BLD
Location SI-I b 2L /, 'n Suite MEC
Q
Contact Person 1 al MA) Ph 626' 2 f PLM
'Contractor Ph SWR
BUILDING Tenant/Owner ELC 1(Y -00/88
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: ( _ !/ SGN
Slab p/i SIT
Post & Beam
Ext Sheath /Shear q7-6;0692.Z. --
Int Sheath /Shear bld yr►+.
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling J- / ^� - .4,
Roof
Misc:
Final
."*
PASS PART FAIL
•
PLUMBING
Post & Beam
Under Slab L 9,7 - 7 0
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
(ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4 0 11•ART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd •
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other s p D Inspector Ext
Final
PASS PART FAIL DO NO REMOVE this inspection record from the job site.