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Permit CITY OF TIGARD ELECTRICAL PERMIT 44 DEVELOPMENT SERVICES PERMIT #: ELC99 -0124 13125 SW Hall Blvd., Tigard, OR 97223(503) 639 -4171 DATE ISSUED: 03/03/99 ° '_ JI PARCEL: 2S112DA -00300 SITE ADDRESS...:1523O SW SEQUOIA PKWY #100 SUBDIVISION ZONING:I —P BLOCK • LOT • JURISDICTION: TIG Project Description : Installation of 51 branch circuits. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 5O0SF...: 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/O SRVC OR FDR.: 1 PER HOUR • 0 401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 50 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 PACTRUST type amount by date recpt 15350 SW SEQUOIA PKWY PRMT $ 285.00 DEB 03/03/99 99- 313409 SUITE 300 SPCT $ 14.25 DEB 03/03/99 99- 313409 TIGARD OR 97224 Phone #: Contract or: WILLAMETTE ELECTRIC INC $ 299.25 TOTAL PO BOX 230547 REQUIRED INSPECTIONS TIGARD OR 97281 Ceiling Cover Elect'1 Service Phone #: 624 -3631 Wall Cover Elect'1 Final Reg #..: 000750 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 • .0 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9521 -001'. hrough OAR 952 'A1 -1987. You may obtain a copy of these rules or direct questions to OUNC by callin. )246 -1987. Permittee Signature: I / .424 Issued 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: i /i 1,� � /� _ DATE: LICENSE NO: /? '5 S ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ RECEIVE CITY OF TIGARD Electrical Permit Application Plan C - • 131:45 SW HALL BLVDMAR 03 199 Rec'd :y _ 7 ffi7J j Date Rec'd - Cf ' TIGARD OR 97223 Phone (503) 639 -4171, MUNITY DEVELOPMEN Date to P.E. ( ) � Date to DST - Inspection (503) 639 -4175 Print or Type Permit # - 9 pl Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed • Name (or name of business) net i a w � \ . Service included: Items Cost Sum I Address • - %• _...'../ A..- / :. �i 4a. Residential - per unit / 1000 sq. ft. or less $110.00 4 City /State/Zip T. N 4 0 G A. 9 1- Z Z 4 Each additional 500 sq. ft. or Commercial'. Residential ❑ portion thereof $25.00 1 Limited 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 tt 't ec rn i c i,, L Installation, alteration, or relocation Electrical Contractor W . I I w.e ' l r' 200 amps or less $60.00 2 - Address P 0 /3dx Zia 5- 4 7- 201 amps to 400 amps $80.00 2 City r i T.4./.9 State O.L.- Zip 94 'ZS / 401 amps to 600 amps - $120.00 2 Phone Nd 6 244 - 36 3 / 601 amps to 1000 amps $180.00 2 Job No. S3 7 - Over 1000 amps or volts - $340.00 2 / / (/ _ Reconnect only $50.00 2 Elec. Cont. Lice. No. '3 4 - Z a C Exp.Date OR State CCB Reg. No. - Sri S Exp.Date S /6 / is 4c. Temporary Services or Feeders COT Business Tax or Metro No. / S 7 6 Exp.Date Erb /y 9 Installation, alteration, or relocation O_..__ 20 amps less $55.00 2 Signature of Supr. Elec'n A r 201 1 to amps to 400 amps $75.00 2 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No / 4 '( S S Exp.Date /o- /- 0 / see "b" above. Phone No is Z '( - 36. T i 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. First r an ch feeder fee. $35.00 S <- 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 z 5 - 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: z Not required for temporary construction services. 5a. Enter total of above fees $ _ f 5% Surcharge (.05 X total fees) $ --/--q- 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 # $ 7 cty zi Total balance Due 1:\DSTS \ELC96 APP Rev 9/96 02 /08 /2000 Activities for Case #: ELC99 -00124 11:57:38 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 03/03/1999 DEB MAIL DRA 03/03/1999 ELCC003 Permit created 03/03/1999 DEB DONE DRA 03/03/1999 ELCC700 Ceiling Cover 04/19/1999 CD PASS AKJ 04/19/1999 ELCC720 Wall Cover 03/17/1999 CD PASS CD 03/18/1999 ELCC730 Elect'I Service DRA 03/03/1999 ELCC799 Elect'l Final 04/29/1999 CD PASS AKJ 04/29/1999 ELCC500 (F)Issue permit 03/03/1999 DEB DONE DRA 03/03/1999 ELCC725 Underground Cover 03/08/1999 CD PASS CD 03/09/1999 under -slab (dining area) ELCC800 Case Finaled 04/29/1999 AKJ DONE No Hold AKJ 04/29/1999 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested �7 '�� AM PM BLD Location 1 S O Sell fcL. Suite /CAM MEC Contact Person Ph 31 PLM Contractor Ph SWR y t� BUILDING Owner .c ELC / / — 0/ 2i 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 C � 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 CA Service Rough In _ UG /Slab Low Voltage Fir larm AS 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 ,y9 4 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •