Permit CITY OF TI G A R D ELECTRICAL PERMIT
�, DEVELOPMENT SERVICES PERMIT #: ELC99 -0148
!+� �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03 / 18 / 99
PARCEL: 1S134BC -00600
SITE ADDRESS...:12390 SW SCHOLLS FERRY RD
SUBDIVISION •PP1993 -057 ZONING:C —G
BLOCK LOT :002 JURISDICTION: TIG
Project Description : Installation of signal circuit or limited energy.
- -- 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 • 1
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/0 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
SCHOLLS SOFT CLOTH CAR WASH type amount by date recpt
12390 SW SCHOLLS FERRY ROAD PRMT $ 40.00 GEO 03/18/99 99- 313798
TIGARD OR 97223 5PCT $ 2.00 GEO 03/18/99 99- 313798
Phone #:
Contractor:
CHRISTENSON ELECTRIC INC $ 42.00 TOTAL
111 SW COLUMBIA
STE 480 REQUIRED INSPECTIONS
PORTLAND OR 97201 Elect' 1 Service
Phone #: 241 -4812 Elect'1 Final
Reg #..: 000458
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 952401-0010 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: /fj 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: 3 -71
LICENSE NO: ��3
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY I OF TIGARD RECEIVED Electrical Permit Application Plan Check# 09/z----
fr 13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 MAR 18 1999' REFERENCE SIGN PERMIT Date Rec'd
SGN99 -0014 2 / 17 /99 Date to P.E.
Phone (503) 639 -4171, x3 MUNITY DEVELOPMENT Date to DST
Print or Type
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # CQY - - O /�f f5
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development SCHOLLS SOFT CLOTH CAR WASH Number of Inspections per permit allowed
Name (or name of business) SCHOLLS SOFT CLOTH CAR WAS 3 Service included: Items Cost Sum
Address 12390 SW SCHOLLS FERRY RD 4a. Residential - per unit
I
TIGARD OR 1000 sq. ft. or less $110.00 4
City /State /Zip Each additional 500 sq. ft. or
Commercial Ii31 Residential ❑ WIRE SIGN portion thereof 1
Limited Energy $25.00
QUE ST IONS ? CONTACT STEVE @ 701 -8673 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 CHRISTENSON ELECTRIC, INC. Installation, alteration, or relocation
Address 111 SW COLUMBIA, SUITE 480 200 am or less $60.00 2
201 amps to 400 amps $80.00 2 -
City PORTLAND State OR Zip 97201 -58R6 401 amps to 600 amps $120.00 2
Phone No.503 241 -4812 601 amps to 1000 amps $180.00 2
Job No. 60 -02588 Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 26 -34C Exp.Date 10/99
Reconnect only $50.00 2
OR State CCB Reg. No. 00458 Exp.Date 5/99 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 5246 Exp.Date 12/99 Installation, alteration, or relocation
_ 200 amps or less $50.00 2 • Signature of Supr. El l + '� 201 amps to 400 amps $75.00 2
� � �' - 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 873S Exp.Date 10 /01 see "b" above.
Phone No. 503 241 -4812 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 Owners 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 $35.00 2
The installation is being made on property I own which is not Each additional branch circui
$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 fi 0 _ 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 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 descnbed 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 $ 40.
5% Surcharge (.05 X total fees) $ - 2 _
NOTICE Subtotal $ /12 .
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 $ 42.
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $ 42.00
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 1�, ! AM PM BLD
st
Location � 2310 7&w r ce Suite MEC
Contact Person Ph PLM
Contractor C
SlDt�t' �Ph SWR [�
BUILDING Tenant/Owner 'I '`' ELC / _
Retaining Wall ELR
Footing
Foundation p FPS
Ftg Drain NOT REQUESTED
Crawl Drain II FOUND DURING RESEARCH SGN
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
\1(
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PLUMBING PART FAIL EXPIRED ` Lrshon/ 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
EL
Service
Rough In
UG /Slab
Low Voltage
F1rE (alarm
P ASS PART FAIL
SITE
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 O /J - Z Inspector ector / / � Ext
Other p
Final OOO
PASS PART FAIL DO NOT REMOVE this inspection record from the ob site.