Permit CITY OF A R D
TI ELECTRICAL PERMIT
G
PERMIT #: ELC98 -1012
^_.� DEVELOPMENT LOPMENT SERVICES 6C ES DATE ISSUED: 08/19/98
PARCEL: 2S102BA -00302
SITE ADDRESS...: 09898 SW TIGARD ST
SUBDIVISION •NO.TIGARDVILLE ADDITION AMEND. ZONING:I —P
BLOCK • LOT :022 JURISDICTION: TIG
Pro.j ect Description : Alteration to electrical service for commercial tenant.
- -- 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 • 1 W /SERVICE OR FEEDER: 3 PER INSPECTION • 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR : 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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
TUALATIN ELECTRIC type amount by date recpt
PO BOX 655REENBURG RD PRMT $ 75.00 DLH 08/18/98 98- 308349
WILSONVILLE OR 97070 5PCT $ 3.75 DLH 08/18/98 98- 308349
Phone #:
Contract or:
TUALATIN ELECTRIC $ 78.75 TOTAL
PO BOX 655
REQUI RED INSPECTIONS
WILSONVILLE OR 97070 Ceiling Cover Elect'1 Service
Phone #: 682 -2955 Wall Cover Elect'1 Final
Reg #..: 000656
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 -0010 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: / /LE6 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: t7 9 DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUP R. ELEC' N: 'Ai the/ e4-7 DATE: 0 V9de
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
a-
TY OF TIGARD Electrical • Permit App.1 #T Plan Check # _
13125 SW HALL BLVD. it��' Rec'd By 2) LH
TIGARD OR 97223 \n r7 1g 1 Date Rec'd if/P /S�'
l I / Date to P.E.
Phone (503) 639 -4171, x304 f ; ;. t
Print or Type � ,`:- Permit #
`t�ct Date to DST
LC9� /Q /�.
Inspection (503) 639 -4175 Incomplete or illegible wiltli be accepted
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) 1 � C O-1i - Service included: Items Cost Sum
O
Address I O S W - 1 - k q0.-Y d S ✓ 4a. Residential - per unit
City/State/Zip -t- CJ �7 3 1000 sq. ft. or less $110.00 4
ty p 1 . ) C� e 12. 3 Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial ❑ Residential
Li mited 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
Electrical Contractor T11P1 erfl El-e-c-1 -'1c Installation, alteration, or relocation 60 .e°
Address R e (QS3" 200 amps or less / $60.00 2
201 amps to 400 amps $80.00 2
City UJ. t .c,r 1lt' State D2 Zip q1010 401 amps to 600 amps $120.00 2
Phone No. (0$2 -7_°t 601 amps to 1000 amps $180.00 2
Job No. (04 ti; 0 Over 1000 amps or volts $340.00 2
./ Reconnect only $50.00 2
Elec. Cont. Lice. No. 3� (o g C _ Exp.Date ,.,��
OR State CCB Reg. No. 6, 5'6 5O Exp.Da , %41,7 " - "4c. Temporary Services or Feeders
COT Business Tax Or Metro No. / If - e Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps _ $75.00 Signature of Supr. Elec'n �� 401 amps to 600 amps $100.00 2
License No. I 3 S `= p.Date /n! // ? '� D see 'b above. 1000 volts
Phone No.
/ 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner instead ns: a) The fee for branch circuits with
purchase of service or •
Print Owner's Name feeder fee. (S CCe
Address Each branch circuit $ 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
imm 6.l..r.rfnrf ft-, r•ln In ',rn n• r■nf - __
(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 41. 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: 9 5-. 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
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 78 -] cj r
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /J 4/.12_ AM PM BLD
Location / �— c c7 Suite MEC
Contact Person >-
�� PLM -
ass
Contractor 77,{ > ��� �s Ph )(O ( SWR /
BUILDING Tenant/Owner AO--?aebd,147 � 0 7 ELC , ;
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain S eCtl
Slab 9Pnp OteS: 17 44 / SIT
Post & Beam �
Ext Sheath /Shear / �..CJ
- O 2 4?2ga
Int Sheath /Shear
Framing
Insulation
Drywall Nailing &Y/1/2e iG
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: �' -� � /� ' /_ _ .A ..
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
tj CTRI ?AR7 FAIL
CTRICAL
iee
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin . 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
Inspector Approach /Sidewalk D Z/2 It �'�"�
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job.site.