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Permit
CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMEN SERVI PERMIIS*: ELC9B -03798 -4171 ,„, 13125 SW Hall Blvd., Tigard, PARCEL: 2S1O2BA -00302 SITE ADDRESS... :09898 SW TIGARD ST SUBDIVISION •NO.TIGARDVILLE ADDITION AMEND. ZONING:I —P BLOCK • LOT •022 JURISDICTION: TIG Project Description: Add five (5) branch circuits to existing commercial building. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 5O0SF...: 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: 4 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 POLYCAST, INC. type amount by date recpt 9898 SW. TIGARD STREET PRMT $ 55.00 GEO 07/10/98 98- 307245 TIGARD OR 97223 5PCT $ 2.75 GEO 07/10/98 98- 307245 Phone #: Contractor: FRAHLER ELECTRIC CO $ 57.75 TOTAL 11860 SW GREENBURG RD REQUIRED INSPECTIONS TIGARD OR 97223 Ceiling Cover Elect'1 Service Phone #: 639 -4627 Wall Cover Elect'1 Final Reg #..: 000374 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 188 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 lay obtain a copy of these rules or direct questions to OUNC by calling 503)246 -1987. Permittee 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 : CEN OZ y ,5- 6 ' / � DATE: /� LI 31- ` LICENSE NO: 3 ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ i CITY OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rec'd By TIGARD OR 97223 Date Rec'd Date to P.E. Phone (503) 639 -4171, x304 D ate to DST Print or Type Inspection (503) 639 -4175 Permit # EGCQ$ " "7 7 Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of business) POLYCAST , INC. Service included: Items Cost Sum I Address 9898 SW TIGARD STREET 4a. Residential - per unit TIGAR OR 97223 1000 sq. ft. or less $110.00 4 • City /State /Zip Each additional 500 sq. ft. or Commercial © Residential ❑ portion thereof $25.00 1 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) 4b. Services or Feeders Electrical Contractor FOWLER ELECTRIC COMPANY Installation, alteration, or relocation Address 11860 ' l' 1 1 ' ' 1 £ 1 200 amps or less - $60.00 2 City TI GARD State OR Zip 9 7223 201 amps to 400 amps $80.00 2 ty p 6 - 401 amps to 600 amps $120.00 2 Phone No. (503) 639 -4627 601 amps to 1000 amps - $180.00 2 Job No. 58426 Over 1000 amps or volts - $340.00 2 3 4 -13L 6/3U/ 9 Reconnect only $50.00 2 Elec. Cont. Lice. No. E xp.Date - OR State CCB Reg. No. 3 / 41 U Exp.Date 7 / / y 8 4c. Temporary Services or Feeders COT Business Tax or Metro No. 1987 Exp.Date 12 Installation, alteration, or relocation /f 200 amps or less $50.00 2 Si nature of Su r. Elec ;,7 L�f, e ./. 201 amps to 400 amps $75.00 2 g p �>rt 401 amps to 600 amps $100.00 2 . Over 600 amps to 1000 volts, License No. ' 2334S Exp.Date see °b" above. Phone No. (503) 639 -4627 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 circ $5.00 2 - b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit l $35.00 2 The installation is being made on property I own which is not Each additional branch circuit -i $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 $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: Not required for temporary construction services. 5a. Enter total of above fees $ 55 5% Surcharge (.05 X total fees) $ NOTICE • Subtotal $ 57. 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 # 5 _ 5 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 1 `f" /1616 Date Requested 1 — � 5 q 8 AM PM BLD Location 'Ira SW \QQ/1 t55 St Suite MEC c Contact Person L (J SO/71 6V-- Ph 63?- PLM Contractor ct4k /L� U Ph SWR BUILDING Tenant/Owner POr! -V ST !&) Cj ELC � ' �O 377 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab 0� �/� SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation /� n Drywall Nailing /Yf (2. 1- _ Firewall Fire Sprinkler Fire Alarm / - Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out �� l Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final ART FAIL ELECTRICAL 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 Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date 7 ° !. S • � Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.