Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00014
��;�, DEVELOPMENT SERVICES DATE ISSUED: 01/24/2000
s ^ 13125 SW Hall Blvd.. Ticiard, OR 97223 (503) 639 -4171 PARCEL: 2S101BB -00301
SITE ADDRESS: 11834 SW PACIFIC HWY
SUBDIVISION: TIGARD ROAD GARDENS ZONING: C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Electrical TI
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: 5 W /SERVICE OR FEEDER: 98 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: 1 PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: X CLASS AREA/SPEC OCC: X
Owner: Contractor:
EQUIVA SERVICES/TEXACO T W E INC
3800 ST HELENS RD PO BOX 781
PORTLAND, OR 97296 13731 SE 312TH
BORING, OR 97009
Phone: 503 - 225 -4223 Phone: 668 -6711
Reg #: LIC 00064400
SUP 2604S
PLM 2640S
ELE 26 -252C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT BON 01/04/200C $1,038.05 00- 320185 Wall Cover
PLCK • BON 01/04/200C $259.51 00- 320185 Underground Cover
5PCT BON 01/04/200C $72.66 00- 320185 Elect'I Service
Elect'I Final
(additional fees not listed here) ORIGINAL
Q r
Total $1,380.60
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 OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY: / // r y r
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:
CONTRACTO 11NST/ dlatiON ONLY
SIGNATURE OF SUPR. ELEC'N: _ !A . Pe DATE:
LICENSE NO: p(,()x -/ S
Call 639 -4175 by 7:00pm for an inspection the next business day
Dec -15 -99 02:52P PNECORP- PORTLAND 503 684 7894 P.03
CITY"OF TIGARD Electrical Permit Application Plan Chec o / -oa-e
13125 SW HALL BLVD. Redd By �� -
Date Recd / -4
TIGARD OR 97223 Date to P.E. /
Phone (503) 639 -4171, x304 Date to DST I - / < 7'- / 13
Inspection (503) 639-4175 Print of Type Permit# F LC 2d.19 -r 2i?t 4-
Fax (503) 598 -1960 Incomplete or illegible will not be accepted - Called
1. Job Address: 4. Complete Fee Schedule Below.
Name of Development TEXACO _ Number of Inspections per permit allowed
Name (or name of business)Equiva Services/TEXACO Service included: Items Cost Sum
Address 11834 SW Pacific Ilwy 4a. Residential - per unit
1000 sq. fl. or less $ 117.75 4
DIY/State/4 Tigard, OR 97223 Each additional 500 sq. R. or
Commercial portion thereof $ 26.25 t
Commercial ❑ L imited Energy $ 60.00
Each Manuf. Home or Modular
2a. Contractor installation only: Dwelling Service of 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 ontract r Te4ilitt 1 k) L r I vt ` 200 amps or less __ _ $ 64.25 39J. 2
Addre s r.0, . 0(j)C - 1 201 amosto400 amos $ 85.50 2
City , _ _ O Y" ; S 401 amps to 600 amps $ 128.50 2
5 ` 601 amps to 1000 amps - ! $ 192.50 2
Phone No. • AO (o C $ - (P I I Over 1000 amps or volts $ 363.75 2
Job No. 0. t. - S 7.)(D I Reconnect only $ 53.50 2
Elec. Cont. Lice. No. c .Q ts -nQ 5, C Exp.Date 10. - 00 4c. Temporary Services or Feeders
OR State CCB Reg. No. , 6 'I CI OCR Exp. D - oR .0E701 Installation, alteration, or relocation
COT Business Tax or Metro No. 1 4 Q E 1. D -Ate, 9- I- 00 200 amps or less $ 53.50 2
Oki 201 amps to 400 amps $ 86.25 2
Signature of Supr. Eisen W f, / 401 amps to 600 amps $ 107.00 2
Over 600 arms to 1000 volts,
License No. 9(0 01 4 S Exp.Date 1 0. • GI see "b" above.
Phone No. 11% - 05 4 � 4d. Branch Circuits
New, alteration or extension per panel
a)
2b. For owner installations: with purchase ase branch circuits s
service or
feeder fee.
Print Owner's Name Each branch circuit 9 g $ 5.35 S29,3 Q 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 sate, 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 circult(s) or a limited energy
3. Plan - Review section (if re uired I : " Minor alteration or extension - - $ 60.00 nor Labels (10) $ 107. . 0
o0
Please check appropriate item and enter fee in section 58. 4f. Each additional Inspection over
4 or more residential units in one structure the allowable In any of the above
Service and feeder 225 arnps or more Per Inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
X Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
• 5a. Enter total of above fees $ / n2)6.0(
Submit 2 sets of plans with application where any of the above apply. 7% Surcharge (.05 X total fees) 1; . / t '
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 k 'isC) 0
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS El Trust Account # . --
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due
CO- 32-0
- 04/07/2000 Activities for Case #: ELC20OO -00014
2:52:44 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 01/04/2000 DRA RECD No Hold BON 01/10/2000
ELCC003 Permit created 01/10/2000 BON DONE No Hold BON 01/10/2000
ELCC102 Plans routed to Plans Examiner 01/10/2000 BON DONE No Hold BON 01/10/2000
ELCC110 Plans checked /approved by P.E. 01/19/2000 BP PASS No Hold DGW 01/19/2000
ELCC115 Approved plans routed to DSTs 01/19/2000 BP PASS No Hold DGW 01/19/2000
ELCC700 Ceiling Cover 01/19/2000 01/19/2000 02/22/2000 BRP PASS No Hold AKJ 02/22/2000
ELCC720 Wall Cover 01/19/2000 01/19/2000 02/22/2000 • BRP PASS No Hold AKJ 02/22/2000
ELCC725 Underground Cover 01/19/2000 01/19/2000 01/19/2000 BRP PASS No Hold AKJ 01/26/2000
ELCC730 Elect'I Service 01/19/2000 01/19/2000 03/20/2000 CD PASS No Hold AKJ 03/20/2000
ELCC799 Elect'I Final 01/19/2000 01/19/2000 04/06/2000 CD PASS No Hold AKJ • 04/06/2000
ELCC117 DST Post - Review complete 01/24/2000 BON DONE No Hold . BON 01/24/2000
ELCC400 (F)Ready to issue 01/24/2000 BON DONE No Hold . BON 01/24/2000
ELCC500 (F)Issue permit 01/24/2000 GEO DONE No Hold DST 01/24/2000
ELCC725 Underground Cover 01/30/2000 01/30/2000 01/28/2000 BRP PASS No Hold AKJ 01/30/2000
ELCC725 Underground Cover 02/17/2000 02/17/2000 02/17/2000 BRP PASS No Hold AKJ 02/17/2000
. ELCC700 Ceiling Cover 03/24/2000 BRP PASS No Hold AKJ 03/26/2000
ELCC800 Case Finaled 04/06/2000 AKJ DONE No Hold AKJ , 04/06/2000 .
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested q Cp/00() AM � ( PM BLD
Location ii <r;(-1 4 G /443 LA Suite MEC
Contact Person PIA Ph COCi —co7 (I PLM
Contractor Ph SWR
BUILDING Tenant/Owner � )YL(,e;p 4 2>ab -Q L)e L/
Retaining Wall C,Y30L05
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 1
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
PASS PART FAIL
E
Rough In
UG /Slab
Low Voltage
Fire Alarm
ta llip . •
PART FAIL
S 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 Date
44/62f2--- Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.