Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00127
- � ��IjA DEVELOPMENT PMEN o
T SERV 2CES 639 -4171 DATE ISSUED: 03/22/2000
SW
PARCEL: 2S 110AB -00200
SITE ADDRESS: 14285 SW PACIFIC HWY
SUBDIVISION: CANTERBURY PLACE ZONING: C -G
BLOCK: LOT : 1 -3 JURISDICTION: TIG
Project Description: Install 1 branch cirucit in existing commercial building.
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:
KOLVE, G C PHOENIX ELECTRIC CO
14389 SW PACIFIC HWY 7379 SW TECH CENTER DR.
TIGARD, OR 97224 TIGARD, OR 97223
Phone: Phone: 684 -3600 LIC Reg #: SUP 41040S 052288 v I''1 • I G I ` A 1 + A
1 L
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT KJP 03/22/200C $37.50 0000865 Elect'l Final
5PC2 KJP 03/22/200C $3.00 0000865
Total $40.50
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 dir questions to OUNC at (503)
246 -1987. am , ,,
PERMITTEE'S SIGNATURE c ,� L Owe" -, 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: - DATE:
LICENSE NO: 471 $
Call 639 -4175 by 7:00pm for an inspection the next business day
MAR -20 -00 MON 02:28 PM PHOENIX ELECTRIC CO FAX N0, 15036843611 P. 02
CITY OF TIGARD
Electrical Permit Application
, 13125 SW HALL BLVD
TIGARD OR 97223 Plan Check.#
Recd By
Phone (503) 63 9 -4171, x304 Date Recd
Inspection (503) 639 -4175 Date to P.E
Fax (503) 598 -1960
Incomplete or illegible will not be accepted Print of Typ Date to DST
Called _____________
# E c W _ /Z 7
1 • Job Address:
Name of Development 4. Complete Fee Schedule Below:
V s6. t_ a. Lr L� a ova
Name (or name of busines
Number of Inspections per permit allowed
Address .4_ .-Y S -, o� v . Service included:
City /State /Zip " �� �` Items Cost Sum �� 4a. Residential - pef unit
1000 sq. ft. or less
!may
Commercial t2Q Each additional 500 sq, ft, or 5 117.75
�C� <\ / c _ Residential ❑ portion thereof `� 4
.,��,.��°� \L� V��L Jy �� Limited Energy $ 26.25
2 Ontl contractor installation only: Each Manufd Home or Modular �� $ 60.00 1
(Prior to permit issuance, applicants must provide contractor license Dwelling Service or Feeder
information for COT data se), 4b, Services or Feeders
' $ 72.75
Electrical Contractor ~ — 2
• ) r ` Inst a ll ation, alteration, or relocation
Address f `�,L� G � ` . 200 amps or less
Clry ` , _ State �� 1 201 amps to 400 amps �— $ 64.25
2
Phone No. • — zip Z;1_11 401 amps to 600 amps $ 85.50 �— 2
Job No, = � w d a l ) 601 amps to 1000 amps - -�_ $ 126.50
• Over 1000 amps or volts — $ 19250 2
. 2
Elec. Cont. Lice, No. 3 - 363.75 2
4 `�' f~xp.bate ° R e c onnect only $ 3 5 �
• OR State, CCB Reg. No, _ " --� $ 53,50 1 : -
Exp.Date 4c. Temporary Services or Feeders 2
COT Business Tax or Metro No. n �{{ .�(� � p0i Installation, alteration, or relocation
'� Exp. Date 200 amps or less
Signature of Supr, Elec'n �` 201 amps to 400 amps
$ 53.50
401 amps to G00 amps '�-- $ 107 00 2
$ 80.25 �� 2
License No. / t7 Over GOO amps to 1000 volts,
Phone No. - ?� ExP•Date I / awl see • "b" above.
4d. Branch Circuits
2b, For OW New, alteration or extension per panel
net installlations . a) The fee for branch circuits
Print Owner's Name with purchase of service or
feeder feo.
Each branch circuit
Address
with
City b) The fee for branch circuits 5 5.35 2
State Zip without
rfee --____•___ Phone No.
orf outpu purchase
fee.
The installation is being made on ro a First branch circuit
P P rty I own which is not Each additional branch circuit _i_____ $ 37.50
intended 'for sale, lease or rent.
$ 5.35 ,
de, Miscellaneous ���
(Service or feeder not included)
Owner's Signature 5 Each pumper litigation circle
Each sign or outline lighting 42'75
3. Plan Review section if r Q Signal circuit(s) or a limited energy $ 42'75
e uired) ;'
Minor Labels (10)
panel, alteration or extension
Please check appropriate $ 60.00
item and enter fee in section 5B, $ 107.00 '—
4 or more residential units in one structure 4f. Each ae allowabble le in an in a n ins
Service and feeder 225 amps or more thy of th a bo ve
Per inspection
over
t
System over 600 volts nominal
Per hour — $ 50.00
Classified area or structure containing Spacial occupancy as In Plant $ 50.00 �—
described in N.E.C. Chapter 5 $ 59.00
5. Fees:
• Submit 2 sets of plans with application where any of the above apply. S
Not required for temporary • Enter total of above fees —�`
on services. E Surcharge (.OS above
total fees) $ lJ
Subtotal $
ora
P ry constructi
•
NOTICE Sb. Enter 25% of line Sa for $
PERMITS BECOME VOID IF WORK OR C ONSTRUCTION AU Plan Review r uired (Sec, 3) •
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR D
$
W Trust Account # ORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS 0' $
AT ANY TIME AFTER WORK IS COMMENCED, S1
'
Total balance Due
.1 dsts 1 forrnslelectric.doc $ — "
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3/2 2/000 AM PM BLD
Q ( , q
Location 1 2-D S p4,Q, t
Suite MEC
Contact Person Person batLe, V Ph ( i i ' -31060 PLM
Contractor Ph SWR
BUILDING Tenant/Owner nAit MAY\ ELC Z n - 06 J 2 T
Retaining Wall ELR
Footing Access:
Foundation lei FPS
Ftg Drain / ��i (34-...1 7 .4. �� SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing Crcc J f
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof / �_-
Misc:
Final
PASS PART FAIL
PLUMBING Q.- 1
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
E SS PART FAIL
ECTRICA)
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4 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 E: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other �q �� Date (J v Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.