Permit CITY TIGARD ELECTRICAL PERMIT
Alk‘ PERMIT #: ELC1999 -00336
_AVIV
DEVELOPMENT H B Tigard, ) 639 -4171 DATE ISSUED: 6/7/99
PARCEL: 2S113AB-00300
SITE ADDRESS: 16075 SW UPPER BOONES FERRYRD
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: • LOT : 036 JURISDICTION: TIG
Project Description: Electrical 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: 1 W /SERVICE OR FEEDER: 10 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
NORTHWEST LANDSCAPING INC WILLAMETTE ELECTRIC INC
16075 SW UPPER BOONES FERRY RD PO BOX 230547
TIGARD, OR 97224 TIGARD, OR 97281
Phone: Phone: 624 - 3631
Reg #: LIC 000750
SUP 1965S
ELE 34 -283C
FEES Required Inspections
Type By Date Amount Receipt Elect! Service
PRMT CTR 6/7/99 $117.75 99- 315924 Elect I Final
5PCT CTR 6/7/99 $5.89 99- 315924
Total $123.64 ORIGINAL
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 or direct questions to OUNC at (503) 246 -1987.
Permit Signature: nn Issued By: n e
(WV IA 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: (�Y . k -, DATE:
•
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
RECEIVED
CITY Of TIGARD lectrical Permit Application Plan Chec
19125 SW HALL BLVD. JUN 0 3 1 99U Recd By
TIGARD OR 97223 Date Recd /0-- � -
Phone (503) 639-4171, x3 COMMUNITY DEVELOPMENT Date to P.E.
( ) Date to DST
Inspection (503) 639 -4175 Print or Type Permit # �C 1 -- (163SLt
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development • L / Number of Inspections per permit allowed
Name (or name of business) Ak,... rAwesT ck crlr(ff /n,oiu / Service included: Items Cost Sum
I
Address / 16 IS S J (Or"- 1147 A/el ' ,Z .r,c y /(- 4a. Residential - per unit
1000 sq ft. or less $110.00 4
City /State/Zip rips Q n 0./v 91 Z Z y Each additional 500 sq. ft. or
Commercial g J Residential ❑ 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 Li _Z 5
Electrical Contractor 13 , /( rf. tit c gee 74#c /ti L Installation, alteration, or relocation
/� A 23!/ Sy 200 amps or less _L $60.00 2
Address PQ
C 201 amps to 400 amps $80.00 2
City 7 , S n n State _o.".. Zip 9 Z6 / 401 amps to 600 amps $120.00 2
Phone No. `i 2J/ - 36 3 ( 601 amps to 1000 amps $180.00 2
Job No. SS-3 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 1 'V - 2..$3 C Exp.Date /O - 7
OR State CCB Reg. No. -1s6 S Exp.Date fr 9 4c. Temporary Services or Feeders
COT Business Tax or Metro No. / S y 6 E p. Date 8-/ `Y 9 Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n p r 201 amps to 400 am $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No M c- 5 Exp.Date i6-/ - Q / see "b" above.
Phone No 67 ' i ' ?/ 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or 7-j,
Print Owner's Name feeder fee.
Address Each branch circuit /0 $5.00 2
City State Zip b) The fee for branch circuits
ty p 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 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 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: I
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ _S�� 5 '
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 # 4
Total balance Due $
nip '
I: \DSTS \ELC96 APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
241.Hour Inspection Line: 639 -4175 Business Line: 639 -4171
I_ QQ BUP
Date Requested (o - (O' C -/ AM PM BLD
Location cp01 S ft;iry iv) Suite MEC
Contact Person (,tl�I h (Q24 ' D?) ( PLM
Contractor Ph SWR '/ nMr�
BUILDING Tenant/Owner ELC � qg 9 —t3
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
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
Final
P RT FAIL
ECTRI
Service
Rough In
UG /Slab
Low Voltage
F' - • larm
PASS PART FAIL
SIT
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 D ! 2 — VY Inspector /� : xt
Other P -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.