Permit CITY OFTIGARD
�.�,;�, DEVELOPMENT SERVICES ELECTRICAL PERMIT
A. ''
PERMIT #: ELC96 -0736
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 11/18/96
PARCEL: 28101DD -00300
SITE ADDRESS...: 07100 SW SANDBURG ST
SUBDIVISION ZONING:I-P
BLOCK • LOT -
Project Description: add 3 amps /feeders, & 15 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 • 1 W /SERVICE OR FEEDER: 15 PER INSPECTION 0
201 - 400 amp • 2 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
PACIFIC LAZER TECH type amount by date recpt
7100 SW SANDBURG PRMT $ 295.00 TAT 11/18/96 96- 286620
SPCT $ 14.75 TAT 11/18/96 96 -2 86620
TIGARD OR 97223 PLCK $ 73.75 TAT 11/18/96 96- 286620
Phone #:
Contract or:
CAPITOL ELECTRIC CO INC $ 383.50 TOTAL
12810 NE AIRPORT WAY #1
REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Underground Cove
Phone #: 503 -255 -9488 Wall Cover Elect'1 Service
Reg #..: 48748
This permit is issued subject to the regulations contained in the ✓y}1d /JJQ ( J
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e S i gnat ur
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started �` ` I 6
within 188 days of issuance, or if work is suspended for more ��/ , 1-f
than 180 days. 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 for inspection - 639 -4175
• .� M••• ■
Community Development ELECTRICAL PERMIT APPLICATION
A 13125 SW Hall Blvd.
Tigard, OR 97223 Permit # L e-9 -167 3(0
4,rl,01�1 ,� Date Issued / / /iig ,
til
Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development /'f'/ C /A2(X' 1.4 Number of Inspections per permit allowed
Address '7/0 a S4 �i�iJor .able./2 5 Service included: Items Cost(ea) Sum
City /State /Zip ;n�// Z/r ,7aZ. 3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of bysjness) Each additional 500 sq. ft. or
L �� '/ portion thereof $25.00
Commercial Residential ❑ Limited Energy $25.00 1
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
� j / 4b. Services or Feeders
� Installation, alteration, or relocation o 0
Electrical Contractor /f i i to .P -C 200 amps or less / $60.00 40 2
Address / 2/5y0 ht
2/5 l l!_ i4//t P rz n,-/- W A 1/ 201 amps to 400 amps ?i $80.00 747 2
/ 401 amps to 600 amps $120.00 2
City / t?O/Z f ��sa/� State [�[_ Zip l�7l_z 601 amps to 1000 amps $180.00 2
Phone No. ZS.S" • e3 Si BS Over 1000 amps or volts $340.00 2
Job NO. 1jlD $ Reconnect only $50.00 2
contractor's license NO. 2(.3- e- 4c. Temporary Services or Feeders
Contractor's Board Reg. No. /15(7yc1 installation, alteration, or relocation
Signature of Supr. Elec'n` g.Aoy,�if44.-"/Wr- 200 amps or less 2
License No. Phone No. 2s5 '5 f/le 201 amps to 400 amps $50.00 2 2
$75.00
401 amps to 600 amps
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 fee. 2
City State Zip Each branch circuit /5" $5.00 75
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. First branch circuit $ $5 . 00
Each additional branch 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
V 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:
. O
5a. Enter total of above fees $ '2 9.S
NOTICE 5% Surcharge (.05 X total fees) $ / V 7s
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for 73 -75- �
$
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. wormcomanneveo ❑ Trust Account #
$
prm.epp ` S 0
Balance Due 3 33 �
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639-4171
Footing Rain Drain Cover /t FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: / d"l 1 I 19
c A.M. P.M. Entry:
Address: dv _ <<�L_ /,' .A An.......—.. Y
Tenant..- � cam-- -" Ste: 1
!U
Con /Own: X61 MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
ec7ivi e- -
ePppet}-
12 _ 9
Inspector: �/ . .. P • I_ Date:
APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 6/7/0 AM PM BLD
Location 7 /O U ,Ci=c44h Lc Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC C16D "On - 7 3 to
Retaining Wall ELR
Footing Access: �/�
Foundation -- ° w1 to "I FPS
Drain �
Ftg Drain � 1� ` SGN
Slab
Crawl Drain Inspection Notes. , /� S
Post & Beam V C.- y k SIT
Ext Sheath /Shear /44f
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall � V v/ Ce_
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof l —
Misc: �
� 1 q
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 P RT FAIL
<ELECTRI L
Service
Rough In
UG /Slab
Low Voltage
Fir- :farm
• 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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk / _
Other Date G Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.