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Permit / CITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00572 I A DEVELOPMENT SERVICES DATE ISSUED: 09/23/1999 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135BD-00300 SITE ADDRESS: 09735 SW SHADY LN 101 SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Add seven (7) branch circuits for a TI. 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: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 6 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: HAZEL INTERNATIONAL, INC AND COMMERCIAL ELECTRIC CORP. HIGASHIYAMA HIGHLANDS CO, LTD 10928 NE KILLINGSWORTH BY NORRIS + STEVENS REALTORS PORTLAND, OR 97220 -1097 PORTLAND, OR 97204 Phone: Phone: 255 -9822 Reg #: LIC 00006145 SUP 1745S ELE 26 -33C FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT GEO 09/23/199€ $69.60 99- 318552 Wall Cover ORIGINAL 5PCT GEO 09/23/1999 $4.87 99- 318552 Underground Cover Elect'l Final Total $74.47 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 ordirect questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE ISSUED BY: 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: 9".# LICENSE NO: 1 7 c -5 Call 639 -4175 by 7:00pm for an inspection the next business day 08/23%99 MON 11:27 FAX 503 598 1960 CITY OF TIG.ARD 0002 CITY OF TIGARD Ical Permit Application Plan Check # • , � RECE -r.. : SW HALL BLVD Recd By • TIGARD OR 97223 Date Recd Phone (503)'839 -4171, x304 SEP 2 2 1999 Date to P.E. • Date to DST - -. - Inspection (503) 639 -4175 COMMUNITY DEVELUr +���:;; Print of Type Permit It Pct /c Do s 7R fax ;503) 598 - 1960 Incomplete or illegible will not be accepted Called 9. 'Job Address: 4. Complete Fee Schedule Below: Name of Development - Number of Inspections •er •erm)tallowed Name (or name of business) -D Sr X1 I L-4 CL-t n1 (,C. Service Included: Items Cost Sum Address R s u..) 5M-fkb4 (..Aki36 ii /O, 4a. Residential • per Lnit City /State /Zip 1 CC-t'/ka-r, OR- 1000 sq. ft. or less 5 117.75 4 L Each additional 500 sq. ft. or Commercial El Li Residential portion thereof 5 26.75 1 R��I>E� Limited Energy $ 60.00 Each Manufd Home or Modular 2a.. Contractor installation only: Dwelling Service or Feeder $ 72.76 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders Information for COT datta�base). Installation, alteration, 3' relocation . Electrical Contractor ( ',DVILry1 th ti n r2 fl .c.Cj-h t... . 200 amps or less 5 6425 2 Address 109 2- g tor IC.t1 a a n 1 pal 1.r )t r+c- 201 amps to 400 amps $ 85.50 2 City P{2r' -1 a vd State fi Z U Zip q •7 2Z L, 401 amps to 800 amps S '128.50 2 .601 amps to 1000 amps S 192,50 2 Phone No. SD?,- 22 - 7 SS -9 R over 1000 amps or volts S 363.75 2 • Job No. 3 8 I s • _ . Reconnect only S 53.50 2 Elec. Cont. Lice. No. 21e- 33 C Exp.Date 11)-1 -19 4c. Temporary Servtcos or Feeders OR State CCB Reg. No. ( I u-5 Exp.Date .1 -I2_- Installation, alteration, '3' relocation COT Business Tax or Metro No. 2 (2-'. -I Exp.Date 1 1- '60 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature cf Supr. Elec'n Vtk ` © 401 amps to 800 amps $ 107.00 2 Over 600 amps to 1000 wits, License No. I/ 1- I - 5'S . Exp.Date 10/61/0 600 "b" above. Phone No. St Sc -9 R-2_7- Nev:, alteration or - Na, alteration or extension per panel a) The. fce for branch circuits 2h. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 2 Address b) The fee for branch circuits • without purchase of service City _ State Zip or feeder faa Phone No. First branch' circuit 1 $ 37.50 3� . Each additional branch circuit (e $ 5.36 3 The installation is being made on property I'own which is not 4e. Mi Intended for sale, lease or rent. (Service or feeder not Included) • ' • Each pump or Irrigation, :Irde $ 42.75 • Owner's Signature Each sign or outline ligh :ing ' I $ 42.75 , Signal circuit(s) or a Uml:ed z-nergy (if required):* For alteration or es tension • $ 60.00 3. Plan Review section (' Minor Labels (10) $..107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional Inspection over 4 or more residential units in one structure the allowable In any of the above • Service and feeder 225 amps or more Per inspection $ 60.00 Per hour ' $ 50.00 I System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as ' described in N.E.C. Chapter 6 5. Fees: . �� Se. Enter total cf above fses 5 '� * Submit 2 sets of plans with application where any of the above apply. 7% Surcharge (.05 X lotal fees) ' S Not required for temporary construction services. Subtotal S bb, Enter 25% of line 6a for • NOTICE Plan Review It requtrei (Sec.•3) S • PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 7411-- IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account* X1-7 AT ANYTIME AFTER WORK IS COMMENCED. Total balance Due $ �4 is \dststlmms'electrlc. doc • 1/25/00 Activities for Case #: ELC1999 -00572 3:17:04 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated • Notes ELCC001 Application received 9/22/99 GEO MAIL No Hold GEO 9/23/99 ELCC003 Permit created 9/23/99 GEO DONE No Hold GEO 9/23/99 ELCC700 Ceiling Cover 9/23/99 9/23/99 No Hold GEO 9/23/99 ELCC720 Wall Cover 9/23/99 9/23/99 10/4/99 CD FAIL No Hold AKJ 10/5/99 post signed permit ELCC725 Underground Cover 9/23/99 9/23/99 No Hold GEO 9/23/99 ELCC799 Elect'l Final 9/23/99 9/23/99 10/21/99 BP PASS No Hold JS 10/21/99 ELCC500 (F)Issue permit 9/23/99 GEO DONE No Hold GEO 9/23/99 ELCC720 Wall Cover 10/5/99 10/5/99 10/5/99 CD PASS No Hold AKJ 10/5/99 front office one receptacle outlet in treatment room ELCA799 Elect'I Final 10/22/99 10/22/99 10/22/99 CD PASS No Hold JS 10/22/99 ELCA800 Case finaled 11/9/99 JMT DONE No Hold JMT 11/9/99 Page 1 of 1 • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested rota - f ( q9 AM PM BLD Location q 1 3 S &J Suite v ( MEC Contact Person Ph a.5--? PLM Contractor /L - - - r�/h-CO Ph $ 4 5 — a.)' SWR BUILDING Tenant/Owner �, - r %.�L. �.. /� �... � ELC / qg9 -6 S'7� 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 777 Final / PASS T FAIL LECTRICA Service Rough In UG /Slab Low Voltage Fice Iarm ADA 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 /1 2 / - FP Other Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.