Permit CITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00213
11 DEVELOPMENT SERVICES DATE ISSUED: 4/12/99
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00300
SITE ADDRESS: 15230 SW SEQUOIA PKWY 100
SUBDIVISION: ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Add three (3) sign or outline lighting.
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: 3
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: 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: v /0 � « v �
PACTRUST C
15350 SW SEQUIOA PKWY G G(5" AJE-- ,q v q
TIGARD, OR 97223 09y(tO %
Phone: Phone: 3G _ � 9 3 `{ 7
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'l Se
Elect'I Service
PRMT GEO 4/1/99 $120.00 99- 314161
5PCT GEO 4/1/99 $6.00 99- 314161
Total $126.00
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.
Permit Signature: � / Issued By:
OWNER INSTALLATION ONL
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
070 SIGNATURE OF SUPR. ELEC'N: J 4 f- - DATE: 99
LICENSE NO: aG i4- v
Call! 639 -4175 by 7:00pm for an inspection the next business day
e h w
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By 6
TIGARD OR 97223 Date Rec'd y
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # 6Gr /'f -6UR13
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
e g T Name of Development G i KU a, / Number of Inspections per permit allowed
Name (or name of business) .17'7179/2 '(--- Service included: Items Cost Sum
Address 1 6 - 4 . 3 0 .5 c E U DI . 4 - Ytr1 Ci 4a. Residential - per unit
/ 1000 sq. ft. or less $110.00 4
City /State /Zip 126,/:/(2d-- 0 . 172- .3 Each additional 500 sq. ft. or
Commercial la Residential ❑ 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) L 4b. Services or Feeders
Electrical Contractor tith 1029- . t) a ile.. b e Ge7 L.[9 Installation, alteration, or relocation
Address 3p /E /.t.J q 20 amps to or less - $60.00 2
, IS c
201 amps to 400 amps $80.00 2
City 1109 ✓P State Zip 1 401 amps to 600 amps $120.00 2
Phone No. .34.o - P43 - '97 7_ g 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts - $340.00 2
Reconnect only - $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. (3 7 f Exp.Date (- 'f ' 0 4c. Temporary Services or Feeders
COT Business Tax or Metro No. a 7A2 g Exp.Date / Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
� Over 600 amps to 1000 volts,
License No. ` > j 3►co Exp.Date see "b" above.
Phone No. n - 3- 9?' ' 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 cir $5.00 2
-
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 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 3 $40.00 f AO. O d 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. S. Fees: Aga 0 0
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
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 ❑ Trust Account # {( / �`
TIME AFTER WORK IS COMMENCED.
Total balance Due
S
I:\DSTS \ELC96.APP Rev 9/96
6/6/99 Activities for Case #: ELC1999 -00213
9:26:24 PM
• Assigned Hold Updated
• Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
• ELCC001 Application received 4/12/99 GEO No Hold GEO 4/12/99
ELCC003 Permit created 4/12/99 GEO No Hold GEO 4/12/99
ELCC799 Elect'I Final 4/12/99 4/12/99 5/6/99 CD PASS No Hold AKJ 5/6/99 Pending lobby sign installation
ELCC730 Elect'I Service 4/12/99 4/12/99 No Hold GEO 4/12/99
ELCC500 (F)Issue permit 4/12/99 GEO DONE No Hold GEO 4/12/99
ELCC799 Elect'l Final 5/10/99 5/10/99 5/10/99 PASS No Hold AKJ 5/10/99
ELCC800 Case Finaled • 5/10/99 AKJ DONE No Hold AKJ 5/10/99
•
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested S 6 -91 AM FPM BLD
Location / G2() 5e9 (/l/r) ! off- Suite CaD MEC
Contact Person , Ph 2ttsi -plat/ PLM
Contractor Ph SWR C���n
BUILDING Tenant/Owner PAM-Dr) S ELC ! -�n�
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notesp.1 6 7 1 Tio 1
SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing ..
Insulation
J o e Drywall Nailing .0'
Firewall
Fire Sprinkler
Fire Alarm ( — :--
Roof Susp'd Ceiling
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
PAU, PART FAIL
(€LE RIW
Service
Rough In
UG /Slab
Low Voltage
Fi - • larm
PART FAIL
SI
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 / (" 9 7 Inspector
D xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
`_ Q y BUP
c Date Requested 5- & -j Z AM PM BLD
Location I S7i3 iA4106L... Suite /(50 MEC
Contact Person 4./32, Ph pR' -I PLM
Contractor Ph SWR
BUILDING Owner iikernZik ELC
Retaining Wall ELR 19961-COOR
Footing Access:
Foundation ( d e'"- FPS
Ftg Drain �/ V� X SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation ,�
Drywall Nailing L�. / 9 q - d O O �(� — /`'�n/AL(-W
Firewall
Fire Sprinkler
Fire Alarm _ p
Susp'd Ceiling C C ! g ! 0l y ` N/4 E0
Roof
Misc:
Final ( L 99 &(3 &ova /A), 4e4
PASS PART FAIL
PLUMBING S/A.J / A S /7 / /.47' /o,✓ - ✓
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 RT FAIL
LECTRI
Se
Rough In
UG /Slab
Low Voltage
Fir- Alarm
410
PASS PART FAIL
SITE
BackfilUGrading
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
D S' G - 99 Inspector Other a-- Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.