Permit TI R D C ITY OF PERMIT #: ELC98 -0530
'4 DEVELOPMENT SERVICES DATE ISSUED: 09/04/98
!+� ',.! , i �l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134BC -00300
SITE ADDRESS...: 12266 SW SCHOLLS FERRY RD
SUBDIVISION • ZONING:C —G PD
BLOCK • LOT • JURISDICTION: TIG
Project Description: Electrical TI
- -- 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 : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp : 0 EA ADD'L BRNCH CIRC: 7 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
DOTTY'S type amount by date recpt
12266 SW SCHOLLS FERRY RD PRMT $ 70.00 B 09/04/98 98- 308866
TIGARD OR 97223 5PCT $ 3.50 B 09/04/98 98- 308866
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 73.50 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Elect'l Service
Phone #: 234 -9900 Wall Cover Elect'l Final
Reg #..: 203
This persit 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 persit will expire if work is not started within 180
days of issuance, or if work is suspended for sore 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- 001 -0010 through OAR 952 -001 -1987. You say obtain a copy
of these rules or direct questions to OUNC y calling (503)246 -1987.
"" ""
Permitt ee Signature: Issued By AAA--f 1 4' 1 (
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: (9'Y (ti Dt\ DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY ®F TIGARD Electrical Permit Application Plan Check #
X3125 SW HALL BLVD. ��
Date Rec � ' d , ' 1 `T_ 1/i
TIGARD OR 97223 Date to P.E. NPt'
Phone (503) 639 -4171, x304 Date to DS
Inspection (503) 639 -4175 Print or Type Permit # 4-- - 0530
Fax (503) 684 -7297 Incomplete or illegible will not NI/lb-LT/2o.; ed Called
1. Job Address: 4. Complete Fee Schedule Below: ■
Name of Development 6 / // (Li Number of Inspections per permit allowed
Name (or name of business) A6/ 1 13
Service included: Items Cost Sum
Address /2286 5 CO S eli.A eL -S r : 2 /b 4a. Residential - per unit
City/State/Zip T 1r4 P - A 012.. Each additional it or less $110.00 4
ty p Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ' Residential El Li mited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) / 4b. Services or Feeders
Electrical Contractor O#Z, E(ee /fi ai v Installation, alteration, or relocation
y � / 40"k 200 amps or less $60.00 2 -
Address /(o ..S "S• E . F .e t 201 amps to 400 amps $80.00 2 -
City State l ? /` .c..a. Ct Zip q7/9..._-3 401 amps to 600 amps $120.00 2
Phone No. d - 0 23 v 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts - $340.00 2
Elec. Cont. Lice. No. de , -95 Exp.Date /U - - /_y Reconnect only - $50.00 2
OR State CCB Reg. No. d O 3 Exp.Date '7 -/• -69 4c. Temporary Services or Feeders
COT Business Tax or Metro No. x .Date Installation, alteration, or relocation
n � 200 amps or less $50.00 2
201 amps to 400 amps 75.00 x Signature of Supr. Elec'n gc.......e, �• X 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 24&9 S Exp.Date /0 -/ -- 9E3 see "b' above.
Phone No. G q8 . 0 7 3 y
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 branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit I $35.00 3 ` ' 2
The installation is being made on property I own which is not Each additional branch circuit - 7 - $5.00 3 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 circuit(s) or a limited energy
panel, alteration or extension $40.00 2
-
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 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
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ °76 • W
5% Surcharge (.05 X total fees) $ r3.3 J
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. ❑ Trust Account # 73.s 6
Total balance Due $
I:\DSTS \ELC96.APP Rev 9/96
03/03/2000 Activities for Case #: ELC98 -00530
8:35:17 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. • Level By Updated Notes
ELCC001 Application received 09/04/1998 B RECD BON 09/04/1998
ELCC003 Permit created 09/04/1998 B DONE BON 09/04/1998
ELCC799- Elect'I Final 10/02/1998 CD PASS CD 10/02/1998 sign not installed, separate
• permit required.
ELCC500 (F)Issue permit 09/04/1998 B PASS BON 09/04/1998
ELCC720 Wall Cover 09/17/1998 CD PASS CD 09/17/1998 front wall cover
ELCC800 Case Finaled 10/05/1998 CD PASS J'H 10/05/1998 Note: No sign at this time.
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
0 702 Date Requested /v £ 11 ` / Q ! AM PM BLD
Location / (, �Q itteid) Suite MEC
Contact Person ) Ph 3„14 10 PLM
Contractor Ph SWR 9
BUILDING Tenant/Owner �l$ L� �ic3O
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
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 FAIL
�CTR
Service
Rough In
UG /Slab
Low Voltage
F - _ arm
PART FAIL
E
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
/0 L 9, Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.