Permit 4 CITY OF T ELECTRICAL PERMIT
PERMIT #: ELC2000 -00540
i( DEVELOPMENT SERVICES DATE ISSUED: 10/16/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S134BC-00900
SITE ADDRESS: 12394 SW SCHOLLS FERRY RD
SUBDIVISION: PP1993 -058 ZONING: C -G
BLOCK: LOT : 003 JURISDICTION: TIG
Project Description: Electrical work associated with new construction.
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:
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: 41 PER INSPECTION:
201 - 400 amp: 1 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:
DENNIS THOMPSON VIKING ELECTRIC INC
12475 SW MAIN 4326 SE WOODSTOCK
TIGARD, OR 97223 STE 518
PORTLAND, OR 97206
Phone: 503 - 781 -0124 Phone: 775 -3479
Reg #: LIC 00056527
SUP 3088S
ELE 26 -569C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 10/16/00 $372.65 2720000000( Wall Cover
PLCK CTR 10/16/00 $93.16 2720000000( Underground Cover
5PCT CTR 10/16/00 $30.36 2720000000( Elect'I Service
Elect'I Final
Total $496.17 •
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 of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE c ISSUED BY:
OWNER INSTALLATION ONLY
The installation is being ma eon 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 Recd By
13125 $W HALL BLVD. Recd By .fir
VGARD OR 97223 Date Recd 9/.5/0 - 6 1
P rint of Type
Date to P.E. 9 / /
Phone (503) 639-4171, x304 Date to DST AP ' 3-0 0
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # e..0 Sono oo55'0
Fax (503) 598=1960 Called 1.(26.
1. Job Address: 4. Complete Fee Schedule Below:
f v1 Number of Inspections per permit allowed
Name of Development 6/0 N w Y ` N C , ,
Name (or name of business F To E / Service included: Items Cost Total
Address 1 3 C4 1 .1. s w Sci-{ OLLS Finity KO 4a. Residential - per unit
�
i 1000 sq. ft. or less $147.15 4
rt
City/State /Zip �g, O , Oa- Eac additional 500 sq. ft. or
portion thereof $33.40 1
Commercial Residential ❑ Limited Energy $75.00
` Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 . 2
2a. Contractor installation only: 4b. Services or Feeders
(Prior to permit issuance, applicants must provide contractor license Installation, alteration, or relocation
information for COT data base). / 200 amps or less $80.30 2
Electrical Contractof V �� N l7 L �C ��) C 201 amps to 400 amps $106.85 /0 b . gs` 2
Address if - 3 6 SC 1 .0000STiC K P ol e 57e 401 amps to 600 amps $160.60 2
City Pu lr++40 State oN Zip q 7 2.0 b 601 amps to 1000 amps $240.60 2
Phone No.(5 3) 775 - 3 .7 i Over 1000 amps or volts $454.65 2
Job No. Reconnect only $66.85 2
Elec. Cont. Lice. No?.6 -s C Exp.Date f0 - / -0O 4c. Temporary Services or Feeders
OR State CCB Reg. No. ,C 66-27 Exp.Date S- 16 ^0 i Ins tallation, alteration, or relocation
9 p 200 amps or less $66.85 2
COT Business Tax or Metro No. 1.076 Ex .Date 12 -! - 0 0 201 amps to 400 amps $100.30 2
n 401 amps to 600 amps $133.75 2
Signature of Supr. Elec'n 0-ex, Over 600 amps to 1000 volts,
see "b" above.
License No. 3O 8 8 $ Exp.Date /0- l - 0 / 4d. Branch Circuits
Phone No. (, r0 3) 77 3 4 7 ! New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Each branch circuit 1/' /)
$6.65 72 2
Print Owner's Name b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
First branch circuit $46.85
Phone No. Each additional branch circuit $6.65
The installation is being made on property I own which is not 4e. Miscellaneous
(Service or feeder not included)
intended for sale, lease or rent.
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40
Owner's Signature Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
3. Plan Review section (if required):* Minor Labels (10) $125.00
4f. Each additional inspection over
Please check appropriate item and enter fee in section 5B. the allowable in any of the above
4 or more residential units in one structure Per inspection $62.50
L- Service and feeder 225 amps or more Per hour $62.50
System over 600 volts nominal In Plant $73.75
Classified area or structure containing special occupancy as 5. Fees: -7 /
described in N.E.C. Chapter 5 5a. Enter total of above fees $ 3 / i b S
* Submit 2 sets of plans with application where any of the above apply.
8% Surcharge (.08 X total fees) $ 0 f I
Not required for temporary construction services.
Subtotal
° $ rl - d
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $ r I O
Subtotal $ �] i I 7
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR ❑ Trust Account #
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ b . ) 7
is \dsts \forms \electric rev.doc - 8/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST-- - - .,
24- H4ur)n9pection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested // AM PM BLD
Location / 2 3 9 t( 5 w 5c1 "I( 1`Yrr y Ai Suite MEC
Contact PersorE7,1 � 4i 0/f gel r2 / Ph 3g PLM
Contractor V / e A/6- �. C , Ph SWR
BUILDING Tenant/Owner ELC 01./ —00 9 y d
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 1i
F
136(2/721An9-1() 6246
ire 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
PASS PART FAIL
I CTRIC
ervice
Rough In
UG /Slab C4/ C'Gt/
Low Voltage
Fire Alarm
Fi -
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Basin
Fire S upply Line [ ] Please call for r inspection RE: Unable to inspect - no access
Fire Supply
ADA
Approach /Sidewalk
Other Date J i /" Inspector
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION M
24 - Hotir Int section Line: 639 -4175 Business Line: 639 - 4171 r`
BUP
Date Requested // - /) AM PM BLD
Location / Y /Ld Suite MEC
Contact Person Ph .3f f 966 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC LC/0 4' G �3
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
PASS PART FAIL
LECTRItAk
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
WO 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
Other Date //- / -7 - " Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY Of TIGARD BUILDING INSPECTION DIVISION Mt,,
24 -1-1dr IiasliSection Line: 639 -4175 . Business Line: 639 -4171
tl / BUP •
Date Requested //- tr AM PM l/ BLD
Location / 73 9 y 5' Sc 474 -C 3 Suite MEC
Contact Person J Ph 3(f S6OO PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC ,2 -G U S C( 0
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 _ G' / elz4
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
PASS PART FAIL
CTR
ervice
Rough In
UG /Slab Get � ' ^ 5
Low Voltage
Fire Alarm
PAS P T 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
Other oach /Sidewalk Date t 1/ 2I Inspector Ext
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Ms CA-1-7-tc-k
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /Z — AM PM BLD
Location / Z 3 % 5 h. SC/ // 4 v A l ' Suite MEC
Contact Person Ph 3/y .94c PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC � ` ' — G U,S 5/0
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 1774,///,
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
PASS PART FAIL
'ELECT OIL
... \"ericce
Rough In
UG /Slab
Low Voltage
ire Alarm
ASS 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
Other Date / - S 8 Inspector _ L 1 _` Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD ENGINEERING PERMIT
PERMIT #: ENG2000 -00044
aa �l j � , D 13125 SW Hal B Tigard , O RV 2CES 639 -4171 PRIM.
D ATE S U SD 2990_. -00009
)oo
SITE ADDRESS: 12394 SW SCHOLLS FERRY RD PARCEL: 1S134BC -00900 4hr
SUBDIVISION: PP1993 -058 ZONING: C -G
BLOCK: LOT: 003 JURISDICTION: TIG
PERMIT TYPE: SOP PUBLIC IMPRV QUANTITY LIN FT VALUE
AGREEMENT DATE:
GRA/EROS: * * **
ASSURANCE EXPIRATION STREET:
PERFORMANCE: SAN SEW:
MAINTENANCE: STM SEW:
PATHWAYS:
ALL OTHER: * * ** $7,800.00
•
TOTAL: $7,800.00
Remarks: STREET OPENING; TO TAP AN EXIST. PUBLIC MAINLINE SP.N!TARY SEWER, TO INSTALL A SERVICE
LATERAL,
Owner: FEES
Type By Date Amount Receipt
OPEN JSH 07/05/2000 $150.00 0003456
DEPS JSH 07/17/2000 $162.00 0003754
BOND JSH 07/17/2000 $7,800.00 0003754
Phone:
Total $8,112.00
Engineer:
VLMK CONSULTING ENGR'ING
3933 SS.W. KELLY AVE.
Phone: REQUIRED INSPECTIONS
STM /SAN SEWER STREET
Permittee / Applicant: MH /CB /CO CRB LINE & GRADE
D. THOMPSON & W. DAVIDSON PIPE LN & GRD SUBGRADE
12475 S.W. MAIN ST. BCKFLL & CMPCT BASE ROCK
TIGARD, OR 97223 AIR & TV TEST LEVEL COURSE
WEARING COURSE
Phone: GRADING TRAFF & PED CONT
CONTOURS MONUMENTATION
/ DRAINAGE STREETLIGHTING
Permittee/ EROSION CNTL. WALK/APRON /RAMP
Applica t
Signature:
P REPR'S /ADJ'S PATHWAYS
Issued By
FOR INSPECTIONS, CONTACT THE CITY OF TIGARD,
SPECIAL CONDITIONS: (SEE ATTACHED) ENGINEERING DEPARTMENT, AT: (503) 639 -4171