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Permit
r CITY OF T ELECTRICAL PERMIT 4 „a a, , ., ,\ DEVELOPMENT SERVICES PERMIT #: ELC99 -0029 � ‘” 1 DATE ISSUED: 01 / 13/99 . !•�- "' — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25112DA -00700 SITE ADDRESS...: 15333 SW SEQUOIA PKWY SUBDIVISION • ZONING:I -P BLOCK • LOT . JURISDICTION: TIG Pro .j ect De scr i pt i on : Add three (3) 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 • 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: 2 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 REALTY ASSOCIATES type amount by date recpt 15333 SW SEQUOIA PARKWAY PRMT $ 45.00 GEO 01/13/99 99- 312141 TIGARD OR 97223 5PCT $ • 2.25 GEO 01/13/99 99- 312141 Phone #: Contractor: STONER ELECTRIC $ 47.25 TOTAL 2701 SE 14TH REQUIRED INSPECTIONS - - -- -- PORTLAND OR 97202 Elect'1 Service Phone #: 233 -3631 Elect'1 Final Reg #..: 000448 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- 001- 1 A10 through OAR 952 -001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246 - 1987. Permittee Signature: Issued Py: OWNER INSTALLATION DNLY - - - -- 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: Olk) DATE: /- /,?-F? L I CENSE NO : 404,15' • 9 __ ++++++++++++++++++++++•+•++++++++++++++++++++++++++ + +• + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Peozws ,, CITY ' F TIGARD RECEIVED Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Recd By TIGARD OR 97223 JAN 1 21999 Date Recd Date to P.E. Phone (503) 639 -4171 eta o r Type Date to DST U N I TY DEVELOPMENT Print 1 v I � Inspection (503) 639- • Incomplete or illegible will not be accepted # 6 Q9 ddb Fax (503) 684 -7297 Called .. 1. Job Address: 4. Complete Fee Schedule Below: . Name of Development Number of inspections per permit allowed Name (or name of business) 2A r r Service included: Items Cost Sum Address 15 5ci SE Qv0114 IDKIA9( 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 City /State/Ztp T G.4-iv7 0 , Each additional 500 sq. h. or r-�I portion thereof $25.00 1 Commercial Residential IJ Limited Energy $25.00 Each Manufd Homo or Modular • Dwelling Service or Feeder 568.00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Services or Feeders Electrical Contractor Srv1 �l=o 7e/ c. Arc_ installation, alteration, or relocation Address 2 f 5E / 411 200 amps or less $80 .00 2 201 amps to 400 amps $80.00 2 City 1 r4RTr.,i+-Vn State ok Zip 972o 401 amps t0 600 amps $120.00 2 Phone No. Z3.3 3 Co 3 [ 601 amps to 1000 amps $180.00 2 Job No. .- 5 Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice- No. 2' 12 -Z_ Exp.Date 1o16 OR State CCB Reg. No. 44-4;2- Exp.Date o3 izo /co 4c. Temporary Services or Feeders COT Business Tax or Metro No1,0.0044 i 6, Exp.Date oho /e /99 installation, alteration, or relocation 74/ 200 amps or less $50.00 _ 2 - Signature of Supr Elec'n �� 201 amps to 400 amps $75.00 - 2 • $100. 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. '4- 25 Exp.Date e0 see "b" above. Phone No. 2 3b 3 / ad. 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 der fee. Each branch circuit $5.00 2 Address b) The foe for branch circuits City State Zip _ without purchase of Phone No. _ service or feeder tee. First branch circuit $35.00 3 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 JO 2 intended for sale, lease or rent 4e. Miscellaneous • (Service or feeder not inducted) - Owner's Signature Each pump or irrigation circle $ 40 . 00 2 Each sign or outline lighting 540.00 2 3. Plan Review section (if required):' Signal circuits) or a limited energy _ 2 panel, alteration or extension Minor Cabala (10) $100.00 Please check appropriate item and enter fee in section 58. 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 $$5-00 as described in N.E.C. Chapter 5 In Plant .s • * Submit 2 sets of plans with application where any of the above apply. S. Fees: 4 Not required for temporary construction services. 5e. Enter total of above fees $ 2 596 Surcharge (.05 X total fees) $ _ y 7. 2-.5- NOTICE • Subtotal $ Sb. Enter 25% of line Sc for / I1\ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if reaulred (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 --- Account # 7 7 S / TIME AFTER WORK IS COMMENCED. $ ' - • Total balance Due L+osrs\ELcse.APP Rev WBC CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested ///2-PAD AM PM BLD Lo o ms --- 533 3 t.J S ��U©i44 Suite MEC Contact Person // 7 7 Ph PLM Contractor S7` 71)E72 Ph SWR BUILDING Tenant/Owner /9-/ /2 ELC ?_=e2,(2 9 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab ar/97%./G‘ • SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler �L - 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 --- eiLECTRICAL ervice Rough In UG /Slab Low Voltage Fire f� 'AS 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 / / oZ� 4-7/ Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.