Permit CITY OF TIGARD 1 — C
� ELECTRICAL PERMIT
Pm rei ;� DEVELOPMENT SERVICES PERMIT #: ELC98 1C
05 "
!+L n 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 DATE ISSUED: 08 / i / 98
PARCEL: 2S101DD -00702
SITE ADDRESS...:06900 SW SANDBURG ST
SUBDIVISION -SALEM FREEWAY SUBDIVISION ZONING:I —P
BLOCK • LOT •004 JURISDICTION: TIG
Project Description : Installation of (2) 200 amp or less services and 2 branch
circuits.
- -- 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... • 2 W /SERVICE OR FEEDER: 2 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp : 0 EA ADD'L BRNCH CIRC: 0 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
NEXTEL type amount by date recpt
6900 SANDBURG ST PRMT $ 130.00 DEB 08/31/98 98- 308717
TIGARD OR 97223 5PCT $ 6.50 DEB 08/31/98 98- 308717
Phone #:
Contractor:
HEIL ELECTRIC CO $ 136.50 TOTAL
8425 SE STARK ST
REQUI RED INSPECTIONS
PORTRLAND OR 97216 Elect'1 Service
Phone #: 255 -4074 Elect'1 Final
Reg #.. 000003
This permit 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 952- %1 ru'.• 1'R 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calli g (503)246 -1987.
•
Permittee Signature: `' ��,�.c�/, (J Issu-d By: I / 4. is I � ... _
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 pp Q
SIGNATURE OF SUPR. ELEC' N: ,Q,QQ, l d�'U DATE: 0',5/18
LICENSE NO: gib S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
f
1
,4,
' Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 (' ^ ^,rIFriffgD1it # L G�'� o5a.
,�� 1 .. Date Issued 8 /
� Phone (503) 639 -4171 F, v �
FAX (503) 684 -7297 P .0 ���
CITY OF TIGARD
TDD No. (503) 684 - 2772 �I : "TY �'M'OPr c. � f
Inspection (503) 639 -4175
1:' `Jd "',, ..- - •• ••- -- .4: Complete Fee Schedule Below:
t1 Number of Inspections per permit allowed
Name of bevelopment�!� - 17 4��.�
Address 6900 5 w 3 D a att.-- Ill. Service included: Items Cost(ea) Sum
City /State /Zip T 9o,,,.cl d--- c l . �3 4a. Residential - per unit
r�� / - 1000 sq. ft. or less $110.00 4
/l
Name (or name of business) t E L_ CP.L.d -ee. Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor _.. X.2.- C{j Installation alteration or relocation ^
200 amps or less Ot $60.00 /Z� 2
Addres 2.,s t 7 cS�'1►� -1L �(' 201 amps to 400 amps $80.00 2
City State (1v Zip 2 6 401 amps to 600 amps $120.00 2
, 601 amps to 1000 amps $180.00 2
Phone No. SS- -,.7
U Over 1000 amps or volts $340.00 2
Job NO. '7?() Reconnect only $50.00 2
contractor's license NO. fsila 2.6 - UCG 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 7 Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less 2
License No. 5 Phone No.625540'4 201 amps to 400 amps $50.00
401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see „b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder /ee. , 2
City State Zip Each branch circuit $5.00 �
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. Eat ddchal b r br $$5.00
Ea
a additionnal anch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): _ Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
-
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
-
In Plant $55.00
Submit 2 sets of plans with application where any of the above -
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees l -c -1
NOTICE 5% Surcharge (.05 X total fees) $ -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. woralcomaeNdeo- ❑ Trust Account #
$
prm.app Balance Due
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
001 Date Requested A1A PM BLD
Location ?DO SW S/ / / (ji Suite MEC
Contact Person c -1 U Ph e, 55 9 7 � PLM
Contractor Ph SWR
BUILDING Tenant/Owner /1/ ex-4-1
Retaining Wall ELR
Footing Access:
Foundation / FPS
( �fl
Ftg Drain � A 5c.Nr ccl� 4. ,z r Crawl Drain Inspection Notes GLGe , /� Slab
Post & Beam
�y/� /
Ext Sheath /Shear
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
FAIL
Service /
gTi In
UG /Slab j
Low Voltage 1
Fire Alarm
Final
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 RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Date ( Inspector /� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
�1 QO p /d Date Rq,sted qu 4 — _ — i AM PM BLD
Location 6 140 i Suite MEC
Contact Person ,l! & E d, Ph 255 - 7 PLR
Contractor ern h SWR
BUILDING Tenant/Owner f5 E
Retaining Wall ELR
) Footing W
Foundation Access: FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
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 T FAIL
Service
Rough In
UG /Slab
Low Voltage
_,Piro arm
Fin
S 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 RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Z
Other Date Z / •P Inspector Ext
Final
PASS PART FAIL O NOT REMOVE this inspection record from the job site.
L