Permit •
CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00462
DEVELOPMENT SERVICES DATE ISSUED: 8/11/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 10 D C -02200
SITE ADDRESS: 15660 SW PACIFIC HWY A -4
SUBDIVISION: WILLOW BROOK FARM ZONING: C -G
BLOCK: LOT : 011 JURISDICTION: TIG
Project Description: 6 branch circuits.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 5 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:
TIGARD, CENTER LP WILLAMETTE ELECTRIC INC
9777 WILSHIRE BLVD #609 PO BOX 230547
BEVERLY HILL, CA 90212 TIGARD, OR 97281
Phone: Phone: 624 -3631
Reg #: LIC 000750
SUP 1965S
ELE 34 -283C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT BLD 8/11/00 $64.25 0004422 Wall Cover
5PCT BLD 8/11/00 $5.14 0004422 Elect'l Final
Total $69.39
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty Codes and all other applicable laves.
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 1 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATUR 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:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Rec'd By
'TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print of Type '11 ----- Permit # & - 0O4 a_
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1.. Job Address: 4. Complete Fee Schedule Below:
I Number of Inspections per permit allowed
Name of Development I tS un a enu e
Name (or name of business) 1+F L. Service included: Items Cost Sum
Address I S 6 (o 0 94. P4.( c N w y A - 4 4a. Residential - per unit
Ci /State /Zi T t s t/k Rcl d rt _ 9 '?-Z 2 V 1000 sq. ft. or less $ 117.75 4
ty p Each additional 500 sq. ft. or
portion thereof $ 26.75 1
Commercial 0 Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor 1..i. I I ri .t, r 6t ae (TA , c /^- C- 200 amps or less $ 64.25 2
Address Po 1l pit 2...7495 1' 201 amps to 400 amps $ 85.50 2
City a.vr State 0A Zip a } 216 / 401 amps to 600 amps $ 128.50 2
tY . S in p / 601 amps to 1000 amps $ 192.50 2
Phone N6. 4 zv - 3(, 3 / Over 1000 amps or volts $ 363.75 2
Job No. VS (.p Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 34 - z Ira C_ Exp.Date ifs- (1-0 D 4c. Temporary Services or Feeders
OR State CCB Reg. No. ? ,, s Exp.Date 6-4 -O / Installation, alteration, or relocation
COT Business Tax or Metro No. / 51 ti Exp Date g -t - e i 200 amps or less $ 53.50 2
`n 201 amps to 400 amps $ 80.25 2
Si Signature of Sur. Elec'n _. 401 amps to 600 amps $ 100.00 2
9 p 1(0 Over 600 amps to 1000 volts,
•
License No. t S D - S Exp.Date I v - / - / see "b" above.
Phone No. 1 - 3 4 1 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee. S u
Phone No. First branch circuit l $ 37.50 3
Each additional branch circuit $ 5.35 Z re 7
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees: // z�
5a. Enter total of above fees $ 10 y
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ S ' `/
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
_0 7
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due
is \fists \forms \electric.doc
1-
8/22/00 Activities for Case #: ELC2000 -00462
4:28:39 PM
Assigned Hold Updated ,
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC003 Permit created 8/11/00 DLH DONE No Hold BLD 8/11/00
ELCC001 Application received 8/11/00 DLH DONE No Hold BLD 8/11/00
,
ELCC700 Ceiling Cover No Hold BLD 8/11/00
ELCC720 Wall Cover No Hold BLD 8/11/00
i
ELCC799 Elect! Final No Hold BLD 8/11/00
ELCC500 (F)Issue permit 8/11/00 DLH DONE No Hold BLD 8/11/00
ELCA510 (F) Reprint permit 8/22/00 ZZZ DONE No Hold ZZZ 8/22/00
ELCA510 (F) Reprint permit 8/22/00 ZZZ DONE No Hold ZZZ 8/22/00
ELCA510 (F) Reprint permit 8/22/00 ZZZ DONE No Hold ZZZ 8/22/00
•
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION •
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AD — Zi AM F PM BLD
Location / ) �i G G $ w f c r . 'v /-1,4- 7 Suite 4. q MEC
Contact Person Ph G 2V 3 5/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC gee-4 G ((4
Retaining Wall • ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof R
Misc:
Final
PASS PART FAIL
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
_pass PART FAIL
E A ..)
C (31-
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4 PART FAIL
fill/ radin
Back G g
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before ne spection. 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 /6 �D / 2-- C 6 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION - -
MST •
24 -your Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
9/2 l / Date Requested AM PM BLD
Location I d s) %4 KILO Suite >r MEC
n Person tact erso n Ph PLM
Contractor �, C .� C� Ph ( ! ( J SWR
BUILDING Tenant/Owner 420 2 e- oo
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam / /,� J/ / Vti-c-0 Ext Sheath /Shear -/-4) / y (,( J va -
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
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
P R FAIL
ELECTRIC
e ��
Rough In (�Wu
UG /Slab �
Low Voltage
Fire Alarm
F.
ASS ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for einspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Other
Approach/Sidewalk 4
Date . Inspector `� / Ext
Other
Final —
PASS PART FAIL D 6 NOT REMOVE this inspection record from the job site.