Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC 8 -061 .
. „.4 v 1111. ,& DEVELOPMENT SERVICES DATE ISSUED: 10/14/98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1S136CD -00200
SITE ADDRESS...:11705 SW PACIFIC HWY #L
SUBDIVISION....: ZONING:C —G
BLOCK LOT ° JURISDICTION: TIG
Project Description: Electrical TI
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS ° 0 0 — 200 amp 0 PUMP /IRRIGAT,ION 0
EACH ADD' L 500SF...: 0 201 — 400 amp.......: 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY.....: 0 40,1 — 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......: 0 W /SERVICE OR FEEDER: 10 PER INSPECTION.....: 0
201 — 400 amp • 1 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
PACIFIC CROSSROADS PROPERTIES type amount by date recpt
BY WYSE INVESTMENT SERVICES CO PRMT $ 130.00 B 10/08/98 98- 309825
200 MARKET STE 345 PLCK $ 32.50 B 10/08/98 98- 309825
PORTLAND OR 97201 SPCT $ 6.50 B 10/08/98 98- 309825
Phone #:
Contractor: - - - - --
AMP ELECTRIC $ 169.00 TOTAL
9400 NE 4TH PLAIN RD
REQUIRED INSPECTIONS
VANCOUVER WA 98662 Ceiling Cover Elect'l Service
Phone #: 222 -1647 Wall Cover Elect'l Final
Reg #..: 000781 • •
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
t he Oregon Utility Notification Center•. Those rules are set forth in OAR 952 -' 1 -''10 through DAR 95 - 001 -1987. You m obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987. 40/,'
Permittee Si nature ' ,(,* - ��
- - - -- 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: /O / f
LICENSE NO: 3sslp j- S
- h+++++=+++++++++++++++++++++++++++++++++++++++++ ++ + + ++ + + + + + + + + + + + + + + + + + ++ + ++ + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++ 4+++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
'/98 W.FD 13:33 FAX 503 598 1960 CITY OF TIGARD 2002
-1 CITY OF TIGARD Electrical Permit Application PlanChec ) 7 -1 C.
13125 SW HALL BLVD. Rec'd By W ,
'TIGARD OR 97223 Date Redd I b - �
Date to P.E. ID A - 1,$.5
Phone (503) 639 -4171; x304 Date to DST
Print or Type s.
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit t 't +I Z
Fax (503) 684 -7297 Called 5'T6-cd - i0 %`9e `
1. Job Address: + 4. Complete Fee Schedule Below:
p .
Name of Development to 5 S()r)rd-tnr Good Number of Inspections per permit allowed
Name (or name of business) bra ` ,('-l C-Ito4c1 Service included: Items Cost Sum
1
Address 1l °lOS 5u3 '('a -G1 -t'(:, l 4a. Residential - per unit
1000 sq. ft. or less _ $110.00 4
City /State/Zip ' T9 O r ( a ■ D t in Each additional 500 aq. ft. or
Commercial ® Residential ❑ portion thereof $25.00. 1
Limited Energy _ $25.00
Each Manut'd Home or Modular
Dwelling Service or Feeder • $65.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor 'Amp E.1 N,.G - 1 - IC-. installation, alteration, or relocation
200 amps or less $60.00 2
Address f 2.2 -00 1.../E tj4 -. 10h S.pi,FP, At hl 201 amps to 400 amps I ' $80.00 RA . co 2
City VA.4 - 1r idwe,l- State \ 1,) A Zi tifS1 o@iZ. 401 amps to 600 amps $120.00 2
Phone No. t,. 5 03 22Z2- - t \.44- --1 601 amps to 1000 amps _ $180.00 2
Job No. SP) .- 3Flot o Over 1000 amps or volts - $340.00 2
Elec. Cont. Lice. No. 3'1 -51g i C.. Exp.Date if) - i - q e ✓ .. Reconnect only - $50.00 2
OR Slate CCB Reg. No. ' ) k 52 Exp.Date b - Ob.,- LX) 1 4c. Temporary . Services or Feeders
COT Business Tax or Metro 1 ,5512.• Exp.Date Installation, alteration, or relocation
• -- 200 amps or less $50.00 2
Signature of Supr. Elec'n Al i_ A A Ali alit/ 401 amps to 600 amps _ $10C o0 z
f O ver 600 amps to 1000 volts,
License No. 3R t A S / Exp.Date I O - O t - p 1 see °b° above.
Phone No. ('5 3" 1.7-'7.... - i la q-`l .
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. e0
Address Each branch circuit 10 $5.00 be 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 teeder 225 amps or more the allowable In any of the above
System over 690 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' 1 et,
Not required for temporary construction services. Ca. Enter total of above fees $ tp 5Q
5% Surcharge (.05 X total fees) $
NOTICa Subtotal $ i
6b. Enter 25% of line 6a for 32 AO
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ 11.,rt -Oa NOT COMMENCED WITHIN 180 DAYS, OP. IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY B
TIME AFTER WORK IS COMMENCED. El Trust Account # iL 7 00
Total balance Due S . . 7
1: \DSTS\ELC5$,APP ' Rev Lob ,
•
.n ;;
3/7/00 Activities for Case #: ELC98 -00612
8:46:40 AM
Assigned Hold Updated .
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 10/8/98 B RECD BON 10/8/98
ELCC003 Permit created 10/8/98 B • DONE BON 10/8/98
ELCC102 Plans routed to Plans Examiner 10/8/98 B SENT BON 10/8/98
ELCC700 Ceiling Cover BON 10/8/98
ELCC720 Wall Cover 10/16/98 BRP FAIL B *P 10/16/98 Refer to art. 370 -20 and
• 370 -23. For compliance with
setback and wood exposed to
the device.
ELCC730 Elect'I Service 10/23/98 BRP PASS J *H 10/23/98 Service pass, old service no
mains, ADT system rough in
. pass, ELR98 -0289.
ELCC799 Elect'I Final 10/29/98 BRP PASS J *H 11/2/98 Service, walls /ceiling rough in
approved also.
ELCC115 Approved plans routed to DSTs 10/13/98 CD PASS CD 10/13/98
ELCC117 DST Post - Review complete 10/13/98 DLH DONE DLH 10/13/98
ELCC400 (F)Ready to issue 10/13/98 DLH PASS DLH 10/13/98
ELCC500 (F)Issue permit 10/14/98 GEO PASS DST 10/14/98
ELCC920 Miscellaneous action 10/19/98 CD FAIL CD 10/19/98 cancelled by j.t.
ELCC720 Wall Cover 10/22/98 BRP PASS B *P 10/22/98 Bathrooms and storage area
Rough in pass.No ceiling cover
until all cables are supported.
Will verify at final.
ELCA700 Rough -in 10/23/98 BRP PASS J *H 10/23/98
ELCC800 Case Finaled 11/2/98 RC PASS J *H 11/2/98
•
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
2..? /55 F Date Requeste '�" " C AM I� PM BLD
Location 1 1 705 Sc Par S y- Suite L MEC
Contact Person Ph 563- 2Z2' / 47PLM
Contractor Am P r r! -6CMC_ Ph �1 SWR
AP ILDING " 7 :'7': Tenant/Owner BIG- 5 Sr 3� ��11as ELC C ?4 )' ' . Q 6 (c;---
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 L t54' — 2 22 - jL tt 7
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling / L / — /.C-4 r/ C6 / F/ � �t / 4 SS
Roof C
Misc: J rt./ CP - R v 12?
Final /, U J A ) 4 LA. a II S 1 -S 5
PASS PART FAIL
PLUMBING x'. ; Dv k I li eel h h, S- P4 5's
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
i
Final
PASS PART FAIL
MECHANICAL ' g ',. ,
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL • CC i
ECTRICAL :: ;: ,
Se rvice
ough In ad2
UG /Slab
Low Voltage Vv
F - ! larm
S PART FAIL
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 Date /()"- ` A-9 9 Inspector 2,4,1_ . Ext 4
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
. 1