Permit 401: CITY OF TIGARD ELECTRICAL PERMIT
! ` "' ° '' ll N . DEVELOPMENT SERVICES PERMIT #: ELC97 -0526
-� _ I ,� 1 3125 SW Hall Blvd., Tigard, OR 97223 (503 639.4171 DATE ISSUED: 08/05/97
PARCEL: 1S135DD -03301
SITE ADDRESS...:11945 SW PACIFIC HWY #303
I SUBDIVISION . HOFFARBER TRACTS NO. 1 ZON I NG : C - -G
BLOCK • LOT •2 JURISDICTION: TIG
Proj ect Description : Installing first branch circuit and one add' 1 branch circuit
- -- RESIDENTIAL UNIT-- - - -- -TEMP SRVC /FEEDERS - - - - --MISCELLANEOUS--
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD' L 500SF...: 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 : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp : 0 1st W/0 SRVC OR FDR.: 1 PER HOUR . 0
401 - 600 amp...... : 0 EA ADD' L BRNCH C I RC : 1 I N PLANT • 0
601 - 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS > 600 VOLT NDMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: - -- - -- -- - - - - -- ------------ FEES - - - - - -- -
TIGARD PLAZA OFFICES type amount by date recpt
11945 SW PACIFIC HWY PRMT $ 40.00 B 08/05/97 97- ;297969
STE 303 5PCT $ 2.00 B 08/05/97 97- 297969
TIGARD OR 97223
Phone #:
i
Contractor: - -- --- -- -- ---
KELSO ELECTRIC INC $ 42.00 TOTAL
7476 SW 173RD
- - - -- REQUIRED INSPECTIONS - - -- - - -- --
ALOHA OR 97007 Ceiling Cover Elect' 1 Service
Phone #: 649 -8142 Wall Cover Elect'1 Final
Reg #.. : 001162
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 952 -iq-8818 through OAR 952-881 -1987. You say obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: j-M ,�.�G- Issued By:_ 6PIAA/14a PA--deat----'
-- - - - --- -- -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 : .- 6/5 S''7
Or
LICENSE NO: V 270S _
++- I-++++++++++++++++++++++++++++++++++++++++++++++ + ++ ++ + + ++ ++ + + + + ++ + + + + + + + + + + + -F4
Call. 639-4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + +- F + +- I- +-F + + + ++
CLTY Or TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd 8`5 -
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # Fgelit 5
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: X03 4. Complete Fee Schedule Below:
Q
Name of Development ` / 1 /G4 124 r2F.47/ .i C Number of Inspections per permit allowed
Name (or name of business) / �1 Service included: Items Cost Sum
I
Address 1/ 5 Ys /04 C / / G. //c /V 4a. Residential - per unit
City/State/Zip 1000 sq. ft. or less $110.00 4
Ci
ty p / r �X .4/lp O' ' 7 7. T 3 Each additional 500 sq. ft. or
Commercial l Residential ❑ Li 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) 4b. Services or Feeders
Electrical Contractor 4 S 54 - / Installation, alteration, or relocation
Address N7/ .S t i2 / 73'°' 20 amps to or less $60.00 2 -
!� 201 amps to 400 amps $80.00 2 -
City 4/ oNA State G Zip epoo7 401 amps to 600 amps $120.00 2
Phone No. ,S 96G_s--' 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 3V- Exp.Date / 7
OR State CCB Reg. No. //‘Z.5 Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
1..'7.-Z 200 amps or less $50.00 2
Signature of Supr. Elec'n .1/1", 201 amps to 400 am $75.00 2 -
401 amps to 600 amps $100.00 2
-
Over 600 amps to 1000 volts,
License No. 4Z7 0 .5 Exp.Date / a// /y$ see "b" above.
Phone No. ,1 96r5 /
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. o n
First branch circuit / $35.00 j' r 2
The installation is being made on property I own which is not Each additional branch circuit T $s.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. 5. Fees: y o 0 o
Not required for temporary construction services. 5a. Enter total of above fees $ o
5% Surcharge (.05 X total fees) $ --�-
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
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # z12 t oo
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
•
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0526
TIGARD PLAZA OFFICES
11945 SW PACIFIC HWY Unit: 303
10/26/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
ELCC001 Application received / / / / 08/05/97 RECD B 08/05/97 DST
ELCC003 Permit created / / / / 08/05/97 PASS B 08/05/97 DST
ELCC500 (F)Issue permit • / / / / 08/05/97 PASS B 08/05/97 DST
ELCC700 Ceiling Cover / / / / / / 08/05/97 DST
ELCC720 Wall Cover / / / / / / 08/05/97. DST
ELCC730 Elect'1 Service / / / / . / / 08/05/97 DST
ELCC799 Elect'1 Final / / / / / / 7/31/98 inspection request sent to 07/31/98 JT
Chuck /research
ELCC799 Elect'1 Final / / / / 08/18/98 a/c unit replaced PASS CD 08/18/98 CD
ELCC800 Case Finaled / / / / 09/02/98 09/02/98 JT
ELCC920 Miscellaneous action / / / / 08/04/98 unable to locate suite 303, left message FAIL CD 08/04/98 CD
for kelso electric to call back with
info.
ELCC920 Miscellaneous action / / / / 08/11/98 need access to roof FAIL CD 08/11/98 CD
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