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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00508 4 DEVELOPMENT SERVICES DATE ISSUED: 8/17/99 .,..., 11 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110AB -00200 SITE ADDRESS: 14411 SW PACIFIC HWY SUBDIVISION: CANTERBURY PLACE IP kliAL ZONING: C -G BLOCK: 14,C - JURISDICTION: TIG Installation of one signal circuit or limited energy Description: g gyp anel. 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: 1 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: 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: G C KOLVE CENTRAL ELECTRONIC ALARM INC 14389 SW PACIFIC HWY 8435 SE STARK TIGARD, OR 97224 PORTLAND, OR 97216 Phone: Phone: 257 -9696 Reg #: ELE 26 -920c1 LIC 00042607 FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 8/17/99 $60.00 99- 317722 Elect'l Final 5PCT DEB 8/17/99 $4.20 99- 317722 Total $64.20 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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 es or direct questions to OUNC at (503) 246 -1987. Permit Signature: �J Issue 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: Call 639 -4175 by 7:00pm for an inspection the next business day • / cITY OF TIGARD Electrical Permit Application Planph n 13125 SW HALL BLVD. RECEIVED Rec`t1.B. I.6.c-Y TIGARD OR 97223 Date secs -!!`I' Phone (503) 639 -4171, x304 AUG 111999 Da te to P.E. Print or Type Date to DST InspeCtiOn (503) 639 - 4175 Permit #Et_I9 J Fax (503) 684 -7297 COMMUN{IQ4�il�t� illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of inspections per permit allowed Name (or name of business) Classic B i l l a rd s Service included: items Cost Sum Address 14411 SW Pacific Highway 4a. Residential - per unit Ci /State/TJ T igard, OR 97224 1a chad it s or les $11o.ao 4 tY p _ Each additional 500 sq.1t. or Commercial 121X 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 installatkr' o nl y: (Attach copy of all currant licenses) 4b. Services or Feeders Electrical Contractor Central Electronic Alarm, n clnsiallatlon, alteration, or relocation Address 8435 S E Stark 200 amps or less $60.00 - 2 P o r tan O R 91216 201 amps to 400 amps $80.00 2 City Sta Zip 401 amps to 600 amps $120.00 2 Phone No. 503 - 257 - 601 amps to1v00 Steam 2 Job No. Over 1000 amps or volts $340.00 2 Elec. Cont. Lice. No. 26- 920CLE Exp.Date 10/ 991°/ / � (99 Reconnect only $50.00 _ 2 OR State CCB Reg. No. 426 Exp.Date 9/00 9 /9/ 4c. Temporary Services or Feeders COT Business Tax or Metro No. 113 Exp.Date 2 /f) installation, alteration, or relocation 200 amps Or 1855 $50.00 2 Signature of SUpr, E {eC'n �' ! 201 amps to 400 amps $75.00 2 401 amps to 600 amps - $100.00 2 Over 600 amps to 1000 volts, License No. 468JLE Exp.Date ( ° / .6 ? 9 see "b" above. Phone No. 25/-9696 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 br oh 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 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 dreult(s) or a limited energy , o o v panel, alteration or extension 1 $40.00 4,Qg u 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 59. 4 or more residential units in one structure 4f. Each additional Inspection over Service and feeder 9 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 oo * Submit 2 sets of plane with application where any of the above apply. 5. Fees: • V V " Not required for temporary construction services. 5a. Enter total of above fees $ !ao S 9'o'Surcherge (.05 X total fees) 1, $ 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. 0 Trust Account # _ Total balance Due s �� c\o3rst5L C9G.APP Re. 9/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP q 21 0 D Date Requested AM PM BLD Location 1 `'I "f I I 1°&C- 1 Suite MEC Contact Person Ph PLM Contractor c /I Ph SWR BUILDING Tenant/Owner CA--& Js l C Ca l J I ) / S ELC t ? 9 DOSOt Retaining Wall ELIE 1 9 9 - O(Q 7 Footing Access. Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab S .,n.t, i�, rt t` / �it %� SIT Post & Beam Ext Sheath /Shear _- / /14 44c),j Int Sheath /Shear Framing Insulation Drywall Nailing Firewall ` _ Fire Sprinkler /Q 9? f l)3 o a %A✓ �22 Fire Alarm Susp'd Ceiling Roof Misc: 9'99 ' © o4 9 Final PASS PART FAIL ©� w x 4v- o . 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 E E Q FAIL T L) �ECCTRfCA Service Rough In UG /Slab Low Voltage Fii Alarm drak • ASS .0 FAIL SITE 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 Othe oach /Sidewalk D ate �j -e-t v Inspector - L__ � E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. L