Permit CITY OF TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC2000 -00419 -
;. /_�, DEVELOPMENT SERVICES DATE ISSUED: 7/27/00
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 200
SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Installation of one branch circuit.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
TIGARD PROPERTIES INC ELECTRICAL CONTRACTORS & DESIG
2106 SE OCHOCO ST 150 NE VICTORY SUITE A
MILWAUKIE, OR 97222 GRESHAM, OR 97070
Phone: Phone: 666 -9358
Reg #: LIC 47712
ELE 26 -466C
SUP 1882S
FEES Required Inspections •
Type By Date Amount Receipt
Elect'l Service
PRMT DEB 7/27/00 $35.00 0004015 Elect'I Final
5PCT DEB 7/27/00 $2.80 0004015
Total $37.80
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies • I es • - s or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE IL.:.. 21/ .4. k ISSUE 0 BY: `/
_ 1.-4 _ _ /
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. .
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: gk,9 DATE:
LICENSE NO: .— •9/71-1-�
Call 639 -4175 by 7:00pm for an inspection the next business day
Community Development ELECTRICAL PERMIT APPLICATION
,, 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # EGC - t9
r? t\ Permit #
1' � ; I j Phone (503) 639 -41Z I Date Issue
` I I � FAX (503) 684-729W° C
nn��Q Issued by k
CITY OF TIGARD TDD No. (503) 684 -2772 c4$ (-
Inspection (503) 639 -4 1. � - 40. NS
1. Job Address: 004N\ O 4. Complete Fee Schedule Below:
Name of Development r� ,, Number of Inspections per permit allowed
Address 1 1 949 SW Pa t^ i f i r Hwy . Service included: Items Cost(ea) Sum
City/State/Zip Ti gard 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) Rn 1
c i P Na i 1 a
Each additional 500 sq. N. or
portion thereof $25.00
Commercial K3ax Residential ❑ Limited Energy $25.00
Each Manurd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
E lectrical Contractors & Design Installation, alteration, or relocation 2
Electrical on raC or 200 amps or less $60.00 2
Address 150 NE Victory Suite A 201 amps to 400 amps $80.00 - 401 amps to 600 amps $120.00 2
CityGresham State Or . Zip 9 7 0 3 0 sot amps to l000 amps $180.00 2
Phone No.( 5 0 3) 6 6 6-9 3 5 8 Over 1000 amps or volts $340.00 2
Contractor's License No. 2 6 - 4 h 6 c to - I -00 Reconnect only $50.00
Contractor's Board Reg. No. 4771 2 530 -0) 4c. Temporary Services or Feeders
1- � Inst0 alteration, or relocation 2
200 amps or less $50.00 2
Signature of Supr. Elec'n � 2
License No. 1882 $ Phone No.h 6 -9358 201 amps' °coo amps $75.00
I 401 amps to 600 amps $100.00
• /D -� _p/ Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
.,_ r. < 011 .
The installation is being made on property I own which is purchase of service or feeder fee. First branch circuit branch 1 $35.00 U 2
not intended for sale, lease or rent. Each additional bran circuit $5.00
Owner's Signature 4e. Miscellaneous d
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation arcs $40.00 2 - Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
-
4 or more residential units in one structure Mi Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per ins $35.00
Per hour $55.00
-
In Plant $55.00 60
Submit 2 sets of plans with application where any of the above �
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fee $ �� . . '
5% Surcharge total fees) g / I $ t0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ P•
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. E % of • for 1 , ; l. - �s
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan f. (Sec. + ; $ �/
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. ❑ Trust Account # $
Balan e Due g ,}2=8)= to
I ' 47. • ` ' ` r
radV.ronM��MMrpm.app �
rill' CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested AM PM BLD
Location // f 4) SGT 6 c c(- Suite 2-V ` MEC
Contact Person Ph eoa - f 3 5d ) PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 'ovL - OU y/
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc ,�' C' g ,5 15 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
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
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
A � /
Approach/Sidewalk
Date Inspector • � • Ext
Other Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.