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Permit .. _ CITY OF T ELECTRICAL PERMIT PERMIT #: ELC99 -0044 � DEVELOPMENT OPMEN SERVICES 6C 9 ES DATE ISSUED: 01/20/99 13125 SW PARCEL: 25110AA -00700 SITE ADDRESS...: 14030 SW PACIFIC HWY SUBDIVISION ZONING:C -G BLOCK • LOT . JURISDICTION: TIG Project Description: Tigard Unocal 76 -- -- 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 CIRC: 11 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 -- -- TOSCO MARKETING type amount by date recpt PO BOX 52085 PRMT $ 90.00 JSD 01/20/99 99-312299 PHOENIX AZ 85072 5PCT $ 4.50 JSD 01/20/99 99-312299 Phone #: Contractor: 911 ELECTRIC LLC $ 94.50 TOTAL 10055 E BURNSIDE REQUIRED INSPECTIONS PORTLAND OR 97216 Ceiling Cover Elect'1 Service Phone #: 408 -7334 Wall Cover Elect' 1 Final Reg #..: 129423 This peroit 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 the Oregon Utility Notification Center. Those rules are set forth in OAR 958 -001 -0010 through OAR ? 'e:- ' 87. You Nay obtai• - ..y of these rules or direct questions to I •y call'ng (•' 46-987. Permittee Signature: � 4 . - 4* Issued By: .1001111k. -- 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: LICENSE NO: ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++- F++++++++++++ + + + + + + + + + + + + + + + + + + + + + ++ + + + + + +-F CITY-OF TIGARD Electrical Permit Application Plan C i/' 13125 SW HALL BLVD. Rec'd : / _ Date Rec'd i TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Print or Type Inspection (503) 639 -4175 Permit# G1-C !- era t< y Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called (51-Y 1. Job Address: 4. Complete Fee Schedule Below: Name of Development.'-7!/!e/V e/i L ,, / 1itL C Number of Inspections per permit allowed Name (or name ,, of business) T�6 -AW/) U /V��L Service included: Items Cost Sum Address / w3 Std ) kiC/ Z i ci /-1w('/ 4a. Residential - per unit City/State/Zip `7/(t' a ©e g 7223 1000 sq. ft. or less $110.00 4 Each additional 500 sq. ft. or Commercial Residential ❑ 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 al r -nt license 4b. Services or Feeders Installation, alteration, or relocation t Electrical C ctor - �� L �- 200 am s or less $60.00 2 AddreS .ura 201 amps to 400 am $80.00 2 City ;uG State '! / Zip ! - - 401 amps to 600 amps $120.00 2 Phone No. 4 (] - 73 3 601 amps to 1000 amps $180.00 2 Over 1000 amps or volts $340.00 2 Elec. Cont. Lice. No. 2 /O Exp.Date /y t 9� econnect only $50.00 2 B Reg. No4 /2 / Ex .Date £ 2G o- OR State CC g 94/ � p � � 4. Temporary Services or Feeders COT Business Tax or Metro N : Ex . ate Installation, alteration, or relocation 200 amps or less $50.00 2 - Signature of Supr. Elec'n .41 Vari 201 amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 - Over 600 amps to 1000 volts, License No. 33 9 / 5 Exp.Dat 4�// 6/ see "b" above. Phone No. C 22 ' _ 7 3 3 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. First branch circuit / $35.00 2 - The installation is being made on property I own which is not Each additional branch circuit $5.00 f 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: 9 0. Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ NOTICE Subtotal $ 9 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 # /a $ % c Total balance Due I: \DSTS \ELC96.APP Rev 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 Q BUP Date Requested 3 "2P ' 1 AM PM BLD Location / 41(7. � � (. U Suite MEC Contact Person Ph 3713- /(l )I PLM Contractor Ph SWR BUILDING T420wner ()Kai "26 t5 sti , ELC 4q I Retaining Wall ELR Footing Access: Foundation // FPS Ftg Drain f14M7%J/'�'ec C Arm lc,or/ S -e G cdr, t-y/ SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing AiYL� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling • Roof / Misc: Final PASS PART FAIL PLUMBING I� Post & Beam J 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 PAT FAIL (ELECTRICAL) Service Rough In UG /Slab Low Voltage Fire Alarm rn PART FAIL S TE 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 — 3 ' 2 9 h Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .