Permit 4 1' CITY OF T ELECTRICAL PERMIT
/Apo A DEVELOPMENT SERVICES PERMIT #: ELC97 -0622
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 09/19/97
PARCEL: 15136DA -00800
SITE ADDRESS...:1154O SW PACIFIC HWY
SUBDIVISION •FRUITLAND ACRES ZONING:C -G
BLOCK • LOT •001 JURISDICTION: TIG
Project Description : Add a 288 AMP service /feeder to a commercial tenant.
- -- 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/0 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
MOCCA HUT type amount by date recpt
11540 SW PACIFIC HWY PRMT $ 60.00 GEO 09/19/97 97- 299417
TIGARD OR 97223 5PCT $ 3.00 GEO 09/19/97 97- 299417
Phone #:
Contractor:
WILLAMETTE ELECTRIC INC $ 63.00 TOTAL
PO BOX 230547
REQUIRED INSPECTIONS
TIGARD OR 97281 Ceiling Cover Underground Cove
Phone #: 624 -3631 Wall Cover Elect'l Service
Reg #..: 000750
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 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 9521 -8818 through OAR 952 -801 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling ( 46 -1987. /
Permittee Signature: Issued By: Limormito;/
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 : 15P DATE : (999/q/
LICENSE NO: /9(i -s
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
i'' -
CITY Of TIGARD 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 DST
Inspection (503) 639 -4175 Print or Type Permit # C c
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development (A o C (t (4- -F- u t Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
I
Address i / c 4 0 S w P ft-c.,4 ( , c_. W .( 4a. Residential - per unit
y 1 1000 sq. ft. or less $110.00 4
f t 6.. n
City /State /Zip 1 15 t& A z Z 3 Each additional 500 sq. ft. or
Commercial ® Residential El 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 current licenses) e 4b. Services or Feeders
Electrical Contractor (0 , I I A M v N e C (e c,vt i s / , Installation, alteration, or relocation O o :.
200 amps or less $60.00 6 2
Address On A x .> 0 S 4 -( ' 201 amps to 400 amps $80.00 2
City T , ,4't n State 0_&_ Zip C/ Y Z5 ( 401 amps to 600 amps $120.00 2
Phone No. 3 4 2-4 - 36 3 f 601 amps to 1000 amps $180.00 2
Job No. is t z N Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 3ti ZS -
C - Exp.Date i s i•• S Reconnect only $50.00 2
OR State CCB Reg. No. 9 5 0 5 `i Exp.Date cs - 6 e t / 4c. Temporary Services or Feeders
COT Business Tax or Metro No. •lS y 6 Ex .Date S - f Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n ' G,. - - � 201 amps to 400 amps $ 5.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. ! 7 S - c Exp.Date l2 -f `' i - see "b" above.
Phone No. l0 2 Li - 3 6 3 / 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 circuit $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 circuit $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. S. Fees: $ L 2
Not required for temporary construction services. 5a. Enter total of above fees
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 ❑ d z
Trust Account #
TIME AFTER WORK IS COMMENCED.
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5 1S/00 AM PM BLD
Location 11 S- d PeLe. Lbw Suite MEC
Contact Person Q,!'1.4 ,/,0 Ph � 7,i)' ZTV, PLM
`Contractor Ph SWR
BUILDING Tenant/Owner ELC /-6()0 -00/68
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: n ��� SGN
Slab p)4 SIT
Post & Beam
Ext Sheath /Shear q 7 -coGo z a
Int Sheath /Shear bld ',Gyp)
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm -
c
Susp'd Ceiling �
Roof
Misc:
Final =
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab L ' 97 ° 7 ® i
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
I ASS PART FAIL
(ELECTRICAL 7
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
F 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 Q^
Approach /Sidewalk Date t� > an Inspector Ext
Other
Final
PASS PART FAIL DO NO REMOVE this inspection record from the job site.