Permit • CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00688
*wtviajlln DEVELOPMENT SERVICES DATE ISSUED: 11/15/1999
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 113AB -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: 3 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:
AKERMAN, RICH/WATHEY, JAMES E 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'I Service
PRMT BON 11/15/199E $80.30 99- 319784 Elect'l Final
5PCT BON 11/15/199c $6.43 99- 319784 OR I G I NA L
Total $86.73
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.
/ t /
PERMITTEE'S SIGNATURE l I (`,J v 14 ,(/ BY: L t
i
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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: f j0 k� Y\ DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY Qf TIGARD RECEIVED Plan Check
Electrical Permit Application
11' 2'6 SW HALL BLVD. Recd By
TIGARD OR 97223 NOV 151999 Date Recd 1
503 639 -4171, x 304 Date to D
Phone
( ) COMMUNITY DEVELOPMENT Date to DST
Inspection (503) 639 -4175 Print of Type Permit # ,U I 119 ' 4
.
Fax (503) 598 -1960 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) A /otirkwac r- Ccv.vers «, e /.,e .:r ,i,. Service included: Items Cost Sum
Address / 6 O * S S l ex . 4 ,,,, r to( 4a. Residential - per unit
City /State /Zip 7 Dil q,22 Lt 1000 sq ft. or less $ 117.75 4
f� Each additional 500 sq ft or
Commercial IGU Residential El Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72 75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor Cu , j ( r} p, r lie ,r, c /rt. L 200 amps or less / $ 64.25 t 4 2 S 2
Address 4D /ge x 7 ? 0 y fi 201 amps to 400 amps $ 85 50 2
401 amps to 600 amps $ 128.50 2
City 7'. >1 2 /}(
e State ,� Zip g i-S8 ( 601 amps to 1000 amps $ 192.50 2
Phone No. !o Z y - 5'6 ?/ Over 1000 amps or volts $ 363.75 2
Job No. L 944 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. ?4 - ZS ? C-- Exp.Date /U - / - CO 4c. Temporary Services or Feeders
OR State CCB Reg. No. 2 co s 1 Exp.Date R- 1, -0! Installation, alteration, or relocation
COT Business Tax or Metro No. /S 6 Exp.Date 8 -/ -Oo 200 amps or less $ 53 50 2
201 amps to 400 amps $ 80 25 2
Signature of Supr. Elec'n AL-s---7,--; 401 amps to 600 amps $ 100.00 2
Over 600 amps to 1000 volts,
see "b" above.
License No. / 4 ' )- - S Exp.Date /0 / - 0 /
4d. Branch Circuits
Phone No. /, ZLI - ?6 g I New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee. o '5
Print Owner's Name Each branch circuit 3 $ 5.35 / 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5 35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42 75
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50 00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59 00
Classified area or structure containing special occupancy as
described in N.E C. Chapter 5 5. Fees: 3 G
5a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ ,
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ Ff C.
i. \dsts \forms \electric doc
CITY OF TIGARD BUILDING INSPECTION_ DIVISION . •
MST
24 -Hour Inspection Line: 639 -4175, • Business Line: -639 -4171
BUP
Date Requested / ?f1 (l AM PM BLD
Location I (00 7S J (ipp r / �S Suite MEC
Contact Person U/ • Ph (04Y 3(4 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ),) U) L(' -e' SCey3L ELC - a (fir
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 / -
Susp'd Ceiling / q
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 11 / Rough In
Gas Line
Smoke Dampers
Final
PA _ FAIL
EL r
Service c�
Rough In
UG /Slab
Low Voltage
Fir- larm
j i
10 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 / Inspector , Q
Other Date l s p / ,4 • Ext
`
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.