Permit CITY OF TIGARD ELECTRICAL PERMIT
�`
���, DEVELOPMENT SERVICES PERMIT #: ELC98 0c J
6
DATE ISSUED: 12/01/98
6 1— 13125 SW Hall Blvd., PARCEL: 2S112DD -00800
SITE ADDRESS...:15670 SW UPPER BODNES FERRY RD
SUBDIVISION ZONING:C —G
BLOCK LOT • JURISDICTION: TIG
Project Description : Add electrical to an existing service station /convenience
store.
- -- 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..: 4
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: 51 PER INSPECTION : 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 0 PER HOUR ° 0
401 — 600 amp ° 1 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
CHEVRON USA PRODUCTS CO type amount by date recpt
6001 BOLLINGER CYN RD BLDG L -1114 PRMT $ 535.00 GEO 12/01/98 98- 311188
SAN RAMON CA 94583 SPCT $ 26.75 GEO 12/01/98 98- 311188
PLCK $ 133.75 GEO 12/01/98 98- 311188
Phone #:
Contractor:
NORTHWEST PUMP & EQUIPMENT $ 695.50 TOTAL
2800 NW 31ST
REQUIRED INSPECTIONS
PORTLAND OR 97210 Ceiling Cover Elect'l Service
Phone #: 227 -7867 Wall Cover Elect'l Final
Reg #..: 000645
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 - 'x+' through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by call' g f )246 -1987.
'
Permittee Signature:\ ssued By:/4
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: /.1
ti
LICENSE NO : � 5S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
11111 •
09/02/1998 14:38 5034926882 KAPPERTZ DESIGN PAGE 01
08/31/1990 22:10 5035891291 KAPPERTZSALEMOFFICE PAGE 02
CITY OF TIGARD Electrical Permit Application Pion Check A%q
13126 SW HALL BLVD. Reo'd By 6 r
Date Recd q - r 2 9
TIGARD OR 97223 !'
� � . Date to P.E. 7 g /y
Phone (503) 834171, x304 Date to DST
Inspection (503) 638 -4176 Print or Type Permit M ,�e �-os
RC
Fax (503) 894 -7297 Incomplete or Illegible will not be eecep ed Caned L412,21 2/rc4'E'/ v -i-1q/
1. Job Address: 4. Complete Fee Schedule Below: 9�is- -
Name of Development, ( ` ` .lC L Gal►v.-41v. Number of Inopeodons per permit allowed
Name (or name of business) Service included: Items Cost Bum
Address 1 5 60 O 5 ,tom, 0P (', 00 g-5 Fie ru./ 2 1) 4e. Resldendal - per unit
t000 sq. ft or teas 5110.00 4
City/Statemp TI G o. Q) . f--12 9 - 7o 3 t Eeon edditton■l 600 sq. It or
Commercial Residential ❑ gorier thereat $2B 00 1
Limited Energy $26.00
Each Maned Home or Modular
Dwelling SeMa or Feeder $68.00 2
2a. Contractor Installation only:
(ABDCh copy of all ou at rrsnt licenses) alb. Semi ,
Qee s or or Feeds,. r relocation
Electrical Contractor a - I - 'T o F> t 4 200 amps or less $80.00 2
Address 201 amps to 400 amps 100.00 2
City. State ZIP 401 amps to 000 amps = 2120.00 f Z..¢ ere 2
Phone No. 801 amps to 1000 amps $100.00 - 2
Over 1000 amps or volts 6340.00 2
Job No. Reconnect only _ $50.00 2
Elec. Cont. Un. No. Exp.Date
OR State CCB Reg. No. , Exp.Date 4o. Temporary Services or Feeders
COT Business Tax or Metro No. , Exp.Date Installation, alteration, or relocation
200 amps or loss $50.00 2
-
Signature of Supr. Elwin 201 amp to 400 amps - 5100,00 2
401 amps to 600 amps $100,00 2
Over 600 amps to 1000 volts,
Uanae No Exp.Date we "le above.
Phone No. - 4d. Branch Circuits
Now, 'Norodom or emansion per panel
2b. For owner Installations: a) The fee for branch circuits with
purchase of sernrae or
Print Owner's Name / 1 A radar a..
/ Each branch circuit 6 f $ 00 u '5 2
Address b) The lee for human circuits
•
Ciy, State Zip without purchase of
Phone No. service or reader fee.
First branch circuit $35.00 2
The Installation Is being made on property I own which is not Each additional branch circuit 55.00 2
Intended for silo, lease or rent. ore. Mlaceganeous
Signature Each p feeder i ati Included) circle cle
g Each pump or Irrigation circle f40,00
Each alga or outline lighting M 240.00 L mo
14
• - 2 2
o
3. Plan Review section (If required):' Signal earwigs) or a limited energy
panel, alteration or extension $40.00 2
Minor libels (10) $ 100 . 00
Please check appropriate Item end enter fee In section 6B.
a or more residential units In one structure 41. Each additional Inepeadon over
T- Service end feeder 225 amps or more the allowable In any of the above $35.00
Sgyysatem over 600 volts nominal Per Inspection 555.00
Classified area a structure containing special occupancy Per hour $66.00
as described In N.E,C. Chapter S In Punt
a Submit 2 sets of plans with application where any of the above apply. 5. Fees: 6 3 S . J )
Not required for asmtporary construction service*. tie. Enter total of above tees 6
5% Surcharge (.OS X total fees) 6 7.4 •7 S
NOTICE Subtotal S 64 l . 75
6b. Enter 26% of line its for 13 3. 7 S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reaulred (6e0.3 ) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY p Trust Reactant S
TIME AFTER WORK IS COMMENCED, S L 5.
GAS � y � Total balance Due
C'an�CT P6 - 2 on/ �s o ,
-So3-5P9- /a�' /. .
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3/3-- AM PM BLD
Location ii Suite MEC
Contact Person 4 `e ` ►J ^ Ph -- 2 - 2 , x2 -- 2 - 2 , x2 7 86 - Z PLM
Contractor Ph SWR
BUILDING Tenant/Owner (VA( �. -�I�/1 ELC 790.1
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 ae
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
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
410 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 Date 5 Z. - 5� � Inspector Ext
Other
Final `
PASS PART FAIL DO NOT REMOVE this inspection record from the job site: