Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00513
40 ft, DEVELOPMENT SERVICES DATE ISSUED: 10/17/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102BD -02600
SITE ADDRESS: 12965 SW PACIFIC HWY
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT : 037 JURISDICTION: TIG
Project Description: Installation of (2) branch circuits.
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: 1 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:
KIM, ROBERT + HAE LIM SONSHINE PRODUCTS
1360 SW WOODWARD WAY 8596 SW DAKOTA DR.
PORTLAND, OR 97225 TUALATIN, OR 97062
Phone: Phone: 503 - 885 -0997
Reg #: ELE 34 -565C
LIC 110240
SUP 4648S
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 10/17/01 $53.50 2720010000( Wall Cover
Elect'I Final
5PCT CTR 10/17/01 $4.28 2720010000(
Total $57,78
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 -00 rough OAR 952 - 001 -0080. You may obtain copies of these rules or dired questions to
L . Permit Signature L n // n� / , Issued By: - �
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: /WI �!. /_ _/, ■ DATE:
LICENSE NO: 1/6 7 c S
Call 639 -4175 by 7:00pm for an inspection the next business day
. ,.. . .
. A Electrical Permit A 1 1 ligation
Datereceived: 0 /11 p) Permit no.: ( ,- f_oosi
_' .�1 City of Tigard T' C-, Projectfappl.no.: - Expire date:
CirynjTigard Address: 13125 • SW Hall Blvd, Tig.. -• s • 97223 Date issued: By Receiptno.:
Phone: (503) 639 -4171 ��
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use appro
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑'Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: /25765 SLr/ %pi r i I C [� Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 'Block: 'Subdivision:
Project name: \ I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCIIEDILE
Job no: • /11 dal C Al l4 Press Fee Max
Business name: - /y S�ii.i£ : er -1, / . .. * o . Description Qty. (en.) Total no. insp
New residential -single or multi- family per
Address! iges5 •1± (`�c:•l'±+t: .� -
., 7 dwelling unit. lncludes attached garage.
City: 4 9, I State: ad ZIP: r - je2(1. . Service included:
Phony :,74$rfCFr'f Fax: E -mail: 1000 sq. ft. or less 4
CCB no.: / 10 A./0 I - Z - C Elec. bus. lic. no: Each additional 500 sq. ft. or portion thereof
� � 5 � 5 C— Limited energy, residential 2
City/ metro lic. no / 0-01 - 0 2 Limited energy, non - residential 2
t'1 4 An . Each manufactured home or modular dwelling
Signature of supervising electrician ( 1 04 Date /e - /r — r Service and/or feeder 2
Sup. elect. name (print): G A R. L. 3 i 6 License no: : s Services or feeders - installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am . s 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: 'service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 1 2
Each additional branch circuit: / •
PLAN REVIEW (Please check all that apply) Misc. (Servlceor feeder not included):
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1&2 O Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension' 2
0 Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
O Egress/lighting plan O Other. Per inspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other y,
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 53. S V
❑ Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6A0/COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES
•
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4
Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1
Limited Energy $75.00 ❑ Burglar Alarm
Each Manuf'd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener*
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other .
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2 •
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ❑ Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel. ❑ Boiler Controls .
a) The fee for branch circuits '
with purchase of service or ❑ Clock Systems
feeder fee.
•
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
.without purchase of service ❑
or feeder fee. Fire Alarm Installation '
`First branch circuit / $46.85
Each additional branch circuit i/ $6.65 ❑ HVAC
Miscellaneous El
Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ • Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ 53. g) ❑ Other
8% State Surcharge $ W. K' p
Number of Systems
25% Plan Review Fee
See "Plan Review" section on • $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ C 7
• Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
All New Commercial Buildings require 2 sets of plans.
Total Balance Due $
•
i :\dsts\forms\elc- fees.doc 08/30 /01
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP /
Date Requested 1 —=)- 9 AM PM BLD
Location / a' 6. g f2'- l■7, / Suite MEC
Contact Person rn Ph xE 0757 PLM r
Contractor Ph3 9 - , Sz) ._,,..co SWR
BUILDING Tenant/Owner - p - - ELC aid l a as73
0 /L mo=
Retaining Wall r-- ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing %v14pti 11fd .
Insulation
Drywall Nailing (4 bra di C `Z-te,1 _
Firewall
Fire Sprinkler /c 7. 1i'� A -/- �1X7
Fire Alarm lJ l
Susp'd Ceiling ) r 47 y, //f / + l /� �'S� -Mie-1 c<
Roof
Misc:
Final
PASS PART FAIL
PLUMBING , IL 'i .,, 1
Post & Beam — -
Under Slab
Top Out
Water Service
Sanitary Sewer 6194
Rain Drains 44,,) ; n s- -- /vaiey 1 i t
Final
PASS PART FAIL VS; s C Cr G)/s ��
MECHANICAL /� �.�,�
Post & Beam 'Y rl'fp ta , M2'� / P n t e � 6lcvii,h C e—t '"y"" Rough In /) (��� p1�® GC' // 1.1 c k.- 4
Gas Line d
Smoke Dampers iAl S //fel c a ,c4.) A., ,yt vvnf
Final
PASS PART FAIL ep ri' ?/ r�� � v r ' Pig ��
s-r..
ELECTRICAL `
Service
craVVD
UGISlab
Low Voltage
Fire Alarm .
■;, PART FAIL . .
SI
•
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required efore next inspection. ay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
1
ADA
Other oach /Sidewalk Date /(, /
'� / Vo ff/ Inspector. Ext
Final I
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.