Permit • CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00634
�w_ DEVELOPMENT I BN � r So SERVICES 639 -4171 DATE ISSUED: 11/15/00
•
- 13125 PARCEL: 2 S 112 DA -00300
SITE ADDRESS: 15230 SW SEQUOIA PKWY 120
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI, installation of (1) 200 amp or less service /feeder and (3) branch circuits. Job No. 8930
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: 1 W /SERVICE OR FEEDER: 3 PER INSPECTION:
•
201 - 400 amp: 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:
PACIFIC REALTY ASSOCIATES BACHOFNER ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 55 SE MAIN
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 233 -2006
Reg #: LIC 00044569
SUP 28085
ELE 26-451C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 11/15/00 $100.25 2720000000( Elect'l Service
5PCT CTR 11/15/00 $8.02 2720000000( Elect'l Final
Total $108.27
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 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 A-t ISSUED Y: st,
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: /7/o ?.
Call 639 -4175 by 7:00pm for an inspection the next business day
' " Electrical Permit Alication
Gov Date received: //./5 Permit no.: eLe ojeag
:;} 1. /ll ih City of Tigard «S' � QQ Project/appl. no.: Expire date:
Add 13125 SW Hall Blvd Tigarq, OR 97223 A Date issued: By: Recei t no.:
City ofTigard Phone: (503) 639 -4171 �� y I p
Fax: (503) 598 -1960 \� ��Qb�Q'*
� e Case file no.: Payment type:
Land use approval: .
co .11 ` *e`,\\
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory j81 Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: 16Z SIB �ju ) L py, Bldg. no.: j5e, Suite no.:0 Tax map /tax lot/account no.:
Lot: 5,p ,Sp:u6_ I Block: [Subdivision:
Project name: ee) .T utors HOro 'Description and location of work on premises: T. ] _
Estimated date oNcompletion/inspection:
CONTRACTOR APPLICATION. FEE SCHEDULE
Job no: Fee Max
Business name[ C to n f 4 J jj'_ L Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address: ,S5 Mti i dwelling unit. Includes attached garage.
City: ]n ,•� -('/,( y) / j I State: 09 I ZIP: 11-7z1(4 Serviceincluded:
Phone: Z 'Ij 2 - Z09(p I Fax: f � -2%31 E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 4U bun Elec. bus. lic. no: Zp - 951e Limited energy, residential 2
City /metro lic. no.: / Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (r . '') Date Service and/or feeder 2
Sup. elect. name (print): _,,, ! 1 bill/ ' L icense no: / • 7(o � s Services or feeders— installation,
alteration or relocation:
- - - PROPERTY OWNER • - - 200 amps or less I i30. � 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only i
Owner installation: The installation is being made on property I own Temporary services or feeders - - _
which is not intended for sale, lease, rent, or exchange according to h stallatioa ,alteration,orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER . Branch circuits - new, alteration,
--_�s - or extension per ravel:
Name: A. Fee for branch circuits with purchase of � �
Address: service or feeder fee, each branch circuit 3 (o. ),), I 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial • 0 Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps -rating of 1&2 O Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories 0 Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
•Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ 1D0 1, '
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ B • (')%
Expires accepted as complete. TOTAL $ /ha. 2.
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6I00/COM)
Electrical Permit Fees: Limited Energy Fees: r . `
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less I $80.30 2 Vacuum Systems
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 n Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2 -
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260)
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see "b" above.
Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel n Boiler Controls
a) The fee for branch circuits
with purchase of service or
feeder fee. Clock Systems
'0. Each branch circuit $6.65 2
b) The fee for branch circuits ❑ Data Telecommunication Installation
without purchase of service
or feeder fee. n Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 HVAC
Miscellaneous
(Service or feeder not included) ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53:40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
Minor Labels (10) $125.00 ❑ Landscape Irrigation Control
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 n
Per hour $62.50 Nurse Calls
In Plant $73.75 ❑
Outdoor Landscape Lighting
Fees:
❑ Protective Signaling
Enter total of above fees $
8% State Surcharge $
n Other
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $
front of application. * No licenses are required. Licenses are required for all other installations
•
Total Balance Due $ Fees:
Enter total of above fees $ _
❑ Trust Account #
8% State Surcharge $
Total Balance Due $
i:\dsts\forms\elc-fees.doc 10/09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hear In pection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested / Z - y AM PM BLD
Location /,S 3u 5 L 5 " 440 1 74h y Suite 1 ID MEC
Contact Person / Ph L3) Z" PLM
Contractor 49-e'Lk 4ir/ &/e__ Ph 9 - ,vey SWR
BUILDING Tenant/Owner 6v / 6 7� tJ /44-72-0 ELC 2e -- era 631/
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 TAM,
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
JE ECTRICAb
e e
— Rough In
UG /Slab
Low Voltage
Fire Alarm
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 Date ' a - - - Ins � _ _ xt
Other —
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.